Steel tooth key dating from around 1820, England. Tooth extraction is the earliest known dental procedure, it was used as a last-resort cure for toothache. From around 1750 the tooth key, whilst still brutal, overtook the less-effective pelican tooth extractor as the instrument of choice for tooth-drawing. The claw would be placed over the crown of the tooth and the device would be twisted to dislocate the tooth (often following prior loosening by an elevator tool). This tooth key is lever operated and has a reversible claw.