_At times the lower molar teeth are much tilted in such a way that the crown surface stands towards the tongue._--Under such conditions their removal is best carried out with instruments of the pattern shown in fig. 30, since the handles of forceps of the hawk’s-bill pattern when applied would come in contact with the upper teeth, and thus impede the inward movement which is so necessary for the removal of teeth in this position. =The Temporary Teeth.=--For the removal of upper incisors and canines, a small pair of straight forceps of the pattern shown in fig. 34 should be used. The first upper temporary molars are best removed with a pair of forceps like fig. 35. The lower incisors and canines require a small pair of hawk’s-bill forceps similar to the shape shown in fig. 27. For the lower temporary molars, a small pair of forceps similar to that illustrated in fig. 29 should be used. [Illustration: FIG. 34.] [Illustration: FIG. 35.] In removing the temporary teeth, care must be taken not to drive the forceps up too high, for fear of injuring the permanent teeth; this is more especially to be noted in connection with the temporary molars, as the roots of these teeth practically embrace the crowns of the bicuspids. Generally speaking, if a temporary molar fractures in the attempt to remove it, the portion of tooth remaining in the jaw should be left alone unless it can be brought away quite easily. [Illustration: FIG. 36.] Roots in the condition shown in fig. 36 are best removed with an elevator as follows: the thumb of the right hand being placed on an adjacent tooth so as to gain a hold, the point of the elevator should be placed below the end of the root and force applied. In a few cases it may be necessary to cut the gum with a lancet before using the elevator. Small pieces of the temporary teeth which persist and become wedged in between the permanent teeth can be best removed with an excavator or a similar suitable instrument. CHAPTER III. The Extraction of Misplaced Teeth. Nothing, perhaps, tests the skill of a good operator more than the extraction of a misplaced or impacted tooth, and although it is impossible to give anything like a complete list of the various malpositions met with, those most commonly seen will be mentioned, and the usual method for removing such teeth indicated. [Illustration: FIG. 37.] (_a_) =Upper Central Incisors.=--An irregularity of this tooth calling for removal is shown in fig. 37.