Early struggles to identify ethical standards in dentistry: Dr. Benjamin Brown and the amalgam war of the 1840s

Dr. Benjamin Boyer Brown was one of the leading physicians and dentists in St. Louis during the 1830s and 1840s as well as one of its most esteemed citizens for his charitable and educational works. He was also one of the founders of organized dentistry, first editor of the Dental Register of the West, as well as a respected researcher and educator in dentistry, and a member of the American Society of Dental Surgery, a forerunner of the American Dental Association. This society, declared the use of amalgam to be not only unethical but malpractice, and members were forced to sign a pledge not to use it. Although many dentists opposed this decision and ignored the pledge altogether, Dr. Brown was morally unwilling to remain quiet. He vocally opposed the decision of his colleagues to ban amalgam on ethical grounds. In spite of his appeal for reason and his high profile, he was one of the few dentists to be expelled from organized dentistry. He moved to California during the height of the gold rush to begin a new life. Dr. Brown's experience illustrates several issues in dental ethics that remain with us today.