My Grandfather Dr Erich Max Isakowitz with his wife Sofie and their daughter, my mother Lore in about 1916-17
Reflections on dentistry and dental problems under the Third Reich
Jerry O’Sullivan and Malcolm Bishop
Abstract: Victor Klemperer was a Professor of Romance Languages and Literature in Dresden during the 1920s and 1930s. He kept a diary and the entries for the period 1933 to 1945 have been examined for references relating to dentistry and dentists. These give an insight into an aspect of the social life of the period that appears to have been previously largely overlooked.
Keywords: Third Reich in Germany, Dentistry, Dentists.
Victor Klemperer (1881-1960) was Professor of Romance Languages and Literature at Dresden Technical University from 1920 until 1935. He was dismissed, not because he was a Jew, but because his subject was not judged to be sufficiently important by the Government. In addition, he was not attracting enough students. He was the son of a rabbi and fought in the First World War. In 1906 he married Eva Schlemmer, a pianist, who was not Jewish. They had no children. Before going into academic life, Klemperer was a free-lance journalist and public lecturer, but his brothers Georg (1865-1946), Felix (1866-1932), both physicians, and Berthold (1871-1931), a lawyer, provided him with an allowance to embark on an academic career.
All his life, Klemperer kept a journal and his diaries have been translated and abridged by Martin Chalmers. This account deals with the dental references in the period of the Third Reich, ‘I Shall Bear Witness’ (1933-41) and ‘To the Bitter End’ (1942-45).
These describe civilian life as the Nazi Government increased its persecution of the Jewish population, with indignities, humiliations and overt cruelties, leading on to the deportations to what were, in essence, death camps, Riga, Auschwitz and Theresienstadt. Klemperer devotes many entries to his own health and to that of his wife, Eva. He suffered from angina pectoris and Eva had a multitude of ailments, some perhaps psychosomatic, but nonetheless real. In the course of the diary, there are a number of references to the dental problems that Eva and Klemperer suffered, as well as those of some of their friends. These give an anecdotal insight into an aspect of life in the Third Reich that seems not to be well documented in the literature on the period.
Dental History of Eva Klemperer
In January 1934, Klemperer writes: ‘Since a week ago and for a long time to come much time lost, torment and exposure because of dental treatment’.
At once, the pattern was set. Dental anaesthesia was not well advanced, there were no antibiotics, and dental treatment cost money.
He continues: ‘Eva is faced with protracted dental treatment in March, and by December she ‘is faring remarkably well with the lengthy dental treatment’. She is attending a Jewish dentist called Isakowitz, (Erich Max Isakowitz Dr. Med. Dent., Zahnarzt, 1891- 1979), Fig 1, who lived at 25 Königsbrücker Strasse, and whom she likes.”
When she attends for dental treatment, she is accompanied by Klemperer, who is always present in the room. Her treatment is interrupted after she has influenza, whatever Klemperer means by that.
In January 1935, Eva has to have a root removed, and this is done under a general anaesthetic, which she prefers to local anaesthesia. Klemperer is as usual in the treatment room and finds it ‘frightful to watch’. Having taken three months, Eva’s bridge work is completed in February. But by April, Eva has trouble with her teeth again, there are further visits to Isakowitz. The problem does not resolve and by May, Eva is needing repeated dental treatment for root inflammation. To add to her troubles, she gets an arsenic burn in her mouth. She is also under general nervous strain. This may be both a cause and a consequence of her dental problems.
Dr Erich Isakowitz
By early October, Isakowitz fears that he will soon not be allowed, as a Jew, to treat insured patients. He decides to sell his practice and move to Israel, when at the last moment such sales of Jewish practices is forbidden. At this time, Eva unexpectedly requires a supplementary dental repair and later in the month an abscess develops very suddenly in her mouth and has to be lanced. By October 1935, the Isakowitzes are living at Werderstrasse 44, Dresden Plauen  and Frau Isakowitz had gone to England to see whether her husband would be able to practise without sitting an examination. On 6th March 1936 , Isakowitz heard that he had received permission to practise in England, and in late June the family left Germany for England.
Dental problems of Professor Victor Klemperer
In January 1936, Klemperer himself develops dental problems. He has been having treatment for a while for ‘a disgusting root infection’, the pain of which keeps him awake at night. By the end of January, after ‘weeks of torment at the dentist’, Klemperer has to have a resection. A week or so later, he decides against having ‘a doubtful resection’ and he has the bad tooth taken out. Eva has a recurrence of pain in her mouth in July, and develops an abscess on her gums. This bursts, and she gets relief from pain when the dentist cleans the wound.
Dr Kunstmann-a new dentist is consulted
The couple’s dental problems continue into 1937, and they continue to attend the dentist in January. By June, ‘Eva’s teeth are playing up again, luckily only the technical ones that do not hurt’. They attend Dr Kunstmann at Reichstrasse 30 (Erich Kunstmann, Dr. Med. No dental qualification but listed under Zahnärzte) but after being presented with a ‘quite shameless bill’, they change to a new dentist, Dr Eberhard Eichler.
The next dentist, Eberhard Eichler, Dr. Med. Dent., Zahnarzt
Eberhard Eichler, Dr. Med. Dent., Zahnarzt) ‘the young and altogether congenial successor to Dr Isakowitz’. He had taken over the surgery at 25 Königsbrücker Strasse, and ‘everything (except the dentist) everything, nurse included, is unchanged’.
In September, Eva has another dental consultation, with ‘the anticipated unpleasant result: removal of loose teeth and replacement by dentures are necessary, lengthy torment, expense, stuttering, uncertain end result’. However, Klemperer seems to be coming to terms with the situation. He comments that there are worse illnesses, and this business is more embarrassment than misfortune. His wife’s dental problems, not specified, recur in September and he notes that he does not like the anaesthetic she has to have. In November, he reports that she has periodontitis or an abscess.
There is no mention of dental problems for the next two years, but in November 1939, Eva’s problems recur. After her first trip to the dentist the following month, Eva gets a bad abscess in her jaw. The worst pains quickly pass but even then she has considerable difficulty chewing, leaving her physically weakened. 1940 passes without comment on dental problems but in August 1941, Eva’s face is swollen up for days because of a jaw abscess and the dental treatment.
Another dentist, Hugo Simon, Dr.med. dent., Zahnarzt
The second volume of the diaries, ‘To the Bitter End’, begins in 1942. In June, Klemperer registers with Dr Simon( Hugo Simon, Dr.med. dent., Zahnarzt). He has previously said that Simon, who lived at 15 Reichstrasse, is registered to treat Jewish teeth, and so has an earned income. He attends Dr Simon for treatment, and notes in the diary that Simon is almost fifty, both doctor and dentist, and here the Professor speaks, ‘a little of the temper and manner of Dr Isakowitz but more boastful and garrulous, yet not without an intellect’. Simon has no staff and has to answer the door himself. In complicated cases he is assisted by his wife, who is non-Jewish, and so is not allowed to accompany him when he is called out to a Jewish patient. During the treatment session, Dr Simon, according to Klemperer, works deftly, while talking about his surgical skill, his great deeds, his former international practice, the incapacity of his German colleagues and the excellence of American dentistry, as well as giving comments on the political situation.
In August, Eva says that she is looking particularly old, because of the gap in her lower set of teeth. By this time there are no dentures to be had as all supplies are going to the army. In November, Klemperer himself has to have a ‘bad back tooth’ filled. Later that month, he is given a cigarette carton full of teeth by a dental technician friend who had worked with the gardener in the Jewish cemetery. He gives them to Eichler, who is going to pick out what can be used and pay the going price for it. Eichler ran out of teeth long ago and ‘Eva has been running around with a huge gap in her mouth’.
Klemperer fortunately lacked our wider knowledge of events in Germany, which makes encountering this entry very difficult, but even so finds the incident grotesque, a fairy tale, and Eichler must not find out where the teeth came from – knowledge enough for prison and “attempted escape”, that excuse for summary execution. We may at least assume that the teeth were porcelain ones recovered from dentures, as these would be all that would be useful to Eichler.
In January 1943, Eva is suffering badly from pain in her lower jaw, but the dentist cannot find anything so it is labelled as ‘neurosis’. Later in the month, Klemperer records that Eva is greatly troubled by her prosthesis, which they christen ‘the rocking horse’. She sees Dr Simon, who assures her that she will become accustomed to it. The diary, being written by a layman as it is, does not make clear whether Eva’s prosthesis is removable or fixed. The colourful description of a ‘rocking horse’ suggests removable, and will be recognised by patient and practitioner alike as regrettably accurate on occasion. Even more descriptive is a rider not translated by Chalmers, where Klemperer is reminded of Robert the Bruce hearing his “sword from Bannockburn rattling and shaking on the stairs”, a reference to Das Herz von Douglas, a poem by Moritz Graf von Strachwitz (1822-1847). It seems to convey much about how Eva’s dental prosthesis gave trouble in addition to its rocking, and porcelain denture teeth were notorious for clicking and rattling.
She visits Simon again in June, presumably for a check-up, as no dental problem is mentioned in the diary. By August, the dental focus switches to Klemperer himself. He has root treatment from Simon. Simon appears to be acting as Klemperer’s doctor as well as his dentist, for in December of that year he consults him because of an upset stomach, and is told that he has ‘pseudo-angina’, as he does not have blue lips, that is he is not cyanosed. Moving on to July 1944, severe pain drives Klemperer back to Simon. He now has ‘an inflamed festering root inflammation’ which requires lengthy treatment. This lasts until November.
Contemporary dentistry in Germany
There are a number of instances of what historians call unwitting testimony, facts that we learn almost accidentally. For instance, we are told, in passing, that Simon performs home visits, if only to Jewish patients. So this must have been the practice at the time. Mrs Isakowitz, in 1935, related to the Klemperers that the rabbis in England were preaching a boycott of German goods, including not buying German Odol mouthwash. And from Eva’s arsenic burn, we learn that the substance was evidently was still used by dental practitioners at the time. Arsenic trioxide has been used since the fifteenth century to devitalise inflamed tooth pulp, and its use was widespread before reliable anaesthesia. It was particularly used in acute symptomatic pulpitis of the mandibular molars, where anaesthesia was difficult to achieve. It has largely dropped out of the modern dental repertoire, although a there is a recent report from Taiwan of two cases of gingival necrosis related to the use of arsenic trioxide paste, showing that it is still in use in certain parts of the world.
Also of incidental interest is that the 1936 Directory for Dresden, lists 153 dental practitioners under Zahnärzte/Zahnärztinnen and a further 238 under ‘Dentisten’. The Directory lists fifteen practising dentists with, like Dr Kunstmann, only a medical qualification, as well as three Dr. Phil., one Dr. Sci.n, one Dr. med. et dent., and one Dr. Phil. et med. dent.
There are a few references to other people’s dental problems. A friend Walter has a dental abscess in 1934 and a lady of 61 years has ‘ruined teeth’. Tooth extraction appears to be common. In 1942 Steinlitz has four front teeth taken out and in 1945 a young girl is ‘a little disfigured by missing front teeth‘. In parallel with this, as already noted, there was during the war a shortage of teeth for replacement. In 1945, teeth ‘are irreplaceable at the moment’. A final aside shows that dentists, at least Jewish dentists, were not a protected profession, as in 1945 Simon is called up for ‘outside duty work‘, i.e. manual labour.
Diaries and art
There are conflicting ideas on whether or not Klemperer intended to publish his diary or merely meant it as a source for a projected book Curriculum Vitae, which never appeared. We will never know the answer to this, but there is no question that it gives a personal, non-polemical account of his and his wife’s dental problems during the time of the Third Reich in Germany. Part of his account of their dental travails appears in an artwork by Monica Petzal, ‘Indelible Marks, the Dresden Project’. Monica Petzal is the granddaughter of Erich Max Isakowitz, the Klemperers’ dentist between 1934 and 1936, when he emigrated to England, and who, with his family, became personal friends of the Klemperers. The artwork consists of images and text, and the text contains those extracts from the diaries that relate to Isakowitz, both professionally and personally. There are other personal accounts of life in the Third Reich, such as that of the wife of a museum director who was dismissed for refusing to embrace National Socialism, What Hitler Did to Us, but this contains no mention even of dental check-ups, and a long article on the Diaries, although mentioning Klemperer’s heart problems, makes no mention of his and his wife’s visits to the dentist. Similarly, there is no mention of dentists or dentistry in a very detailed analysis of the Klemperer diaries which comments on Klemperer’s encounters with non-Jewish persons. This is not surprising as the Klemperers attended only Jewish dentists.
State of the nation’s teeth
It is probable, however, that the severe dental problems experienced at the time by the Klemperers were not specific to them. In 1937, over a quarter of a sample of 350 workers’ families in Germany used no toothpaste and only 30% of a sample of 8,000 Cologne health service patients enjoyed perfect dental health. And there was a wartime campaign centred on the dental health of boys aged fourteen to eighteen because tooth decay was adversely affecting the intake into the armed forces. Bad as this situation was, British dental health at the time was probably worse. 90% of male and 86% of female British army recruits required dental treatment on enlistment. 13% of the men had dentures and a further 10% needed them. Children were equally affected, with, in 1942, 98% of children leaving public elementary schools showing signs of dental caries, with 70% requiring treatment
Dental treatment fees
Finally, there is the question of the dentist’s fee. Klemperer, although never rich, was at least in comfortable circumstances until he was dismissed from his post. There were continuing financial exactions by the Nazi government, and these were more severe on Jews. Klemperer mentions the extra strain caused by dental charges a number of times. As early as 1934, he fears that Eva’s dental treatment ‘will cost hundreds [of Reichsmarks]’, and in 1935, Eva’s bridge work costs 600 marks, which Klemperer promises to pay at 50 marks a month. After further visits to Isakowitz, Klemperer is again worried about the bill. He is worried about the expense of having a resection in 1936. By 1937 they are seriously short of money and Klemperer complains of a dental bill of 74 marks. This comes at a time when a filling has fallen out and it had not even been paid for yet. Klemperer is again beset by the financial burden of the dental bills. As noted previously, he reports ‘a quite shameless bill from Dr Kunstmann‘ in June 1937.
That Klemperer, as a Jew, although converting, survived the war, and survived the destruction of Dresden by the Allies, was a result of the quick thinking and resolution of his first wife Eva (1882 -1951). The diaries survived the war and were published thanks to two other women. At great personal risk pages were kept by Annemarie Köhler (1893-1948), who was not Jewish, but would have been very likely to have been shot had the diaries been found in her possession. A doctor, her Practice was in Pirna, just far enough out of Dresden to have escaped the destruction of the city, and in 2012 a plaque in her honour was unveiled in the presence of the Mayor of Pirna. The other was Klemperer’s second wife, Hadwig, (1926-2010) who, together with Walter Nowojski, spent eight years deciphering and transcribing the journals and preparing them for their publication in 1995.
Overall, Klemperer shines a light on an aspect of life in the Third Reich that seems to have been overlooked in other accounts of the social history of the time. He was an intelligent observer, so his account, presenting the patient’s point of view, is the more valuable for it. It is probable that dental health in Germany at the time was no better or worse than in Britain, but it is not often that we have a patient’s view of the problems of dental health, its treatment and the associated financial consequences of having it seen to.
Acknowledgements: The kindness of Monica Petzal in providing the picture of her grandfather is gratefully acknowledged.
 Reiss, H., Victor Klemperer (1881-1960): Reflections on his ‘Third Reich’ Diaries. German Life and Letters 51: 1, 68-9, 1998
 Klemperer, V. I Shall Bear Witness 2000 Phoenix, London 1999, p. 59. Hereafter cited as Witness.
 Witness p. 71
 Witness pp. 123-4
 Witness p. 134
 Witness p. 135
 Witness p. 147
 Witness p. 148
 Witness p. 164
 Witness p. 168
 Monica Petzal, personal communication, May 2016
 Witness p. 188
 Witness p. 209
 Witness p. 182
 Witness p. 183
 Witness p. 185
 Witness p. 187
 Witness p. 218
 Witness p. 219
 Witness p. 279
 Witness p. 287
 Witness p. 290
 Witness p. 294
 Witness p. 389
 Witness p. 390
 Witness p. 520
 2000 Klemperer V., To the Bitter End, Phoenix, London, p. 96. Hereafter cited as Bitter End.
 Bitter End p. 48
 Bitter End p. 97
 Bitter End p. 146
 Bitter End p. 206
 Bitter End p. 208
 Bitter End pp. 225-6
 Bitter End p. 239
 Bitter End p. 241
 Klemperer, V., Ich will Zeugnis ablegen bis zum letzten. Tagebücher 1942-1945. Aufbau Verlag, Berlin 1995.
 Bitter End p. 286
 Bitter End p. 310
 Bitter End p. 341
 Bitter End p. 409
 Bitter End p. 458
 Witness p. 169
 Chen, G., Sung, Po-Ta. Gingival and localized alveolar bone necrosis related to the use of arsenic trioxide paste – Two case reports. J. Formosan Medical Association 2014; 113 187-190.
 Adressbuch der Landeshauptstadt Dresden, Freital, Radebeul, Vororte 1936. Section III pp 15/16 and 167/168
 Witness p. 113
 Witness p. 170
 Bitter End p. 203
 Bitter End p. 545
 Bitter End p. 545
 Bitter End p. 493
 Lips, E., What Hitler Did to Us, 1938, Michael Joseph, London
 Reiss, H., Victor Klemperer (1881-1960): Reflections on his ‘Third Reich’ Diaries. German Life and Letters 51: 1, 65-92, 1998.
 Baker R.L. Relations between Jewish and non-Jewish historians 1933-1945: A case study in the use of evidence by historians. M.A. Thesis, University of Canterbury 2009
 Grunberger, R. A Social History of the Third Reich, 1974 Penguin Books: Harmondsworth, p. 290
 Grunberger, R. p. 295
 Zamet J.S. Aliens or colleagues? Refugees from Nazi oppression 1933-1941, British Dental Journal 2006, 397-407, 2006, p. 403.
 Witness pp. 123-4
 Witness p.135
 Witness p. 145
 Witness p. 185
 Witness p. 260
 Witness p. 279
 For example, there is no reference to dentists or dentistry in, The Social History of the Third Reich 1933-1945, Pierre Ayçoberry, 1999, The New Press, New York, The German Bourgeoisie. Eds. D. Blackbourn, R.J.Evans 1991, Routledge, London and New York, Encyclopedia of the Third Reich, Louis L. Snyder, 1976, Robert Hale, London, A Dictionary of the Third Reich, James Taylor, Warren Shaw, 1987 Grafton Books, London.
Jerry O’Sullivan qualified in medicine from the University of Glasgow in 1966 and became Consultant Histopathologist and Cytopathologist at St Richard’s Hospital, Chichester. He has an MA in Victorian Studies from Birkbeck.
Malcolm Bishop BDS LDS MSc, a member of the Unit for the History of Dentistry, King’s College London Dental Institute, qualified from Guy’s in 1968, and has retired as a general dental practitioner and part-time lecturer in dental radiology. His essay writing has covered subjects ranging from dental history to sundials.