Quackery in Dentistry -- Past and Present

Malvin E. Ring, DDS

Copyright 1998 Journal of the California Dental Association.

Quackery in dentistry has been a problem as far back as the earliest days when sufferers from dental ills sought relief from their aches at the hands of some type of practitioner. Some were genuine, some were quacks. Following is a historical perspective of quackery.

Frequently a quack can be a self-styled expert, making himself out to be the director or president of an important-sounding -- even if non-existent -- scientific society. Like the plaque that proclaims World's Greatest Cook, taking a title for oneself is, on its own, not illegal. The use of that title to defraud others is.¹ But what impels quackery? It results when competent and trained practitioners are in short supply or when their charges appear prohibitive to a segment of the population. Then untrained individuals step in to supply a genuine need. But the quack differs from the ethical practitioner in that the quack's basic tools are incompetence and fraud. A study of medical quackery in the 1930s found that the charlatan achieves his great power by simply opening a possibility for men to believe what they already want to believe.² Then the half-educated become the eagerly gullible prey of the quack, and their number at times becomes indeed a majority.

Colonial America

Little was done in colonial times to curb fraudulent practice. In 1649, the colony of Massachusetts enacted a law requiring surgeons, midwives and physicians to act in accordance with what were then understood to be the approved "Rules of Art". But it set up no educational or licensing provisions. Medical legislation in the Virginia colony was aimed more at medical practitioners "excessive rates and prices" than at their skill. Under a law of 1645 a physician might be arrested for unreasonable charges, but not for worthless treatment and quackery.³

FOLK MEDICINE

Although not truly quackery, many home remedies and treatments seldom cured toothache or relieved the anguish of oral disease. The person who suggested or carried out these "remedies", in contrast to the quack, did not do so out of a profit motive, but from a sincere desire to help. Nevertheless, it is interesting to note only a few of these curious procedures. The numbers of these "cures" are legion!

Figure 1

The Amish relied on a special "Toothache Pillow" to assuage the torment. It was a small pillow, generally filled with some aromatic herbs, upon which the sufferer would lay his head. The promise was that the toothache would be gone on the morrow. (Figure 1)

In early America, and up until modern times, most people relied on self-dosing. Numerous concoctions were recommended in countless almanacs, cook books and books of self-treatment. A typical remedy: "Ground chestnut, mixed with mutton tallow is said to be good for toothache -- if you have nothing better...Dried hops, placed in a small bag and held against the jaw is another remedy.⁴

Figure 2

Touching an aching tooth with a common nail -- or what was claimed to be even better, a horseshoe nail -- and then pounding that nail into a live tree was widely practiced in Europe. But these fanciful practices varied from country to country. Norwegian tradition, for example, holds that there are nine kinds of toothache, and the Norwegians handle different toothaches differently. The carious lesion is pricked with sharpened sticks of hardwood from nine different varieties of trees until blood is drawn. Then the sticks are hidden in a place where they would never be found, or sometimes are driven into a tree.⁵

Non-Dentist Quackery

The most common form of dental quackery was that which was foisted on a gullible public at country fairs, carnivals and on public streets. One of the most blatant was an Italian quack pictured in a spectacular painting of around 1850 titled "Cacciamole in Carnevale" (The Hunter of the Tormentor, the "tormentor" being the aching tooth.). Here the quack not only sought and removed the aching tooth -- from what was obviously his accomplice -- but flourishes his "trophy", a huge jawbone with teeth embedded! (Figure 2)

Figure 3

More truthful and typical of the charlatans ministrations is an illustration which appeared in a London newspaper of 1872. It shows a quack in Italy extracting a tooth from a struggling unfortunate, while a band plays loudly behind him, as much to attract attention as to drown out the cries of the victim. The inscription above a painting in the background touts the quack's herbs to counteract woes and to conserve the teeth. (Figure 3)

Figure 4

Charlatans plying their trade in the streets were not limited to Europe. The popular magazine Scribner's Monthly ran a series of illustrations in the 1870s entitled "The Street Venders of New York." The December 1870 illustration pictured a quack pushing the sale of his "special" dentifrice. He holds a street urchin's nose with one hand while vigorously scouring the child's teeth with the other, all the while loudly proclaiming the virtues of his marvelous concoction. (Figure 4)

But this type of quackery is insignificant when compared with the description of a charlatan at work in the streets of England in 1860:

A quack makes a mixture of acids and other vile stuffs which he colors or perfumes, then dons the dress of a knight or prince, and with an attendant, mounts an attractive and somewhat mysterious looking carriage, drawn by two or sometimes four richly caparisoned horses, and drives into the public squares. He then harangues the crowd on the virtues of his vitriol which he calls "Elixir of Life" and which he avers will cure all the maladies of the gums and in a twinkling give the teeth a durable whiteness unequaled by a row of pearls. This does not fail to bring an accomplice before him who complains bitterly of pain is several of his grinders.

The multitude look on in wonder to see the magic effect of his remedies...A few flourishes by an attendant on a drum, and the sufferer (?) declares himself free from pain and opens his mouth to the gaping crowd to show how quick his teeth have been made white as snow. A burst of enthusiasm drowns the thunderous noise of the drum, and hundreds of bottles of elixir are instantly sold.⁶

But there was always danger to the patient from untrained personnel, and this can be well illustrated by a case that was described in a book by an English dentist. He recounted the sad tale of a Baroness, who, being troubled with a toothache, was assured that her local blacksmith was adept at pulling teeth. In this book, published in 1862, the author tells how the blacksmith "pulled out a dirty handkerchief, with which to lap round the key tooth, an instrument of his own forging...and with some difficulty and force, managed to extract the vicious molar." Unfortunately, his key "formed better to remove a granite boulder than a human tooth...fractured the Baroness's alveolary process and a portion of the jaw bone. Her Ladyship for the rest of her days, concealed in her mouth, the reminiscence of a blacksmith's skill in tooth drawing."⁷ What is shocking is that results like this were happening by the thousands in this country as well as abroad.

A startling aspect of medical quackery is that practiced by the religious evangelist, and there are evangelists who find dentistry, in particular, an irresistible source of income. In November, 1986, a Rev. Willard Fuller visited Rochester, New York. Mr. Fuller was a former Baptist minister who parted ways with the denomination because it did not subscribe to faith healing. The Reverend warmed up the crowd by claiming that at a previous ministry in Phoenix, after "the laying on of hands," an 11-year old girl with six filled teeth suddenly had whole teeth and no fillings! He told of another woman in upstate New York whose teeth had all been previously extracted. After he "touched" her, she grew a new set of teeth! He also claimed that he changed silver fillings into gold, and at the Rochester meeting, he claimed to have changed a silver-colored crown into gold by touching it. The director of the Committee for the Scientific Investigation of Claims of the Paranormal was at the meeting and asked for some people present to examine those who claimed that changes had taken place, to see whether there actually were changes. There were no takers! The charge to the believers to attend the meeting was $10 in advance and $12 at the door. The Syracuse (N.Y.) Post-Standard of about the same time reported that Fuller claimed to have "witnessed some 35,000 miracles in the mouth, with an average of about 1,500 healings a year."⁸

Magnetism, Electricity and Quackery

Figure 5

The experiments with electricity by Benjamin Franklin and others, in the late 18th Century, gave impetus to trials using all forms of hitherto poorly understood forces. Anton Mesmer's theory of "animal magnetism" was sweeping the world and bold physicians were attempting its use in assuaging pain. Mesmer himself became so popular that he claimed to be able to "mesmerize" patients by remote control through the medium of "magnetized" objects.

A quack in Connecticut, Elisha Perkins, entered the field in 1798 with his patented "Electric Tractors." This was a forked contrivance, one end sharp and one blunt, most commonly made of combinations of copper, zinc and gold. He claimed to effect cures of innumerable diseases -- including toothache -- by stroking the affected part, the "curative" power, he claimed, being due to an action similar to Mesmer's "animal magnetism". His nostrum swept not only the U. S. but much of Europe and it was not discredited until an English physician showed that the same "cure" could be effected by stroking the patient with a wooden fork, gilded to resemble metal. (Figure 5)

Other quacks capitalized on this new found magnetic force. A Scottish quack, James Graham, built a colossal Temple of Health, whose main attraction was a huge Celestial Bed, supported on forty "magnetized" pillars. A night spent in the bed, with accompanying soft music and scantily clad exotic dancers, Graham claimed, would rejuvenate the most senescent of men, at a cost of a mere 100 Pounds a night! ⁹

Figure 6

The novelty of electricity led to its being tried as an anesthetic in tooth extractions. A report in a dental journal of 1858 ¹⁰ described a process being used in Baltimore where a current of electricity was passed through the tooth at the time of extracting. Its mode of use was described as follows: "The patient grasps firmly in his hand one pole from an electro-magnetic machine, the other pole is attached to the forceps, and by this means a current of electricity is passed through the tooth, and produces a local anesthesia, and so avoids the use of chloroform or ether." (Figure 6) Unfortunately, carefully controlled studies some years later showed there to be no anesthetic effect whatsoever in this method. In fact, a dentist of 1860 had a woman patient who was desirous of having a tooth extracted by electricity. His battery had run dry, but he nevertheless had her hold the electrodes -- even though he passed no electricity through them -- while he extracted the tooth. She then "threw down the rod and jumped out of the chair perfectly delighted, saying it did not hurt her a bit!" ¹¹

Figure 7

In the mid-1850s an enterprising company, Davis and Kidder, brought out its "Patent Magneto-Electric Machine". (Figure 7) It was a simple generator, current being produced by the turning of a crank handle, the amount of current being determined by the speed of cranking. The patient held one electrode, the operator the other. The accompanying instructions for treating toothache instructed the operator to hold an electrode in one hand, and with the other hold a wet sponge to the face, in the area of the aching tooth, while the patient holds the other electrode. An assistant then cranks away, ostensibly making the toothache disappear. Lack of success soon made the machine a relic, to be consigned, one would think to oblivion. However, quackery is ever present, because around 1920 an enterprising entrepreneur resurrected it and renamed it the Electraply.

Figure 8

It was powered by one D-cell battery, and the manufacturer touted that "electro-therapeutic treatments may be had inexpensively and effectively in your own home by applying the Electraply." (Figure 8) In addition to treating toothache, the manufacturer claimed it would cure poor circulation, headache, neuralgia, neuritis, tonsillitis, catarrh, asthma, goiter, hoarseness, earache, lumbago, backache, dandruff, falling hair, paralysis, nervousness and sexual weakness, to name but a few of the recommended uses! ¹²

Figure 9

The electricity craze reached such extremes that an "electric toothbrush" manufactured by the Pall Mall Electric Association of London was imported to the United States in the 1880s and sold for 50 cents. It came with a special cloth, which when rubbed on the handle was supposed to impart special electrical qualities to the brush which extended the life of the teeth. This even though the handle was of ordinary hardwood! (Figure 9)

Patent Medicines And Other Worthless Devices

Patent medicines and similar nostrums had flooded the country to such a degree that the health and well-being of the population was threatened. In response to flagrant abuses, Congress passed, and on June 30, 1906, President Theodore Roosevelt signed, into law the first Food and Drug Act. This required that patent medicines list their ingredients on the label. And although narcotics were not banned from syrups given to babies, it was assumed that by means of education, mothers would be less likely to use them. Samuel Hopkins Adams quotes a conversation between an office scrub-woman and the lawyer she worked for: "How can you go to these evening parties, Nora, when you have two young children at home?" "Sure, they're all right," she returned blithely, just one teaspoonful of Winslow's and they lay like dead till morning." ¹³

Figure 10

Mrs. Winslow's Syrup had indeed been a wide seller. Its manufacturer touted it as having been used by mothers for children teething for over 50 years with perfect success. It relieves the sufferers at once, produces natural, quiet sleep by freeing the child from pain, and the little cherub awakes "bright as a button." It is little wonder that the child was effectively silenced. The syrupy nostrum contained almost 30 percent opium and morphine in alcohol! ¹⁴ (Figure 10)

Figure 11

In addition to the quack electrical machines which were discussed earlier, other devices were peddled to the populace, the rationale for them being based on totally false premises. From ancient times, man has explained the source of the gnawing pain of toothache as the burrowing of a "tooth-worm" in a carious tooth. Various means were employed either to lure the "worm" out of the tooth by bait, such as honey, smeared on the outside of the tooth, or to kill the "worm" with smoke from burning seeds of henbane or leek. And because people have frequently been fearful of dental treatment, such painless quack treatments have been attractive through the years. An advertisement in an English newspaper of 1837, claiming to cure tooth-ache by fumigation is evidence that quack devices are hard to get rid of, and are a quack's easy sell. (Figure 11)

Quackery Within the Profession

There is a long history of flamboyant practitioners in the dental profession, stretching back to the 1600s. One of the most notorious was Le Grand Thomas, a giant of a man, bedecked with a plumed hat and flowing garments, who carried on his activities in the 1720s in the middle of Le Pont Neuf in Paris. He sat on a high platform while his assistants probed the mouths of waiting sufferers; then, from on high, he would give his opinion as to the desired treatment and its fee.

England had its share of flamboyance among dental practitioners, the most notable one being Martin van Butchell. He rode through the streets of London in a golden coach, driven by two gorgeously caparisoned coachmen. Walking before the coach, similarly attired, were two footmen blowing golden trumpets, announcing that the great doctor was driving by. Van Butchell had let it be known that his fees were the highest of any of the dentists of London, and thus he attracted to himself the very cream of society, and peers and nobles fought to be his patients.

A short time later there appeared in London another quack who quickly became the most notorious of all. He was known only as M. Patence. His flamboyant newspaper advertisements touted his supposed expertise, and he achieved notoriety in spite of his lack of training. An idea of his "bamboozling" technique can be gleaned from a book he published in 1774. In it he describes the actions of the mandible. Can one gain head or tail from it?

If we consider the six-fold action of the jaw, it excels all mechanical motions whatever: all the parts move from the centrical points, except the compound rivet, which few understand; the rest terminate in angle from the centre, but this when it opens moves quite different; its actions are horizontal, vertical, forward, backward, extends behind or shuts before: for when the grinders meet, the upper fore-teeth project over the lower, and when the fore-teeth are employed in eating, there is an open space betwixt the grinders; so that the rest is given alternatively throughout the whole, the methods of which no mechanic can comprehend, there being no screw, or constructed lever, to alter the wonderful operation of such an amazing construction. ¹⁵

It was because for so long there was no adequate educational system for the training of dentists that unskilled practitioners held sway. Even many years after the establishment of the first dental school in the world at Baltimore in 1840, most dentists still received their training by the preceptoral method. The student would be associated with an established dentist for a period of one to two years, and generally became a proficient practitioner. The teacher would receive a fee, in a manner similar to that of master and apprentice. But there were unscrupulous individuals who took in students merely for the money and turned out miserably unqualified operators to prey on an unsuspecting public. This was of such moment that the first dental journal editorialized "We know of one who has the unblushing effrontery to promise to fit them for the profession in one month -- to teach them the whole art and science of dentism, both surgical and mechanical, in 26 days; and this, not requiring their constant attendance, but two hours twice or three times a week." ¹⁶

In some cases the quackery was simple out-and-out thievery. A case was reported in 1844 of a couple who chanced to stop in Boston on their travels. The lady was in need of a new upper denture, her existing gold upper not fitting her well. They saw an advertisement of a dentist who offered the needed treatment and, after consultation, agreed to pay him a liberal amount in cash plus her old gold denture for the new set of "mineral teeth on gold." The work was accordingly completed and the couple went on their way, but when they reached Portsmouth, Maine, one of the teeth came off the denture. They stopped at a local dentist to have it resoldered and discovered to their dismay, that when the repair was undertaken, the metal proved to be not gold, but silver gilded over so as to look like gold! ¹⁷

In some cases quackery by dentists took bizarre forms, such as a licensed practitioner conniving to let an unlicensed person treat his patients for a fee. This was a frequent occurrence in England in the last century and even into the early years of this one. A case was brought to court in Cardiff, Wales, in 1898 by a woman who described the actions of just such a quack who looked at her mouth, pronounced it in very bad shape, and said he would "...cut the teeth off and fit new ones on the top." He then "cut away all the top teeth except one, and all the other stumps he snapped off with something like a pincers, the bits flying all over the room." He then immediately took some sort of impression and the next day inserted a denture. The patient, being in great distress, sought out a licensed dentist who found her mouth in a deplorable state, with lacerated and inflamed gums, pus oozing freely everywhere. This dentist testified that he ultimately extracted twenty-two roots for the patient, declaring in court that the previous treatment rendered her by the unlicensed person was exceedingly improper. Monetary judgment, plus court costs, was awarded to the plaintiff. ¹⁸

A New Type of Quackery Today

With the increasing popularity of "alternative medicine," a number of dentists have seen an opportunity to garner a great deal of wealth by trading on patients' fears. Thus, there are some who advocate the wholesale removal of amalgam fillings and their replacement with composites, even though scientific studies have shown that there is no danger to the patient from the amalgams. Some have gone even further, and have taken a page from the practice of many chiropractors. They are no longer "tooth oriented" but attend rather to the "wellness" of their patients. A representative of the Shaklee vitamin company reported that some dentists increased their annual gross by $50,000 by having a dental assistant, with no nutritional training, counsel patients on dietary supplementation, dispensing these supplements at a hefty charge! ¹⁹

Fortunately, these unscrupulous individuals are not always getting off scot-free. In 1990, a dentist licensed to practice in New York State, charged with nine counts of "unprofessional conduct" had his license revoked. ²⁰ Among the complaints was the fact that he urged a patient, who complained of arm and leg pain, to have her amalgam fillings removed, going so far as to tell her that when she chewed food she was poisoning herself, because the mercury in her fillings was toxic and was being released in small doses. And when she later complained of a sore throat, he urged her to take "detoxifying agents" to get rid of the mercury in the tissues of her mouth.

Dentistry has come a long way in the last century and a half, to the point where today it is ranked as one of the most respected of professions. It is incumbent upon dentists everywhere to protect that hard-earned reputation by weeding out quacks from among them, and to consign to the dust-bin of history the shady and nefarious practices of the past.

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