by Theo Schall

 

There’s a clear affinity between bioethics and the history of science. The history of science is (like all history) a story of changing values. Bioethics, the collective examination of ethical issues in health and research, benefits from reflection on the triumphs and missteps of the past.

The Baltimore area is richly endowed with archives and museums that preserve the historical record of science, medicine, and technology. In this new series of posts, I’ll highlight ethical puzzles (and droll odds and ends) to be found in local collections.

 


 

DentalMuseum-001The Dr. Samuel D. Harris National Museum of Dentistry is operated by the University of Maryland School of Dentistry. The museum serves two functions: teaching visitors about oral hygiene and preserving the history of dentistry.

 

Important pieces in the collection include George Washington’s dentures, Queen Victoria’s personal dental instruments, and more toothbrushes than can be looked at in a single afternoon.

 

 

 

 


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The collection also includes colorful memorabilia from the of history dental advertising and education around the world. This devilish Art Deco toothpaste ad is from Germany.

 

 

 

 

 


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While human tissue makes up only a small part of the National Dental Museum’s public collection, there are a number of remarkable specimens. Pictured left is a child’s jawbone, mounted in 1867. You can see the growth of adult teeth above the gum line.

 

 

For a nuanced take on the ethics of museum archived human tissue samples, check out:

Jones, D. G., Gear, R., & Galvin, K. A. (2003). Stored human tissue: an ethical perspective on the fate of anonymous, archival material. Journal of Medical Ethics, 29, 343-347.

 

 

 


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This machine is nicknamed “Mighty Mouth.” It simulates chewing so that dental researchers can evaluate the strength of new materials. You can push a button to watch the halves of the jaw mash against one another.

 

 

While I don’t have phobias about the dentist, this piece struck me as nightmare-worthy. Maybe it’s too much like the brain-in-a-vat experiment?

 

 


 

Bioethics Highlight:

 

“In the Victorian era, dentists extracted healthy teeth from paid donors to make dentures for the wealthy. In 1887 Dr. Thomas Evans made a set of teeth for an Englishwoman out of teeth extracted from 20 French girls. When the set was lost during an earthquake, another 20 donors were paid to provide teeth for a replacement denture.”

 

This sounds exploitative and unethical to a modern visitor, but how much have things changed? While the poor no longer provide teeth to the rich, they do provide other parts and services. Poor people in developing countries resort to selling their organs. Poor young women are paid for their eggs and for gestational surrogacy despite the fact that the latter practice is illegal in almost every other developed country. Less invasive, but still troubling, is the international trade in human hair, which relies on a steady supply from poverty-stricken women in India, China, and eastern Europe.

 


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This display of frontier dentistry tools was strikingly similar to the tools still used today. Obviously, some very important things have changed (power tools, running water, safe painkillers, good lighting, etc.), but the color-matching set looks very similar to the one my dentist uses. A good reminder that the fundamentals of clinical care persist.

 

 


 

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How did people explain the pain of cavities before they learned about destructive bacteria? One internationally popular account was the “tooth worm,” a gnawing parasite that lived inside the tooth and tormented its host.

 

In this picture, the closer tooth contains a tooth worm. The farther tooth contains a little scene of hell, complete with fire and demons, to illustrate the pain of toothache.

 

 

 


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Dentistry’s transition from frontier medicine to respected profession didn’t happen overnight. Before dental associations and oversight boards controlled the quality of dental care, patients were vulnerable to mistreatment at the hands of hucksters.

 

Pictured at right is an early dental parlor known for overpromising and underdelivering. Even today, dentists warn against choosing a dental practice on the basis of its billboards.

 

 

 


 

The National Museum of Dentistry is located at 31 S. Greene St., Baltimore, MD 21201. It is open by appointment only.

 

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