2 EXTRACTION OF TEETH. 



to assure a prompt recovery, by the removal of the effects 

 of the disease of the tooth. 



The removal of molars may therefore involve extraction 

 with forceps, trephining the dental alveolus and repulsion 

 of the tooth and trephining of the sinuses because of em- 

 pyema or other pathologic conditions referable to the dental 

 affection ; consequently all of these should be studied as re- 

 lated topics. 



Instruments. Extracting forceps, fulcra of various 

 sizes, mouth speculum with abundant lateral working room, 

 exporteur forceps, toothpick, splinter forceps, reflecting lamp. 



Technic. In simple cases with a quiet animal the pa- 

 tient may be sufficiently confined by -being backed into a 

 corner or very much better by securing in stocks. In com- 

 plicated cases or very resistant animals it is best to place 

 upon the operating table or in default of this, cast and secure 

 in lateral decubitis on the sound side. 



Apply the speculum and identify the diseased tooth by 

 manual exploration ; determine if the tooth is of unnatural 

 size or form, if it is loose, if the gums are separated from the 

 neck at any point, if it is out of line with the other teeth in 

 the row, if it is painful to the touch, if it be split, etc. An 

 external tooth fistula or a tumefaction over the affected 

 member may aid in distinguishing it. Aid may also be had 

 by illuminating the mouth with a reflecting electric or other 

 lamp. 



Remove any accumulations of partially masticated food 

 by means of the toothpick or with the fingers. 



In applying the forceps, have an assistant draw the 

 tongue out at the commissure of the lips on the side oppo- 

 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, push the opened 

 forceps backward upon the dental row until they reach it, 

 then firmly grasp the diseased tooth with the instrument, 



