It is ironic that despite his power, the Mayor yields to Aurelio Escovar’s power and authority over him during the removal of the Mayor's tooth. Throughout the play, there is an apparent power imbalance between the Mayor and the dentist, which is displayed by the coercion the Mayor uses to compel Aurelio to remove his bad tooth. The Mayor threatens to shoot Aurelio if he does not attend to him.

Reluctantly, Aurelio decides to remove the Mayor’s tooth. However, he informs the Mayor that he will not use anesthesia “because you have an abscess.” It is unclear whether that is true, especially considering what the dentist says shortly before removing the Mayor’s tooth. He says,

Now you’ll pay for our twenty dead men.

The Mayor does not respond to this brazen, malicious, and unprofessional conduct from the dentist, even though the Mayor obtained the procedure by threatening to shoot the dentist. It is ironic that in this situation, the Mayor is helpless, and Aurelio possesses all the power.

Further, it is ironic that despite his incompetence, lack of a degree, and minimal regard for his work, Aurelio is the only dentist in the town. The story says,

He seemed not to be thinking about what he was doing, but worked steadily, pumping the drill with his feet, even when he didn’t need it.

We learn later that the lack of proper medical facilities in the town is perhaps due to abject corruption in the town, which is discernible from the Mayor’s last remarks. When Aurelio asks where to send the bill—“To you or the town?”—the Mayor says, “It’s the same damn thing.” This sentiment implies the lack of proper administration in the town, as the Mayor’s money and the town’s funds are deemed to be the same.