NEVERS, France (AFP) – A Dutchman dubbed the “dentist of horror” by French media went on trial yesterday after allegedly causing horrific injuries to the mouths of more than 100 patients in France.

Jacobus van Nierop, 51, ripped out healthy teeth and left dozens of patients in the rural central village of Chateau-Chinon with broken jaws, recurrent abscesses and septicaemia.

He is charged with aggravated assault, as well as fraud over claims that he tried to rip off patients and insurance companies, and faces up to 10 years in prison and a US$165,000 fine if found guilty.

Although he is not required to offer a plea under French law, Van Nierop has previously sought to deflect responsibility, saying he suffers from “psychological problems” including gender identity issues and suicidal tendencies.

The court in Nevers, in central France, heard conflicting evidence about Van Nierop’s psychological state.

One psychiatrist found he had “narcissistic tendencies” and had therefore been unable to make a moral judgement of his own actions.

But another found that the Dutchman was “perfectly aware of what he was doing”, according to statements read to the court.

Van Nierop himself told the court: “I was not in the right state to put myself in my patients’ position”.

Van Nierop, who went by the first name of Mark, was hired by a head-hunter and was initially welcomed by locals in the area which was sorely lacking in medical services.

A neighbour recalled the arrival of a smiley, larger-than-life character, with a “big 4×4, a big dog, a big cigar”.

But by 2011, the authorities were starting to question some of his accounting practices, and patients were starting to compare notes on his dentistry.

Sylviane Boulesteix, 65, visited Van Nierop in March 2012 to have braces fitted.

“He gave me seven or eight injections, and pulled out eight teeth in one go. I was gushing blood for three days,” she said.

An 80-year-old patient, Bernard Hugon, said the dentist left “pieces of flesh hanging everywhere” after tearing out a tooth.

“Every time, he would give us what he called ‘a little prick’ and we were asleep, knocked out,” said Nicole Martin, a retired teacher who lost several teeth to abscesses caused by the horrific operations.

“When it was over, we would find a Post-it note saying to come back for an appointment the next day or the day after,” she added.

With the help of one of Van Nierop’s assistants, Martin set up a victims’ group in early 2013 to press charges, and it soon swelled to 120 members.

In June of that year, police arrested Van Nierop but left him free pending trial, and he fled the country the following December.

He was eventually tracked down to a small Canadian town in New Brunswick and arrested under an international warrant in September 2014.

Local media reported that he tried to slit his throat when police came for him.

Van Nierop tried to block his extradition first to the Netherlands and then France on psychological grounds, but was eventually placed in a prison psychiatric unit south of Paris.

“He claimed to have killed his first wife, he acted crazy, he said he was transsexual. He tried everything” to avoid extradition, Martin said.

According to Dutch media, Van Nierop had already come under investigation in the Netherlands over his working practices before coming to France.