Dolarhyde’s cleft palate, though repaired, has left him with a lisp.  Specifically, a lateral lisp – one in which air escapes from the sides of the mouth when making sibilant sounds.  In order for a person to produce sibilant sounds:

“…air must flow over the tongue and strike the front teeth … if teeth are missing or misaligned … then the air flow may escape before striking the front teeth.  Many children with repaired cleft palate have restricted (or collapsed) upper dental arches.” (x)

An exercise to make one aware of the direction of air flow while annunciating sibilant sounds is to hold a finger in front of one’s mouth to help consciously redirect the air.  As seen above, Dolarhyde uses this exercise by directing “sixty-six” at his index finger.

Not lost is the juxtaposition of Dolarhyde’s ability to control and perfect his physique through exercise while remaining unable to master his speech through the same.  And while he is able to assert his physical strength through the Tooth Fairy murders, he feels forced to communicate through images – moving, still, on film, on canvas, in mirrors and on flesh.  Because the sibilant sounds are incurable, so does the man assume himself to be.