American pattern vs English pattern extraction forceps

Dental extraction forceps are hand instruments that grip a tooth at the neck and use a beak-and-handle lever to loosen it from the alveolar bone and remove it. Each forceps is built for one job: a specific tooth, in a specific arch, with a beak shaped to match that tooth's root anatomy. The number stamped on the handle (150, 151, 23, 88R) tells you where it belongs, and the pattern of the hinge (American or English) tells you how it was made. This guide covers both, gives you a full number-to-tooth chart, and settles the questions people get wrong most often, like whether the 151 is an upper or a lower forceps.

If you already know what you need, you can jump straight to the extraction forceps collection and match by number.

What is a dental extraction forceps?

A dental extraction forceps is a two-part lever instrument with beaks that seat on the tooth and handles that transmit squeezing and rocking force. It has three working parts: the beak, which grips the root surface below the crown; the joint or hinge, which sets the leverage; and the handle, which the operator holds. The beak is the part that changes from one forceps to the next, because it is contoured to a particular tooth. Upper forceps tend to run in a straight line from handle to beak. Lower forceps bend the beak close to a right angle so force can be aimed downward onto a mandibular tooth.

That single idea, beak matched to tooth, is the reason there are dozens of numbered forceps instead of one universal tool.

American pattern vs English pattern extraction forceps

The difference between American pattern and English pattern forceps is the hinge. American pattern forceps use a box joint that is polished smooth, so no screw or pin is visible from the outside. English pattern forceps use a lap joint held by a visible screw or pin, which sits the fulcrum closer to the beak and gives more leverage per squeeze. Everything else, the beaks, the numbers, the steel, can be the same. It is the joint that names the pattern.

Here is the clean comparison, since this is where a lot of online guides contradict each other:

Neither pattern is "better." An American 150 and an English figure-numbered equivalent remove the same tooth; they just feel different in the hand and reach the fulcrum differently. Most instruments sold in the US, including the ones in the standard extraction forceps range, are American pattern unless the listing says English pattern. If you trained in the UK and the smooth-hinge American forceps feels unfamiliar, that box joint is the reason.

Quick way to tell them apart in the tray: look at the hinge. See a screw head? English. See a smooth, seamless joint? American.

How dental forceps numbers work

Dental forceps numbers are a shared style code, not a size in millimeters. The same number means the same intended tooth across most manufacturers, so a 150 from one maker and a 150 from another are both upper universal forceps. Letters added to a number narrow it further: R and L mark right and left (88R, 88L), S usually marks a serrated beak, and A often marks an anterior or "Cryer" variant. Learn the core numbers and the letters, and you can read almost any tray without a legend.

The numbering is not sequential by tooth, which is why a chart beats memory. That chart is the next section.

Dental extraction forceps chart: numbers and uses

The chart below maps the common forceps numbers to the arch and the teeth they are made for. This is the reference most people are actually searching for when they look up "dental forceps numbers and uses" or an "extraction forceps chart."

A note on the upper-molar numbers: the R and L refer to the patient's side. An 88R seats on the patient's right upper molars. If your tray is labeled by manufacturer rather than by side, confirm against the beak shape before you seat it.

You can see these instruments photographed and grouped by tooth in the extraction forceps collection, which doubles as a visual "names and pictures" reference next to this chart.

Is the 151 forceps upper or lower?

The 151 is a lower forceps. It is the mandibular universal, made for lower incisors, canines, premolars, and roots on both the left and right sides. Its partner, the 150, is the upper universal for the same tooth types in the maxilla. The easy way to keep them straight: 150 is up, 151 is down; the higher number sits lower in the mouth.

This one gets miswritten online more than any other forceps, with some study sites listing the 151 as a maxillary instrument. It is not. Manufacturer specifications for the 151 describe a lower universal beak that adapts to mandibular incisors, canines, premolars, and roots, usable left or right. If you only stock one lower anterior-to-premolar forceps, the 151 is it. You'll find it, and the 150, listed together in the extraction forceps collection.

Which forceps for which tooth: a fast walk-through?

Upper anteriors and premolars. Reach for the 150. It handles incisors through premolars and remaining roots in the maxilla.

Upper molars. Use the paired 53R/53L or 88R/88L, matched to the side. Their beaks are shaped for the three roots of an upper molar.

Upper wisdoms. The 210 bayonet design reaches back and works on either side.

Lower anteriors and premolars. The 151 is the universal choice; the 103 is a straight-beak alternative.

Lower molars. The 15, 17, 16, and 23 all serve here. The 23 is the cow horn, and it deserves its own note below.

Lower wisdoms. The 222 bayonet reaches mandibular third molars on both sides.

Root tips and fragments. The 300 and similar fine serrated root tip forceps grip what a standard beak can't.

The 23 cow horn is a special case, because used on the wrong tooth it does damage rather than nothing. Its two sharp beaks are driven into the bifurcation of a two-rooted lower molar and squeezed, levering against the bone between the roots. On a fused-root or single-rooted tooth there is no furcation to engage, and the beaks can split the crown. We wrote a full breakdown of when to use it in what cow horn forceps are and when to use them, and you can see the instrument itself as the universal cow horn forceps 23.

Extraction forceps PDF: names, pictures, and chart to download

The chart above is available as a printable PDF you can keep in the sterilization area or hand to a dental student. It pairs each forceps number with its arch, its target teeth, and the American-versus-English note, so the whole cluster (names, numbers, pictures reference, and pattern) sits on a page or two. Download it, print it, and tape it inside a cabinet door. For the actual instruments beside the pictures, the extraction forceps collection shows each numbered pattern photographed and priced.

If you're building a first kit, the shortest useful set is a 150, a 151, a 23 cow horn, and a pair of upper molar forceps, which together cover most routine extractions across both arches.

Frequently asked questions

Is the 150 upper or lower? 

The 150 is upper. It is the maxillary universal forceps for incisors, canines, premolars, and roots. Its lower counterpart is the 151.

What is the difference between American and English pattern forceps? 

The hinge. American pattern forceps have a smooth box joint with no visible screw. English pattern forceps have a visible screw at a lap joint, which brings the fulcrum closer to the beak for more leverage.

What forceps is used for lower molars? 

The 15, 17, 16, and 23 are the common lower molar forceps. The 23 cow horn is used specifically on lower first and second molars with a confirmed root bifurcation.

What does the R or L mean on a forceps?

 It marks the side. An 88R is for the patient's right upper molars; an 88L is for the left. Universal forceps like the 150 and 151 have no R or L because they work on both sides.

Are dental forceps numbers the same across brands? 

Mostly, yes. The number is a shared style code, so a 150 is an upper universal from almost any maker. Beak finish and steel quality differ, but the intended tooth does not.

What are the three parts of an extraction forceps? 

The beak, which grips the tooth; the joint or hinge, which sets the leverage; and the handle, which the operator holds.