Alexander Monroe first mentioned tooth keys in 1742 in his “Medical Essays and Observations.” Early forms were made of iron with a straight shaft and with handles that were quite similar to turn keys for door locks and hence the name “toothkey.” At the distal end was a bolster together with a hinged claw;  the bolster was placed against the root of the tooth and the claw engaged. The handle was turned with a rapid motion to dislocate and extract the tooth. For 150 years it was the standard tool for every practitioner.