Sir, Giovanni of Arcoli (1412-1484), often better known by his Latin name Johannes Arculanus, was one of the most eminent Italian surgeons of the fifteenth century. He taught at Bologna in the period 1412-1427, and then in Padua and Ferrara where he died.1 His masterpiece Practica medica seu expositio vel commentarii in nonum Rhazis ad regem Almansorem (Venice, 1483) contained several chapters on diseases of the teeth. He described anatomy of teeth, although with many errors, such as the number of dental roots.2,3 According to Giovanni, oral hygiene played an important role in dental health. In detail, he recommended avoiding too hot or too cold foods and sweet and viscous foods (eg figs, honey and jams). He also maintained that the teeth should be cleaned at once, after every meal, from the residues of food left in them. For this reason, Giovanni suggested to brush teeth with thin pieces of soft wood (cypress, rosemary or juniper), not sharp-pointed or edged, so they did not injure the gums. After cleaning, it was essential to rinse the mouth with a mouthwash based on a vinous decoction of sage or cinnamon, juniper seeds, rosemary leaves and juniper root.1,2,3

Giovanni appeared to favour conservative therapy in diseases of the teeth. In his opinion, a surgeon could remove a tooth only when any attempt to soothe the pain failed, when tooth disease could spread to neighbouring healthy teeth or when speaking and chewing were extremely difficult due to pain. However, his contributions to oral surgery were important. According to Vincenzo Guerini (1859-1955), Giovanni of Arcoli could be looked upon as the inventor of the 'dental pelican', the main instrument for tooth pulling until the end of the eighteenth century.2,3,4,5 Named after the bird beak, which it resembles, the pelican was placed in the mouth, with the hook on top of the tooth and the round part against the gum so that the tooth can be pulled out sideways. The pressure from the lever was intended to remove the tooth; the skill of the surgeon allowed the extraction in a rapid way.2,4,5,6 Finally, Giovanni also reported some problems related to tooth extraction. In particular, he stated that cauterisation with a red-hot iron could be the surest treatment to stop bleeding after extraction. In conclusion, the several contributions provided by Giovanni of Arcoli in diseases of the teeth make him worthy to be remembered in the history of dentistry.2,3,4,6