Dental MythBuster #1 – The dentist pulled so hard he put his knee on my chest!
As a general dentist who routinely extracts all kinds of teeth, I’ve heard this story so many times that sometimes I am even inclined to believe it! However, it is not true, at least not in the United States for the past 50 years. I’ve heard this story everywhere I have practiced dentistry, from Buffalo, NY to my current city of Orange, CT. The dental myth is documented on numerous areas on the internet, including here.
When people hear this myth, the image to the left is immediately conjured up. They envision a dentist with a rusty pair of pliers purchased at their local Home Depot, pulling hard with sweat dripping. The forces require that the dentist stabilize the patient with their knee. Variations on this myth include “legs on my chest”, “forearm on my neck” as well as my personal favorite “the dentist had two assistants hold me down to pull my tooth.”
The extraction of a tooth requires more “brains than brawn.” It is not about brute force applied randomly nor haphazardly. Extractions require the controlled, methodical, and timely application of forces in a variety of directions, with a pulling force being the least frequently used and least effective. Tooth extractions use the concept of a “lever” which is a lesson most of us learned in high school physics. A lever is a rigid object (in this case a piece of molded metal called a dental elevator) that is used with a pivot point (called a fulcrum). The lever is placed against the tooth to be removed, and by rotating the elevator against the fulcrum, a large force is exerted against the tooth to be removed. The force then “elevates” the tooth out of the jawbone without producing any pulling forces – and without a need for a knee to be placed on the patient’s chest!
The graphic to the left shows a dental elevator being used as a lever, with the fulcrum being the adjacent tooth. A sideways and upwards force is generated using the instrument in this way. Note that there are no pliers here! I (along with other dentists who extract teeth) can frequently get the tooth out with this motion only. It requires only wrist strength and no muscles above the elbow are used. And most importantly, it does not require the dentist to put his or her knee on the patient’s chest!
On occasion, some teeth require more than just elevation with a dental elevator to remove completely. This can include sectioning the tooth into 2 or more pieces, cutting some of the tissue surrounding the tooth, use of dental forceps, and other techniques. The detailed descriptions of each technique are beyond the scope of this blog post. However, none of the techniques involve a pulling motion.
So the next time you hear this myth, call them out on it, as it is not true… unless their dentist is Steve Martin and they are living in the movie Little Shop of Horrors! Or they resemble Dustin Hoffman and just recently were found acting the movie Marathon Man!
If you are in the vicinity of New Haven, CT and need your tooth removed, you can come see me. As promised, I perform all types of tooth extractions, some with IV sedation. And I promise I won’t put my knee on your chest!
Stay tuned for another Dental MythBuster blog post in the near future!