In the early days of the United States of America, dentistry was very basic. Tooth decay was generally treated with one method: tooth extraction. The tool of choice to do the job, from the mid 1700s to the 20th century, was the dental key. The device was modeled after a door key, with a claw that could be tightened over a tooth. Then the tool was rotated, often with the result being a broken tooth, or even a broken jaw, and soft tissue damage.
In the decades it was used, it was modified and improved, but basically remained the same. Regular tooth care was not generally practiced in the US. In fact, it wasn't until 1885 that an American company even made a toothbrush. The majority of Americans did not brush until after WWII when soldiers brought back the European habit. It was in the early 20th century when the dental key was finally replaced with forceps, much to the relief of many.
-Professor Walter
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