To keep or extract severe periodontitis damaged teeth is one of the controversial topics in the dentistry from ancient times to present. From different perspectives, professions, technologies, time, and economics, there may be different choices with unidentified consensus. Based on the author’s own understanding, experience, literature review, and other aspects, this article proposes some exchange views on influencing factors, abandoning consideration, preserving possibility, and how to detect and prevent the development of lesions. The aim is to stimulate more thinking and accumulate clinical evidence-based data among peers, in order to facilitate cooperation and promote oral health.
