Straight From History To The Future Of Orthodontics
Straight From History To The Future Of Orthodontics
Neither an overbite, an underbite, nor having crooked, crowded, or gapped teeth are new in human development. The endeavour to have straight teeth has gone on forever.
Well, maybe not forever.
Anthropologist Professor Ron Pinhasi alerted us to the shrinking of the human mouth in 2015; rather differently to the 55-second silent film of Georges Méliès in 1901, or the idea Richard Matheson had for his 1957 novel.
When our ancestors ceased a nomadic life of hunting and gathering to practice agriculture and cook softer foods, it precipitated a biological evolutionary change we’ve been chewing over for the last 10,000 years.
Because that’s essentially what we stopped doing.
And it had started earlier than that.
The advent of stone tools happened more than 3 million years ago, and with it the ability to cut smaller pieces of meat. It allowed for a more carnivorous diet; one that required less chewing for greater nutritional value.
No longer was there the need for broader, more powerful jaws.
The maxilla (upper jaw), is not simply the base of the skull, it’s actually the fusion of two bones, one on each side.
Likewise, the mandible (lower jaw) is the fusion of two bones.
Both jaws can move and change during the process of merging. When it all develops correctly, there is ample room for 32 teeth, and they align well, both top and bottom. It is the physical exertion, pressure and stamina of biting, tearing and chewing that maintains the proper structure of the jaw.
It was the shift from foraging to farming that accelerated craniofacial change.
What didn’t change was the number of teeth; what did, is the space in the jaw for them to fit.
Malocclusion – the misalignment of teeth, and the most common reason for orthodontic intervention – is not because there are too many teeth, but because evolution shortened and narrowed the jawline.
Thankfully, that same evolution gave us a bigger brain; and with it, sharpened creative and problem-solving abilities.
So we started coming up with ways to correct the bite that was biting us.
Egyptian mummies have been discovered with gold wires and catgut wrapped around their teeth in an attempt to rearrange dental disorder.
Around 1000BC the Etruscans, wanting to ensure beauty in the afterlife, formed a type of mouth guard made of gold as protection against teeth falling out after death.
Clearly you can’t be a scrummy plummy mummy if you’re gummy.
400 BC had Hippocrates taking reed pen to papyrus to document his observations and treatments for misaligned jaws and teeth.
Roman medical encyclopaedist of “De Medicina”, Aulus Cornelius Celsus (c.25BC-50BC), recorded his findings when he applied consistent, gentle finger pressure to a tooth he wanted to move.
Assuming he would’ve used his middle finger for the job because it’s the longest and strongest, there’s delicious irony to ‘digitus impudicus’ if in fact it didn’t work.
It took until the early 1700s for anything much to happen after that.
It was then that French dentist Pierre Fauchard wrote “The Surgeon Dentist” in which he described his teeth-straightening procedures, along with the use of his “Bandeau”. It was a horseshoe-shaped oral insert; made of gold and attached with fine wire to help expand the palate in order to straighten the teeth.
It marked the beginning of modern orthodontics.
Thirty years later in 1757 and still in gay Paree, dentist to the King of France Ettienne Bourdet, published “The Dentist’s Art”. He too, devoted an entire chapter to newly devised techniques and appliances to align teeth.
Not only did Bourdet further perfect the Bandeau, he was the first dentist to scientifically prove jaw growth, and recommend premolar extraction to alleviate crowding.
Vive la France and God Bless America when in 1819, Christophe-Francois Delabarre devised the placement of a ‘crib’ over a set of two teeth, before moving to the US. It was the instigation of a method of orthodontic braces that remains to this today.
And if you thought tyres had nothing to do with teeth, it was Charles Goodyear who vulcanised the rubber that made elastic bands – one of its thousand uses being in orthodontry.
In the 1950s dentistry was generally uncomfortable and braces were less popular than McCarthyism.
It wasn’t until the ‘70s that less trauma, more stainless steel and the marvel of dental grade cements innovated better techniques, lingual braces and cost-effective change.
Since then, technology has brought astounding materials, equipment, techniques and precision to the art of orthodontics.
Invisalign happened, and it wasn’t even a dental student who developed it.
Zia Chishti was simply a Stanford graduate who had stopped using his retainer, and noticed his teeth were moving back to the original position that needed correcting in the first place.
Maybe his orthodontist was a dud; maybe Chishti didn’t do the things he was supposed to. Either way, necessity is the motherlode of invention and invisible aligners are undoubtedly that.
That thermoplastic polymer it’s made of? NASA developed it. Translucent ceramic? Ditto. As well as the nickel-titanium alloy wire orthodontists use. It’s heat reactive material originally developed as a for solar panels and satellite antennae.
Puts a whole new slant on having space between your teeth.
So where to from now? The future’s so bright you gotta wear shades.
Contemporary orthodontics has age as no barrier. No longer is it necessary to have had adjustments as a teen.
Exponential advances in technology are streamlining and exacting orthodontics from diagnosis to device design.
Treatments are easier and less invasive; outcome timelines shortened.
Virtual monitoring and online appointments are commonplace. Less time in the chair, along with updated manufacturing processes reduces the cost.
Robotics, biotechnology and nanotechnology offer the possibility and probability of future orthodontic treatment options we can barely imagine.
What’s certain is that it will be the merging of hardware and human happiness.
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