Tooth retention—keeping natural teeth healthy and functional throughout life—is a strong indicator of good oral and overall health, positively impacting quality of life. It supports proper eating, speaking, and social interaction. While dental implants are often touted as a panacea to address dental diseases through extraction and prosthetic replacement, they are also susceptible to peri-implant disease, which is prevalent, serious, and destructive. Premature extraction, particularly in cases where advanced procedures, such as periodontal regeneration, can help maintain teeth can set patients on a path of peri-implant disease and continued inflammatory burden and tissue destruction. These impacts may be even more critical for individuals with more severe initial disease, including those with Stage III and Stage IV periodontitis. Periodontists should be at the cutting edge to promote what is possible when it comes to saving teeth and the positive impact of maintaining a natural dentition on overall health. Comprehensive patient assessment, control of local and systemic etiologic factors, and identification of sites amenable to periodontal regeneration can enable us to rebuild tissues destroyed by periodontitis and offer increased longevity to the natural dentition. Predictable regenerative outcomes require carefully choreographed therapeutic approaches involving all members of the dental team and ultimately benefits our patients’ oral and overall health. Utilizing interdisciplinary care and advanced surgical techniques to repair and regenerate lost periodontal support around teeth can increase tooth retention and improve systemic outcomes for patients diagnosed with periodontal diseases.