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How Real Was That Mouth Horror Scene In 'Cast Away'? We Asked A Dentist

Don't try this at home. Or while shipwrecked. Or ever.

"Cast Away" is a famous movie for all kinds of reasons, from its long periods of onscreen silence (80 minutes in total), to Tom Hanks' amazing, Oscar-nominated transformation in the lead role, to the embarrassing way it made us all sob hysterically and inconsolably over the "death" of a volleyball.

20th Century Fox

Cast Away

RIP, Wilson. You were too good for this world.

But for some of us, the most memorable thing about "Cast Away" is that scene -- you know the one -- in which our hero performs an act of amateur dentistry on himself, using nothing but an ice skate and a titanium set of... um, nerves.

It's an absolutely epic moment of pure, total mouth horror. But could you actually do it IRL? In honor of the movie's 15th anniversary, we called up a dentist friend, Aaron Schwartz (DDS, MPH), to find out.

MTV News: As a dentist, what's your first reaction to that scene?

Aaron Schwartz: [Laughs.] It's pretty hilarious.

MTV: Can you tell what's going on there? What would be happening in Tom Hanks' mouth that led him to take such desperate measures?

Schwartz: Odds are that he had some sort of cavity -- or an active caries lesion, if you want to be scientific. In terms of cavities, it's a big one, with an accompanying bacterial infection. It causes a condition called irreversible pulpitis, which is inflammation in the nerve of the tooth that would lead to constant, really bad pain.

MTV: So it's not unrealistic that he would have been in agony to the point of doing something drastic like this.

Schwartz: Not at all. The infection gets trapped along the bone line, and the ligament that surrounds the tooth, so it creates a crazy build-up of pain and pressure. And you know, it's attached to your head, so it's especially bad. There are two treatment options when this happens: You either do a root canal on it, or you take the tooth out.

MTV: That brings us to the main question: How possible would it be to take the tooth out like he did in this scene?

Schwartz: I would be really surprised if someone actually managed to do it the way he did it. The tooth is pretty tightly fit into the jawbone. You just can't slap out a big molar. A front tooth, you could -- people get their front teeth knocked out all the time, if they fall or get punched -- but it's different with a molar, because there are multiple roots, multiple points of attachment, that help it stay within the jaw. So you have to slowly expand the bone around the tooth, and the tooth slowly loosens in its socket. There are cultures where people take out their own teeth -- they don't just slap it out. They use proxy dental instruments, they wedge a stick in there, they rock it back and forth. That's what needs to happen on a molar. It's a much slower, finessed process.

MTV:So realistically, what are we seeing? Would it be just a piece of tooth that flies out of his mouth?

Schwartz: Yes, he would have definitely succeeded in taking out a piece, probably breaking it in half. So the roots would remain and the crown just came out. But with the roots still in, the infection is still hanging out there, which means he doesn't solve it or save himself any pain down the road. It's really too bad for Tom Hanks.

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