The selection of appropriate forceps is critical to the success of dental extractions. Proper instrument choice enhances procedural efficiency and patient outcomes, while improper selection may lead to complications.

This guide reviews the principal types of dental forceps utilized in contemporary practice, the numbering systems for identification, the anatomical features defining each pattern, and the criteria for selecting appropriate forceps based on tooth, patient, and procedural requirements. It serves as a practical reference for both dental students assembling their initial instrument kits and clinicians assessing which patterns are essential for routine use.

What are dental extraction forceps?

Dental extraction forceps are designed to grip and remove teeth. Each forceps pattern is tailored to a specific tooth type or clinical scenario: the beak conforms to the tooth’s shape, the handle transmits force, and the hinge influences grip and articulation.

A comprehensive forceps set comprises a series of specialized instruments, each designed to address distinct anatomical challenges. Selecting the appropriate pattern is a critical component of the extraction procedure. Before examining specific forceps patterns, it is important to understand the four structural components that characterize all dental forceps:four parts that define every forceps.

The beak grips the tooth. Their shapes, curves, and points distinguish each pair of forceps. Molar beaks are wide and concave; anterior beaks are narrow and pointed; root beaks taper to reach below the gum line.

The hinge (also called the joint or pivot) connects the two halves and determines how the beaks articulate. American-pattern forceps have a horizontal hinge; English-pattern forceps have a vertical hinge with a different ergonomic profile.

The shanks are the metal bridges between the hinge and the beaks. Shank angulation defines whether a forceps is upper or lower and whether it has a straight or bayonet design. The shank angle determines whether the forceps can reach posteriorly without obstruction from the lower lip or opposing dentition.

Handles transfer force to the beaks. Serrations and contouring help grip and provide tactile feedback.

High-quality surgical steel forceps exhibit precision in all components. In contrast, lower-quality forceps may appear similar but are prone to failure at the hinge or beak.

The dental forceps numbering system explained

Dental forceps follow a numbering convention developed in the late 19th century and still used worldwide. The number identifies the pattern - the combination of beak shape, shank angle, and intended tooth—not the size. A #150 forceps from a German manufacturer and a #150 from a Pakistani manufacturer should have the same geometry; the difference is in the steel and the precision of manufacturing.

Although the numbering system is not inherently logical, the corresponding tool patterns are practical. Familiarity with the numbers associated with each tooth is essential for effective use. Key references include:

Upper (Maxillary) Forceps

• #1 — Upper anterior incisors and canines

• #99C / #99A — Upper anterior incisors (alternative pattern)

• #150 — Universal upper, anterior to premolar

• #150A — Modified #150 with finer beaks

• #210S — Upper third molars and impacted molars

• #18L / #18R — Upper left and right molars (cowhorn-style beaks)

• #53L / #53R — Upper left and right first/second molars

• #88L / #88R — Upper left and right molars (alternative pattern)

• #65 — Upper root forceps (bayonet)

• #286 — Upper root tip forceps (fine bayonet)

Lower (Mandibular) Forceps

• #151 — Universal lower, anterior to premolar

• #151A — Modified #151 with finer beaks

• #16 — Lower molars (cowhorn-pattern)

• #17 — Lower first and second molars

• #23 — Lower molars (cowhorn-pattern, alternative)

• #222 — Lower third molars

• #74 — Lower root forceps

Pediatric (Deciduous) Forceps

• #150S — Small upper, universal for deciduous teeth

• #151S — Small lower, Proficiency in forceps numbering serves as a professional shorthand. The primary consideration is to understand the clinical purpose associated with each forceps number to facilitate effective decision-making. The purpose behind each forceps number is to make effective clinical decisions.

Upper (maxillary) deUpper forceps are specifically designed for the maxillary arch, where the bone is typically thinner and more cancellous, and visualization is improved. However, access may be restricted by the upper lip and a shallow vestibule. These forceps are tailored to address maxillary anatomical challenges, thereby maximizing control and minimizing complications.d minimize complications.

Upper anterior forceps (incisors and canines)

Forceps #1 is the workhorse pattern for upper incisors and canines. The beaks are narrow, straight, and meet point-to-point to grip the conical roots of anterior teeth without crushing the relatively thin crowns. Handles are straight, allowing direct in-line force delivery.

Forceps #99C offers an alternative pattern with slightly curved shanks - useful when access to the anterior segment is restricted by lip position or limited mouth opening.

The clinical principle for anterior teeth is that narrow beaks, which meet precisely below the cementoenamel junction, provide controlled grip while minimizing the risk of crown fracture. Forceps #150, often referred to as the ‘universal upper,’ is among the most frequently utilized forceps in clinical practice. It is suitable for upper incisors through premolars, featuring beaks that are slightly wider than those of the #1 to accommodate broader premolar root anatomy. A comprehensive instrument tray typically includes both the #150 and #1 to address the entire anterior region and the posterior region with two instruments.

For premolars specifically, the #150 grips the buccal and palatal surfaces of the cervical root, allowing buccal-palatal rotation that’s the foundation of premolar extraction technique.

Upper molar forceps

Upper molars are anatomically distinct because of their three-root configuration: two buccal roots and one palatal root. This is why upper molar forceps come in pairs, left and right.

Forceps #18L and #18R are cowhorn-pattern molar forceps. The beaks have a pointed projection on the buccal side that fits into the bifurcation between the mesiobuccal and distobuccal roots, providing exceptional grip and mechanical advantage. The palatal beak is smooth and concave to fit the single palatal root.

Forceps #53L and #53R are non-cowhorn alternatives with smooth beaks shaped to grip first and second molar crowns broadly. Some clinicians prefer these for molars with extensive crown decay, where a cowhorn pattern might crush the crown.

Forceps #88L and #88R offer a third alternative with longer, more pointed beaks — useful for molars with high cervical breakdown where the operator needs to grip deeper toward the furcation.

Upper third molar forceps

Forceps #210S is purpose-built for upper third molars (wisdom teeth) and impacted molars. The shank angulation is extreme to reach posteriorly past the maxillary tuberosity, and the beaks are designed to grip teeth in awkward positions. For impacted thirds, the #210S is often the only upper forceps that can establish purchase before surgical elevation is required.

Upper root and root tip forceps

Forceps #65 is a bayonet-design root forceps with offset beaks that allow the operator to reach below the alveolar crest without the handles obstructing visualization. The bayonet shank - where the working ends are offset laterally from the handle axis - is a critical feature for retrieving fractured roots.

Forceps #286 is the fine-tipped, bayonet version, with narrower beaks for retrieving small root fragments and apical tips. Pair it with the #65 in any tray that handles extraction complications. Lower forceps are designed to address challenges distinct from those encountered in the maxillary arch. The mandibular bone is denser and more cortical, access is more restricted by the cheek and tongue, and the operator’s hand positioning differs. It is essential to select forceps that correspond to the anatomical features of the lower jaw to ensure effective and efficient extractions.

Lower anterior and premolar forceps

Forceps #151 is the lower universal - analogous to the #150 but with shank geometry suited to the mandibular arch. It serves lower incisors, canines, and premolars. The beaks meet to grip narrow roots, and the handle angle directs force apically rather than horizontally.

Forceps #151A is the fine-beak variant for narrow lower anteriors and small premolars.

Lower molar forceps

Lower molars are two-rooted (mesial and distal roots) rather than three-rooted, which significantly changes the forceps geometry.

Forceps #16 represents the classic lower cowhorn pattern. Both beaks possess pointed projections that fit into the bifurcation between the mesial and distal roots. When properly positioned and compressed, these projections wedge into the furcation, elevating and securing the tooth. This mechanical advantage renders the #16 particularly valuable for extracting solid molars without significant crown decay.

Forceps #17 is a non-cowhorn lower molar forceps with smooth, concave beaks. Preferred when the molar has extensive caries or restoration that would fracture under the focal stress of a cowhorn point.

Forceps #23 — also called the “cowhorn” colloquially - is similar to the #16 with subtle geometric differences. Some textbooks list #23 as the primary cowhorn pattern; others use #16. The names vary by region; the technique does not.

Lower third molar forceps

Forceps #222 is the dedicated lower third molar pattern, with shank angulation that reaches behind the second molar without obstruction from the retromolar pad or the tongue.

Lower root forceps

Forceps #74 handles lower root fragments and apical tips. Similar in principle to the upper #65 but with mandibular shank geometry.

Pediatric (deciduous) dental forceps

Pediatric dental extraction differs significantly from adult extraction. Deciduous teeth are smaller, often exhibit partially resorbed roots, and are surrounded by less dense bone. The use of adult forceps on deciduous teeth often results in crown fractures and incomplete extractions.

Forceps #150S is the small upper universal for deciduous incisors, canines, and molars. It has the geometry of a #150 scaled to deciduous dimensions.

Forceps #151S is the small lower equivalent - universal for lower deciduous teeth.

Forceps #1A and #1AS are pediatric anterior patterns with narrow beaks for deciduous incisors specifically.

A pediatric-focused dental practice typically maintains a complete set of #150S and #151S forceps, along with dedicated anterior patterns. General practices that occasionally treat pediatric patients should, at a minimum, include the #150S and #151S as universal pediatric forceps.

How to choose the right dental forceps: the five-question framework

Once a comprehensive forceps set is available, the primary consideration shifts from identifying existing forceps types to determining which instruments are currently accessible. The following five questions guide the selection process:

1. Upper or lower? This determines the shank angle. Maxillary forceps point upward-forward; mandibular forceps point downward-forward. Using a lower forceps on an upper tooth is mechanically possible, but it is ergonomically incorrect.

2. Anterior, premolar, or molar? This determines beak width. Anterior beaks are narrow and pointed; premolar beaks are intermediate; molar beaks are wide and may have cowhorn projections.

3. Which side? For molars only - upper and lower molars require paired left/right patterns because of the asymmetric root anatomy.

4. Is the crown intact? Yes → cowhorn molar patterns (#16, #18, #23) work well for solid teeth. No → use non-cowhorn smooth-beak alternatives (#17, #53) that distribute force more broadly across compromised crowns.

5. Is this a root or a whole tooth? Whole tooth → standard forceps. Root only or fractured root → bayonet root forceps (#65, #74, #286). Bayonet geometry is mandatory for Clinicians who internalize this framework are able to select the appropriate forceps for any extraction efficiently. In contrast, those who do not may rely on a limited set of instruments, potentially increasing procedure time and risk of complications. Everything pays for the choice in chair time.

What separates premium forceps from cheap ones

Two forceps stamped “#150” can perform very differently in the hand. The differences live in places you can’t see at first glance:

Steel grade. Premium forceps are forged from surgical-grade stainless steel - typically German DIN 1.4034 or American 420-series alloys. Cheap forceps may be cast (not forged) from lower-grade steel that fatigues at the hinge and loses beak sharpness within months. Material is the single biggest determinant of forceps lifespan.

Hinge precision. A premium forceps hinge articulates smoothly, holds calibrated tension, and survives thousands of autoclave cycles without seizing. A cheap hinge stiffens, develops play, and eventually fails.

Beak geometry and finish. Premium beaks are precision-finished to match anatomical cervical curvature. Cheap beaks are approximate - they grip the tooth, but slip more readily, crush more often, and require more replacement applications during the extraction.

Handle ergonomics. Premium forceps balance in the hand. The weight distribution lets the operator feel the tooth’s resistance through the handles. Cheap forceps feel dead in the hand; the operator gets less tactile feedback and works harder to feel the tooth’s response.

Certification and traceability. Premium manufacturers are ISO 13485 certified, produce MDR-certified dental instruments for the EU market and FDA-approved dental instruments. Although there is a notable price difference, the disparity in service life and clinical reliability is equally significant. Premium German dental forceps from manufacturers with documented quality controls can last five to ten years with daily use, whereas lower-quality forceps may require replacement within a year. Cheap forceps may need to be replaced within the year.

Buying dental forceps: what to look for

Most clinicians buy forceps from a small handful of sources: the local dental supply rep, a distributor, an online retailer, or  increasingly, direct from the manufacturer. Each has trade-offs.

When buying dental forceps online, the variables that matter:

• Specified steel grade. If the listing doesn’t state the alloy (420, 440C, DIN 1.4034), the manufacturer isn’t proud of what they used.

• Country of manufacture. German and U.S. forceps generally meet higher regulatory standards. Pakistani and Chinese forceps span a wide range of quality; some are excellent, many are not.

• Regulatory certification. ISO 13485, MDR, FDA. These aren’t marketing logos; they’re verifiable credentials.

• Manufacturer transparency. Can you contact the manufacturer? Will they provide mill test reports? Do they back the instrument under a warranty?

• Return and replacement policy. Premium manufacturers stand behind their forceps. A no-return policy on $200 worth of dental instruments purchased directly from the manufacturer eliminates the unverified reseller intermediary between the steel mill and the dental practice. Manufacturers can provide direct information on material composition, production processes, and quality systems that third-party resellers may not be able to offer. A seller usually cannot.

Building a forceps tray: the essentials

In a general dental practice, a complete forceps tray covers anterior, premolar, molar, root, and pediatric extractions in both the upper and lower arches. A working starter set includes:

• #1 — Upper anterior

• #150 — Upper universal (anterior to premolar)

• #18L and #18R — Upper molars (paired)

• #210S — Upper third molars

• #65 — Upper roots (bayonet)

• #151 — Lower universal

• #16 or #23 — Lower molars (cowhorn)

• #17 — Lower molars (non-cowhorn alternative)

• #222 — Lower third molars

• #74 — Lower roots

• #150S and #151S — Pediatric universals

• #286 — Fine root tip retrieval

This set of twelve forceps addresses nearly all routine extraction scenarios. Specialty practices, such as oral surgery or pediatric dentistry, may expand the set with additional pediatric anterior patterns, atraumatic extraction forceps (such as Physics Forceps or Luxator), and other specialized surgical instruments.

Frequently Asked Questions

What are the different types of dental forceps?

Dental forceps are categorized by arch (upper/maxillary vs. lower/mandibular), tooth type (anterior, premolar, molar, root), tooth side (left or right for molars), and patient (adult vs. pediatric). The major patterns include #1 and #150 for upper anteriors and premolars, #18L/#18R for upper molars, #210S for upper third molars, #65 for upper roots, #151 for lower anteriors and premolars, #16/#23 for lower molars, #222 for lower third molars, and #150S/#151S for pediatric extractions.

What is the difference between upper and lower dental forceps?

Upper (maxillary) and lower (mandibular) forceps differ primarily in shank angulation. Upper forceps angle the beaks upward to align with the maxillary teeth; lower forceps angle the beaks downward to align with the mandibular teeth. The beak geometry also differs to match the root anatomy; upper molars are three-rooted, while lower molars are two-rooted, which is reflected in the beak design.

What are cowhorn forceps used for?

Cowhorn dental forceps (#16, #18L/R, #23) have pointed projections on the beaks that fit into the bifurcation between molar roots. When the handles are squeezed, the points wedge into the furcation, elevating the tooth while gripping it. They’re ideal for solid molars with intact crowns. They should be avoided on molars with extensive caries or restorations, where the focal force can fracture the crown.

What is a #150 forceps used for?

The #150 is the “universal upper” forceps, used for upper incisors, canines, and premolars. It’s one of the most widely used patterns in general dentistry. The #150A is a finer-beak variant for narrow anterior teeth. The #150S is the pediatric version for deciduous upper teeth.

What is a #151 forceps used for?

The #151 is the “universal lower” forceps, the mandibular equivalent of the #150. It serves lower incisors, canines, and premolars. The #151A is the fine-beak variant; the #151S is the pediatric version for deciduous lower teeth.

What are bayonet forceps?

Bayonet forceps have shanks that offset the beaks laterally from the handle axis, allowing the operator to reach below the alveolar crest without the handles obstructing visualization. They’re used primarily for root and root tip retrieval, where the operator needs to grip below the gum line. The #65 (upper roots) and #286 (upper root tips) are the most common bayonet patterns.

How do I choose the right dental forceps for an extraction?

Use the five-question framework: (1) Upper or lower? determines shank angle, (2) Anterior, premolar, or molar?  determines beak width, (3) Which side?  for molars only, paired left/right, (4) Is the crown intact?  determines cowhorn vs. non-cowhorn, (5) Whole tooth or root?  determines standard vs. bayonet pattern. Apply the questions in order, and the right forceps becomes obvious.

Are pediatric dental forceps different from adult forceps?

Yes. Pediatric (deciduous) forceps, such as the #150S and #151S, are smaller versions of the adult patterns, designed for the smaller crowns and partially resorbed roots of deciduous teeth. Using adult forceps on a deciduous tooth typically crushes the crown without removing the tooth. Any practice that treats children should, at a minimum, carry the #150S and #151S as the universal pediatric pair.

What steel are quality dental forceps made from?

Premium dental forceps are forged from surgical-grade stainless steel, most commonly 420-series martensitic alloys (American designation) or DIN 1.4034 (European designation). The steel is heat-treated and hardened to retain edge geometry through repeated autoclave cycles. Cheap forceps may be cast from lower-grade steel that fatigues at the hinge and loses precision within months of use.

How long do dental forceps last?

Premium dental forceps from a quality manufacturer can last 5 to 10 years of daily clinical use and withstand thousands of autoclave cycles. The lifespan depends on the steel grade, manufacturing precision, sterilization protocol, and care during use (avoiding contact with hard surfaces, properly lubricating the hinge, and using distilled water in the autoclave).e). Cheap forceps may need replacement within a year as the hinge develops play or the beaks lose geometry.

Where can I buy quality dental forceps?

Buy from manufacturers with documented ISO 13485 certification, MDR or FDA registration, and transparency about the steel grade and country of manufacture. Buying dental instruments directly from a manufacturer eliminates the unverified reseller layer and provides traceability back to the steel mill. Avoid suppliers who can’t or won’t specify the steel grade in their forceps; that’s the single biggest red flag in the category.