EXTRACTION OF TEETH. 3 



site to the affected member and introducing one hand into 

 the mouth, place the index finger on the posterior border 

 of the diseased tooth and with the other hand, push the 

 opened forceps backward upon the dental row until they 

 reach the diseased member, then firmly grasp it with the 

 instrument, pressing the jaws down as deeply as possible 

 against the alveolus. 



In many cases the diseased tooth can be clearly seen, 

 especially with the aid of the reflecting lamp, and the 

 forceps may be readily applied by sight, which is frequently 

 preferable to the sense of touch. 



Withdraw the free hand from the mouth, grasp the 

 forceps handles firmly and loosen the tooth in its alveolus 

 by establishing and maintaining as long as necessary a gentle 

 to and fro lateral movement. The tooth is thus loosened in 

 its alveolus by causing it to revolve very slightly back and 

 forth on its long axis, thereby spreading the alveolar cavity. 

 When the tooth has become well loosened, the fact is indi- 

 cated by its revolving with the forceps and by an audible 

 crepitant sound caused by the passage of air bubbles to and 

 fro through the blood and lymph in the alveolus. Maintain 

 the forceps in position with one hand and with the other 

 introduce the fulcrum to a point where the depression on its 

 superior surface will receive the projecting rivet-head of the 

 instrument or in an otherwise secure position affording a 

 safe support, while the inferior surface rests evenly upon 

 the crown of a tooth anterior to that which it is desired to 

 extract, as is shown in Plate I. The fulcrum needs be held 

 firmly in place in order to prevent it from gliding away 

 under pressure. 



In extracting the first premolars there is no opportunity 

 for resting the fulcrum on teeth anterior thereto and con- 

 sequently forceps have been made with fulcra beyond the 

 forceps jaws resting upon teeth more posteriorly situated. 

 This is not essential. If the tooth is thoroughly loosened. 



