By Nancy LeBrun
Roots broken off in the gum and bones during extractions. Tennis ball-sized abscesses requiring emergency surgery.
What should have been routine dental procedures followed by life-threatening infections.
These are a few of the many documented complications of treatment by unlicensed dentists in the U.S. The problem of “Fake Dentists” may not be widespread, but the consequences for unwitting patients can be severe – and costly.
Criminal cases involving those who practice dentistry without a license arise persistently in the U.S.
Recent incidents include one that came to public attention in late 2018 in metro Atlanta.
Krista Szewczyk is facing 48 counts, under Georgia RICO laws, of practicing dentistry without a license, forging prescriptions, and insurance fraud. She left a trail of botched procedures, including the abscess that required life-saving surgery, as patient David Marsh told WSB-TV.
The Georgia Board of Dentistry first referred her to the authorities in 2013. When charges were brought, she shuttered her “practice” and entered a pre-trial diversion program that allowed her to avoid prosecution.
Shortly after she completed the program, however, she opened another “dental clinic” in a neighboring county and was back in business. Her “County Dental Providers” operated until she was arrested twice over the course two weeks last September, according to AJC.com. Her case is pending.
Around the same time authorities were closing in on Szewczyk, police arrested two people in Miami for fake dentistry after months of undercover work.
Daniela Sulbaran Gonzalez and Victor Bernal set up shop in a bright red bus with the image of a cartoon kid named “Matthew” on it, complete with addresses of fake social media accounts.
When two investigators posed as patients and were offered treatment, Gonzalez and Bernal were busted. According to a CBS Miami report, investigators “confiscated a bag of prescription drugs, which included lidocaine, mepivacaine, ibuprofen 600 and other dental products.”
The fakers often take advantage of people who cannot afford standard care and are taken in by the lure of low prices.
In late 2017, Isidro De Jesus Manjarres, a former dental lab tech, was arrested in San Antonio, Texas, after performing an eight-hour dental procedure on a woman in his home.
According to MySanAntonio.com, he gave anesthesia 12 times during the ordeal, during which he completed two extractions and used a grinding tool to make a bridge fit. The victim paid him $1,800, but the subsequent repairs cost her more than $10,000, not to mention a great deal of unnecessary pain.
Some of the unlicensed dentists who have had charges brought against them practiced legally in other countries and chose to set up shop in the U.S. without obtaining the proper licenses and permits, according to a report in the ADA News. Others were hygienists or dental technicians like Manjarres, and some appear to have had little exposure to dentistry at all.
The scope of the fake dentist problem in the U.S. is hard to quantify because there is no national database. It’s up to each state to respond to complaints, investigate, and bring charges if warranted.
States have different ways of keeping track of the offenses, so there’s no discernable pattern, just a trail of infections, dangling teeth, and crowns that have to be glued in daily, according to various reports. The problem of dental impersonators appears to have been around as long as the profession.
Origins of Fake Dentists
When the American Society of Dental Surgeons was organized in 1840, there were only about 300 trained dentists in the U.S. for a population of more than 17 million. The rest were freelancers or quacks. As the profession grew in rigor and oversight, efforts to eradicate the imposters expanded.
By 1913, twenty states had passed legislation to halt practicing dentistry without a license.
Nonetheless, the problem persisted, and in 1923 New York’s Attorney General directed Dr. Minor J. Terry, secretary of the state dental board, to investigate. Dr. Terry estimated some 1,000 fakes were operating in New York City alone, and an equal number elsewhere in the state.
“They purchase a few dental tools and rent an office,” Dr. Terry said. After securing payment in advance, they would often botch procedures and then disappear, reappearing in another area in a pop up “dental parlor,” as they were known.
The effort to clean up the problem was ill-fated, however. The Brooklyn Eagle reported that it had been “all but abandoned” within a year, when authorities discovered that the detectives assigned to investigate the problem were shaking down the fakes for protection money to avoid prosecution.
The Great Showman
Perhaps the most memorable case of questionable dentistry involved a man who actually was a real dentist, but whose practices inspired the American Dental Association to declare him "a menace to the dignity of the profession."
Edgar R.R. Parker, aka Painless Parker, graduated from Philadelphia Dental College, later Temple University School of Dentistry, in 1892. He set up offices in his native Canada, but more than a month later had not seen a single patient.
At the time, advertising was discouraged among dentists, but Parker had enough. He installed an enormous sign to bring in customers, which met with some success. He came back to the U.S. and became a street dentist, hawking his profession on the sidewalks, offering painless extractions at 50 cents per tooth – five dollars back if it hurt - while musicians played to attract the curious. By this time, he was billing himself as “Painless Parker.”
In 1913, Parker bought a traveling circus and, with the help of William Beebe, who had worked for P.T. Barnum, concocted a plan to take the act on the road.
The Parker Dental Circus traveled from town to town, drawing big crowds. Along with sideshow performers and a band, Parker had a dental chair set up in a horse-drawn wagon. When the audience was big enough, Parker would call up a plant from the audience and “extract” a tooth, “painlessly.”
When real toothache sufferers in the crowd came forward after viewing the marvel, he would give them a solution of what he called hydrocaine (whiskey and watered-down cocaine) before pulling the offending tooth. It is said he tapped his foot to cue the band to play more loudly when he needed to drown out the groans of the patients.
Parker’s act appalled traditional dentists.
He was stripped of his license in several states, sued with some regularity, and charged with false advertising for the claim of painless extractions. Parker’s response was to change his name legally to “Painless” so he could proceed under that moniker.
He ended up with 28 offices employing 70 dentists across several states, grossing an astounding $3 million a year at his peak. For all his flamboyance, Parker is a complex figure. Though he was the object of ridicule and disdain, he is also credited with bringing the importance of oral hygiene to the masses and was the first to create his own brand of mouthwash and toothpaste.
You can see the necklace of 357 teeth that he wore, which he claimed to have pulled in one day, in the Weaver Historical Dental Museum at Temple University in Philadelphia. Few patients seemed to have complained about their treatment at the hands of Painless Parker, but for many individuals who have undergone painful and damaging dental work by untrained and unscrupulous individuals, the outcome is often not so benign.
Author: Contributing writer Nancy LeBrun is a veteran health and wellness writer, and an Emmy-winning video producer. A former editorial staff member at WebMD, she is based in Roswell, GA.