English Pattern Extraction Forceps — Upper and Lower Dental Guide

English pattern dental extraction forceps are the most widely used forceps design for tooth extraction across Asia, the Middle East, Africa, and the UK. They differ from American pattern forceps in handle ergonomics and handle-to-beak angle — and those differences are not cosmetic. They affect grip mechanics, fulcrum placement, and the direction of applied force during extraction movements.

English vs American Pattern Forceps — The Structural Difference

The core difference is the angle between the handle and the beak (working end):

• English pattern — the handles are held in a palm grip, parallel to the floor, with the beak angled downward at approximately 90 degrees from the handle. This creates a leverage advantage for the buccal-lingual rocking movements used in English extraction technique.
• American pattern (cowhorn, upper root tip) — handles are designed for a pencil grip or modified palm grip; the beak is in line with the handle axis rather than angled away. Common in North American dental schools and practices.

English pattern forceps are the default in most Commonwealth countries and are the standard taught in dental schools across Pakistan, India, Bangladesh, Saudi Arabia, UAE, and East Africa.

Upper (Maxillary) English Pattern Forceps

• No. 1 Upper Universal Forceps — straight beak, suitable for upper incisors and canines; the most-ordered single forceps in most dental instrument sets
• No. 7 Upper Premolar Forceps — angled beak for upper premolars; S-shaped handle allows access without cheek obstruction
• No. 17 Upper Molar Forceps (Right) — anatomical upper right molar forceps with specific beak geometry for the bifurcation of upper right molar roots
• No. 18 Upper Molar Forceps (Left) — mirror image of No. 17 for upper left molars
• No. 76 Upper Wisdom Tooth Forceps — bayonet-style handle design for access to the upper third molar without premature palate contact

Lower (Mandibular) English Pattern Forceps

• No. 74 Lower Universal Forceps — the single most versatile lower forceps; used for lower incisors, canines, premolars, and as a general-purpose lower extraction instrument when a more specific forceps is not available
• No. 75 Lower Molar Forceps — broader beak with two points on each side to engage both buccal roots and the bifurcation of lower molars; the most critical lower molar forceps
• No. 79 Lower Wisdom Tooth Forceps — extended handle for third molar access; angular handle design clears the opposite arch during third molar extraction
• No. 44 Lower Incisor Forceps — narrow beak for the fine alveolar bone necks of lower incisors and for root fragment removal

Beak Grip Quality — What Determines Extraction Success

The serration pattern on the beak inner surface determines how securely the beak grips the tooth at the cementoenamel junction. Coarse serrations grip better on well-erupted teeth but can crack enamel if grip is not placed correctly. Fine serrations are more forgiving. Fizza Surgical extraction forceps use a fine-to-medium serration pattern with consistent serration depth across the beak width — avoiding the pattern of shallow serrations at the beak edges that is common in lower-cost forceps and causes lateral slippage during the extraction movement.

Forceps Number to Tooth Reference (2026 Update)

Ordering by number alone causes more mis-picks than any other step in dental instrument procurement, because the same number can be catalogued as “upper universal” in one list and “upper anterior” in another. The table below fixes each English pattern number against the tooth it is cut for, the beak profile, and the working length so a purchase order can be checked line by line.

Note that No. 17 and No. 18 are anatomically handed. A clinic that orders “two upper molar forceps” and receives two of the same side has effectively bought one usable instrument. Specify right and left explicitly on the order line.

Three Errors That Break Beaks and Crack Roots

Seating on enamel rather than root. The beak is designed to sit on cementum below the cementoenamel junction, driven apically under the gingival margin before any force is applied. Gripping the crown converts an extraction into a crown fracture, and the case becomes a surgical retrieval. The beak curvature exists to follow the root surface, which is why an anatomical forceps seats deeper than a universal one on the same tooth.

Applying rotation to a multi-rooted tooth. Rotation works on conical single roots — upper incisors and canines. On a lower molar with divergent roots, rotational force shears the roots at the furcation. Lower molars come out with buccal-lingual expansion and figure-of-eight movement, not rotation.

Skipping the elevator. Forceps are not a first instrument. Luxating the periodontal ligament first expands the socket and lets the beaks seat further apically, which reduces the force needed and the incidence of root fracture. Instrument selection for that stage is covered in our comparison of the dental luxator and elevator and in the guide to root elevator patterns.

Where the patient is a child, do not substitute adult forceps scaled down by eye — the beak width and the root anatomy of deciduous teeth differ enough to warrant a dedicated set, as set out in our guide to pediatric extraction forceps.

Inspecting a Delivery of Extraction Forceps

Four checks take under a minute per instrument and catch nearly everything worth rejecting:

• Beak alignment. Close the handles fully and sight along the beaks. The tips should meet in the same plane. Offset tips mean the joint was pinned out of true and the forceps will slip laterally every time.
• Serration depth at the beak edges. Run a fingernail from the centre of the beak toward each edge. The serration should be continuous. Shallow or absent serrations at the margins are the commonest defect in low-cost forceps and the direct cause of lateral slip.
• Joint play. Hold one handle and try to rock the other laterally. Perceptible side-to-side play at the joint will become significant looseness within a year of autoclaving.
• Spring return. The handles should separate under their own tension when released. A weak return means the instrument will need two hands to reposition mid-extraction.

Certification and Supply

All English pattern extraction forceps are manufactured from 316L stainless steel under ISO 13485:2016 with CE marking. Available individually, in upper/lower pairs, or as complete extraction forceps sets for dental clinics and oral surgery departments. Contact Fizza Surgical for pricing, volume quotes, or to request a catalog.