Dr. Golden's Blog

History of Orthodontics Part VI

Whether you want or need braces, had braces in the past, or are looking to get braces for your child, it will amaze you how much braces have advanced in the last hundred years. Today’s braces are light-years more affordable, comfortable, effective, efficient, and aesthetically pleasing than braces of the past. Today’s braces aren’t just the best, our braces are a breeze.

You see, the great thing about history is that it helps us understand the world we live in today and, in doing so, let us reflect on how far we’ve come and how good we have it.

Blaise Pascal famously wrote, “Cleopatra’s nose, had it been shorter, the whole face of the world would have been changed.” (In her day, long, aquiline noses were considered the most beautiful.) Pascal never wrote anything about Cleopatra’s teeth, but they probably weren’t as nice as yours. I hate to burst your bubble, but Cleopatra, along with every other famous historical person, probably had much more crooked teeth than Hollywood would have us believe.

That’s because, even though Egyptian mummies have been found with metal bands wrapped around their teeth (as you may remember from Part I), a human couldn’t find an orthodontist and get a real set of braces until about 100 years ago.

For the majority of the last century, orthodontists used metals to make loops, hooks, ligatures and spurs to make braces. A large metal band was wrapped around each individual tooth, covering most of the tooth. Before they switched to stainless steel in the 1950s, most orthodontists preferred using gold because of its malleability. But, lest you start pining for the bling of yesteryear, gold had two big drawbacks: 1) Because it’s soft, it needed to be readjusted quite frequently; and 2) gold was even more expensive then than it is today.

It wasn’t until the mid-‘70s, when Woody Hayes was busy leading my Buckeyes to Big Ten Championships here in Columbus, orthodontists’ braces could finally be attached to the front of the teeth with brackets.

Not having a metal band wrapped around each tooth was huge step forward. At long last, people could get their teeth straightened and their smiles perfected without fairly being called a “metal mouth.” But the new brackets, though small in comparison to their predecessor, were still stainless steel and thus still, well… visible.

So the task was set: How and where can we find invisible braces? Interestingly enough, in 1975, the next innovation was developed independently by two orthodontists living half a world apart, one in the U.S. and the other in Japan.

Their great invention? Lingual braces, which attach to the teeth on the inside of the mouth. Lingual braces didn’t catch on immediately, but advancements in digital imaging have made them much more comfortable and they are now in widespread use.

The next advancement in the quest for invisible braces came in the 1980s. Ceramic braces, with brackets made from a mix of ceramic and metal, were as strong as their metal counterpart, but less noticeable. While we now offer a variety of colored braces, tooth-colored braces are the most popular.

Will we ever find invisible braces, that Holy Grail of Orthodontia? Find out next time in the final installment of The History of Orthodontics.

History of Orthodontics Part V

Congratulations, fellow traveler. We’ve arrived safely in the 20th Century. That's no small feat, considering that so far the treatment options for tooth problems have been either: 1) death, or 2) ripped out with pliers at the barber shop. We now have proper dentists, and a good number of them specialize in orthodontics.

So why, you’re surely wondering, do so many people still have crooked teeth in the early 1900s? We’ve been building braces piece by piece over the last 150 years, from Fauchard’s Bandeua to the Baker Anchorage. These people can finally get braces, so why won’t they find the local orthodontist and invest in the perfect, healthy smiles that await them?

The answer: There probably isn’t a local orthodontist to find. They might be able to find a local dentist who has taken classes or attended lectures on orthodontics, but at the turn of the century, there’s no such thing as an “orthodontist.” That’s all about to change, due to the indefatigable determination of one man.

It’s 1900, and Edward H. Angle, 45, is about to quit his job. He’s already the nation’s expert on all things orthodontia. He coined the term “malocclusion” (the improper alignment of teeth) and created a classification system for malocclusions that is used around the country. He’s been professor of orthodontics at several schools. (Unfortunately for Columbus, The Ohio State University, my beloved alma mater, won’t open its College of Dentistry for another fourteen years).

Angle has been teaching orthodontics to dentists who want to specialize in it. But he knows that orthodontics has the potential to change millions of lives if his students could focus their entire profession on practicing it. This year, he will open the Angle School of Orthodontia and formally establish orthodontics as a specialty. Also, just for good measure, he’ll found the American Society of Orthodontics. It will become the American Association of Orthodontics, the world’s largest dental specialty organization.

Flash forward to the Roaring Twenties. A dapper chap can pick up his honey pie in his automobile and take her to the picture show, where the electric lights dim before they watch “The Jazz Singer.” America is flying forward faster than one of the Wright brothers’ planes. So too is Angle’s vision of orthodontics. Over the years, Angle has opened more schools, written more books and invented more appliances. As he enjoys retirement in California, orthodontists all over the country are practicing what has become its own, distinct specialty.

Now flash forward to 2014, Columbus, OH. Orthodontist Cheryl Golden, a member of the American Association of Orthodontics, is giving a free consultation to a child who needs braces. She is using the most advanced technology, but at a fundamental level, her work is based on ideas first taught at the Angle School of Orthodontia. She loves her profession and is mighty glad Edward Angle had the vision and tenacity to establish it.

Next time, we’ll find out how braces developed from a clunky mouth of metal to the sleek and easy treatment of today.

History of Orthodontics Part IV

So far, we’ve covered the major precursors to modern orthodontics. We’ve traveled through vast spans of time and have come to the most exciting part: The Father of Modern Orthodontics. (Though the French revolution was pretty exciting, depending on which side you were on.) I’d like to be able to say, “On this date, Dadd E. O’Rthontics slapped a proper pair of braces on a child, called it ‘orthodontics,’ and the world was forever changed.” Alas, it’s not that simple.

*Before I continue, I should note that there could not have been a “Mother of Orthodontics,” as women were not allowed to practice medicine at the time. This is a tragedy because, as our patients can attest, women make some of the best orthodontists.*

You see, there is quite a bit of debate over who deserves the title “Father of Orthodontics.” Some argue that Christophe-François Delabarre wins the honor for introducing the wire crib, a wire placed directly on the teeth, which was probably the first piece of what we would call “modern day” orthodontics. Others vote for Edward Maynard, the first to use gum elastics to correct improper alignment, or Henry Baker, who combined the methods of his predecessors into what he (so humbly) called the “Baker anchorage.”

But these men, crucial as they were, still belong in the precursor category. In my book, Norman W. Kingsley gets the nod, for the same reason I called Fauchard the Father of Modern Dentistry in Part III. To explain what I mean, we need to take a trip to the barber shop. In my time machine.

As recently as 250 years ago, if you had a tooth problem, you went to the barber. “Physicians” throughout the Middle Ages were educated by and involved with the church, most often as monks, and were banned from getting their hands and/or souls dirty with the bloody work of practicing medicine. Their work was relegated to that most enduring, cushiest of jobs – making recommendations.

So, every task that involved cutting some part of a person fell to the barbers. Besides trimming bangs, they performed surgeries of all kinds, administered bleedings (you know, the semi-annual bloodletting to get rid of the blood that’s gone bad from demons or something), and pulled teeth. Not to bleed a dead horse, but it was a very bloody business. The charming candy-striped pole in front of the local barber shop is a curiously morbid remnant of this history: Red for blood, white for gauze.

In general, barbers stopped pulling teeth in the mid-18th century. That’s because dentistry had become a specialty (though it’s now considered a branch of medicine), and its practitioners studied and employed treatments beyond the barbers’ let’s-yank-the-sucker-out approach. Important ideas in dentistry had been percolating for more than a century, but Fauchard’s 1721 book made it a specialty. By collecting those ideas and synthesizing them into basic, consistent principles, he fundamentally changed the approach to treatment in a way no individual invention ever could.

Kingsley did the same thing for orthodontics by writing several books on the subject, most notably his “Treatise on Oral Deformities,” the first standard orthodontics textbook. Kingsley’s work is seminal to the profession I love, so I have to support the assertion made in this 1908 article about him:

“Without doubt, he is the Father of Modern Orthodontia. It was Kingsley who first gathered, in the early day, the then scattered knowledge of that subject, and gave us the first book on Orthodontia ever published.”

(1908 was not just a great year for articles about “Modern Orthodontia,” it was a great year for the planet. It was, of course, the year that the shining city of Bexley, OH, was founded!)

And if somehow you’re still not convinced, get this: Kingsley was also a sculptor and a painter, except instead of using paint, he recreated Rembrandts in sepia by blowing fire through a glass pipe. He called it “flame painting.”

Next time, we’ll meet runner-up for “coolest orthodontist ever” and learn how today’s braces came to be.