Celsus (VII. xii) says extraction may result in injury to the temples and eyes, and fracture or dislocation of the jaw may occur. He recommends therefore to free the tooth all round down to the socket, then to shake it repeatedly till it has been thoroughly loosened, and remove it with fingers or forceps. If the tooth be hollow, it should be plugged with lint or lead to prevent it breaking under the forceps. The tooth should be pulled out straight, lest the alveolus be broken. Stumps are to be removed with the forceps which the Greeks call ῥιζάγρα. Paulus Aegineta (VI. xxvii) bids us scarify down to the socket and loosen the tooth gradually by shaking with a tooth extractor (ὀδοντάγρα) and extract it. Supernumerary teeth are, if fast, to be rasped down with a graving tool; if loose, to be extracted with tooth forceps (διὰ τῆς ὀδοντάγρας). There is no ancient forceps which can with certainty be set down as a tooth forceps, although some have looked upon the Pompeian forceps (see [p. 135]) as a tooth extractor. Although its shape is not otherwise unsuitable for this purpose its jaws are not particularly well adapted for seizing a tooth, as they are not hollowed inside. It may be noted that the tooth forceps was evidently a ‘universal’, as no special variety is ever mentioned beyond the two I have given—‘tooth’ and ‘stump’. Whatever the shape of the Graeco-Roman forceps was it seems to have been a handy instrument for many different manipulations. Soranus (ii. 63) says that in impaction of the foetal cranium we may open the head and remove the bones with a bone forceps or a tooth forceps (ὀστάγρας ἢ ὀδοντάγρας). Paul (VI. xc) says that in fracture of the skull the fragment is to be surrounded with perforations by the drill and finally separated with chisels, the chips being removed with the fingers or with tooth forceps, bone forceps, &c. (ὀδοντάγρα ἢ ὀστάγρα). Again in ch. lxxxviii he says that if the shaft of a weapon imbedded in the flesh be broken off, the weapon may be extracted with a tooth forceps or a stump forceps (ὀδοντάγρας ἢ ῥιζάγρας).
Tooth Elevator.
In a note on a passage in Hippocrates describing the lever for replacing the protruding end of a fractured bone, Galen mentions an instrument for levering teeth. He says the instruments for levering the bone are of the same size as the instrument for levering teeth (xviii. 593). As we know from Paul (VI. cvi) that these bone levers were seven or eight finger breadths in length, we may take this as the length of the tooth elevator.
Tooth Scalers.
Greek, ξυστήριον, σμιλίον, σμιλιώτον (sc. ὄργανον); Latin, scalper medicinalis.
Paul (VI. xxviii) mentions a small raspatory used for removing tartar from teeth:
‘The scaly concretions which adhere to teeth we may remove with the scoop of a specillum, or with a scaler (ξυστηρίῳ) or a file.’
Scribonius Largus (Comp. liii) mentions an excavator:
Itaque cum etiam exesus est aliqua ex parte, tum non suadeo protinus tollendum, sed excidendum scalpro medicinali, qua cavatus est, quod sine ullo fit dolore, reliqua enim solida pars eius et speciem et usum dentis praestabit.
Marcellus conveys this passage entire (De Med. xii).