Abstract: A telescopic, mouth-held manipulating and writing apparatus for paralytics consists of a replaceable mouthpiece, a fixed arm and an elongated extendable arm that interchangeably receives either a manipulating instrument or a writing instrument. An adjustment nut for extending or retracting the telescopic extension arm from the fixed arm is incorporated in the apparatus. A locking nut is incorporated on the extension arm of the apparatus for securing and releasing the manipulator or writing instrument. The adjustment nut, locking nut and extension arm are metallic, thereby promoting sterilization at high temperatures.