![]() The cusp of the teeth could also slide into the hole of the pads (Figs. Furthermore, the pads could adjust to each surface of the teeth or endentouls alveolus. The additionally pads pivotally mounted keep close contact to the patient’s alveolus or teeth during opening and passive manipulation (Fig. Because of its basic construction, the Denhart mouth gag allowed this technical changes in a sufficient way. The Denhart–Hoefert mouth gag was developed in order to optimize the qualities as well as to bypass the disadvantages of the Denhart mouth gag and to improve benefits with its modification in the practice. This modification will be presented here.ĭenhart–Hoefert mouth gag with a removable tongue plate mounted to the gag The use of this mouth gag in practice showed less frequency of sliding and dislocating, especially during manipulation. Therefore, I would like to introduce a new mouth gag on the basis of a Denhart mouth gag, which was modified to have a better fixation in the mouth. In those times, he already remarked besides the large number of different gags on the market, that a single perfect gag was missing, which supplies all needs. Interestingly, in early 1907, Colt already mentioned, that there were enough reasons for bringing forward the subject of a mouth gag designed to suit the needs of the general practitioner, surgeon, dental surgeon and anaesthetist. Especially disadvantages of single-sided mouth gags are sliding as well as the dislocation within use. Besides the fact that some of the different models also fixate the tongue, other models showed a more or less tendency to slip, slide away and finally to dislocate. ![]() It was obvious from the early beginning, that a reliable mouth gag was needed to keep the mouth open continuously. Since the medical use of mouth gags, a wide variety of different mouth gags, with or without tongue depressors or plates, one- or double-sided, were invented and distributed. Sometimes this was necessary because of fear, but more frequently due to illness such as tetanus, epilepsy, stroke, hysteria, coma etc. In later times, mouth gags were used in medical situation to open the patients mouth for examination, insertion of instruments, administration of feeding or dental care. Additionally, liquids could be instilled causing asphyxia. In torture, especially mouth gags were used to keep the suspects mouth open, leading to dysphagia and jaw pain, inability to speak and swallowing saliva. In the beginning of 1220 AD, torture was reintroduced though recommended in Roman law and considered as a legitimately lawful procedure. ![]() Besides the fact, that the Christian inquisition is linked with barbarous torture, it was not used principally in every cases. In german medieval times mouth gags or props were called “Kiefer- or Mundsperre” and were instruments used in torture practice. Besides the description of these modifications a short historic overview of the mouth gag discussion is presented. The use of the Denhart–Hoefert mouth gag in practice showed a less frequency of sliding and dislocation, especially during manipulation. These pivotal pads give a stable and better fixation to the teeth, to the edentulous jaws and enable also to fixate other instruments like tongue plates. The new Denhart–Hoefert mouth gag has pivotal pads, which allow to compensate movements in surgery without dislocation. A modification of the well known one-sided Denhart mouth gag is presented. The need for introducing a suitable mouth gag is emphasized since then. ![]() These problems were already discussed at the beginning of the ninteenth century. Till now, slipping, sliding and dislocation in the mouth are problems observed during use, especially of one-sided mouth gags. Since the beginning of the use of mouth gags in medicine, a wide variety of different models has been invented and described. Mouth gags are surgical devices placed between the upper and the lower jaw to prevent the mouth from closing during operative procedures of the mouth or throat. ![]()
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