The first permanent molar is vital for dental health but often faces severe decay. This lecture, “Saving or Extracting First Permanent Molars: Best Practices and Guidelines,” explores the decision-making process for managing these teeth. Topics include criteria for saving or extracting, clinical guidelines, and evidence-based practices. Attendees will learn about extraction indications, orthodontic impacts, and advanced preservation techniques. By the end, dental professionals will be equipped to make informed decisions, enhancing patient care and outcomes.