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In the context of a primary tooth that has caused a severe throbbing toothache, extraction is often the most appropriate treatment option. A throbbing pain suggests that there may be significant pulpitis or infection in the tooth, indicating that the tooth may no longer be viable. Primary teeth have a limited lifespan and, when they are compromised by severe decay or infection, extraction can prevent the spread of infection and alleviate pain.

While options like filling or root canal treatment may be considered for teeth with less severe issues, they may not be effective for a tooth that has already exhibited signs of significant pulpal involvement. Filling would not address the underlying infection, and root canal treatment, although a viable option in some cases, may not be suitable given the potential complications and the fact that it is often not performed in primary teeth due to their temporary nature. Observation would not provide any immediate relief to the pain the child is experiencing and could lead to further complications.

In this scenario, extracting the affected tooth is the recommended course of action to ensure the child's comfort and health, as well as to allow for proper future dental development.