Tooth extraction is not recommended for painful tooth decay because it is not an indication for tooth extraction, and the pain caused by tooth decay can be completely treated to save our teeth. Each tooth that erupts normally to serve as a chewing unit is a very important chewing unit, and the loss of any one tooth is an irreparable loss to us. In the principle of the overall treatment of the oral cavity, teeth should be preserved as much as possible, and only when it is necessary to remove teeth, it will be considered to remove teeth, and toothache caused by tooth decay is far from reaching the stage where it is necessary to remove teeth. In general, most cases of toothache caused by tooth decay are reversible pulpitis or endodontitis. In this case, we can decay and fill the decayed part of the decayed tooth or treat the decayed pulp of the decayed tooth by direct root canal treatment, and finally apply crown restoration to protect the crown of the decayed tooth, so that the tooth can continue to serve the chewing function for a long time without extracting it.