27 November 2009

Avoiding the need for dental anaesthesia

At times, in his practice, to break down the iron will of an incorrigible patient, the author has resorted to the towel procedure. It is drastic, but "the spirit must be conquered before the flesh can be subdued." The mother must necessarily be excused, and, as she leaves the room, the latch should be turned on the door---otherwise, she will be back at the crucial moment and destroy all that has been accomplished.

To proceed, take a towel in your left hand. Put that arm around the headrest, placing the towel over the child's mouth while holding his two hands in your right hand, which is also pressed down against the body, holding him firmly in the chair. Talk directly into his ear, saying, "As soon as you stop crying, I will let go." If, after a minute or two, no response is given, close the thumb and finger of the towel hand over the nose, shutting off the air supply. In a few seconds he will exhibit symptoms of reasoning and will agree to submit, but the moment the hand is released he will yell loudly for his mother. Immediately replace the towel and proceed again. This time pay no attention to the initial overtures, and hold him until he experiences some discomfort. Prior to releasing him say, "Will you help? Are you sure? Are you sure? Sure?" This time when he agrees to cooperate he will be as good as his word, and the crying will be but momentary. Immediately take the mirror and, in a gruff tone, remark, "Now open your mouth and let me look at your teeth." Almost before the child realizes it, the mouth will open like a trap suddenly sprung, and one may proceed with the examination. The rest is easy.

It is recognized that there is a great deal of criticism of this so-called manhandling procedure. However, the reader must bear in mind that it is only the very rare child who must be treated in this manner; it does not occur with greater frequency than once or twice a month. Certainly it is not a pleasant thing to do, yet when a child has a history of having created an embarrassing scene in three or four different offices, it is necessary if anything is to be accomplished. It should be a means of last resort, the last card in the operator's deck of possibilities.

From "Incorrigible Children," in Juvenile Dentistry, a textbook by Dr. Walter C. McBride, published in 1941 . An excerpt from the book appeared in issue number 12 of Chip's Closet Cleaner, a 'zine published in Chicago by Chip Rowe, republished at ChipRowe.com.

Reprinted in Harper's Magazine, August 1995, p. 26


  1. holy shit... no wonder our parents and grandparents hate dentists. Bad enough one who makes my gums bleed, but one who would smother a child who was frightened and fighting back?

  2. After watching a few thousand children throw fits during our county's H1N1 vaccination clinics, I have some sympathy for the author. These kids bite.

  3. You got that right, even here in Chicago dental, it's pretty messy from time to time.

  4. Wow! Dentists were brutal back in the day!


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