Many times I hear patients say ” but doc I have no pain , the tooth is okay” Unfortunately, pain could be the last symptom to a tooth problem, not the first. This tooth was on its way to creating a potentially serious infection. The patient had no pain at the time but it was apparent that the tooth was not salvageable. Upon extraction the sac of infection could be seen by the root tip. If left untreated, this could cause additional bone loss and a fistula which is an infection through the bone. The gradual loss of the bone surrounding the tooth is the most detrimental and irreversible condition which could limit a patients ability to replace the extracted tooth with a dental implant.