Nowadays, anyone can buy a title on the Internet. Aparently, it helps convince people that a royal dentist (in this example) is better than a commoner.
 This might be a good occasion to note that Nobility communicates within its circles differently than it does with commoners.
A person of Nobility would be approached by a commoner as, for example 'Von' (in Germany) or 'de' (in France), but when addressing each other, the Nobiliary particle would be omitted.
I once saw a 'Von' handing out his visit card to another 'Von' and striking out the 'Von' from his visit card.
We can see in this exchange between the Emperor and his Empress, that the same etiquette was also practiced in Lilliput, 300 years ago.