There was a time that teenagers and adults alike trembled at the thought of having to get braces. The minute a dentist recommended seeing an orthodontist, the words “metal mouth”, “tin teeth” and other unattractive adjectives ran through people‘s heads. Boy, have times changed. Today, with the new technologies available, people of all ages are choosing orthodontic treatment to achieve a beautiful, healthy smile. Family Braces invisalign
An Overview of Modern-Day Braces
Orthodontic treatment used to be considered “cosmetic”, but today, dentists and patients alike realize that orthodontic treatment may be a necessity. Correcting misaligned teeth can often prevent a lifetime of periodontal problems and severe tooth wear, and even premature tooth loss!
Generally, orthodontic evaluations are done on all children around the ages of 6-10 years old. By the time most children are 12-years-old, they have all of their permanent teeth and are able to receive orthodontic treatment. Many older patients now are seeking orthodontic treatment to correct their misaligned teeth, but don‘t want to go through traditional wires and brackets; hence the introduction of clear aligners.
Braces leverage the basic principles of engineering. Constant, mild pressure in the direction of desired movement will allow for an overall change in tooth position. As pressure is applied to the periodontal ligament, which holds the teeth in place, the body will automatically create room in the desired new location while also filling in the space where the teeth used to be located. If too much force is applied at once or in a short period of time, tooth loss is possible. This is the reason for the need for small changes to be made every 30 or so days for the duration of treatment. To be sure, teeth movement by way of orthodontic treatment must be constantly monitored and adjusted. While every patient is different, movement of 1 mm per month is usually possible with orthodontic care.
Traditional braces are generally worn for two to two-and-a-half years, depending on the extent of orthodontic treatment needed. When a lot of movement is needed, a longer duration of care may be necessary. Conversely, small amount of movement of the dentition will require a shorter period of time.
Since braces require regular adjustment (in addition to the initial application), the cost of orthodontic treatment is somewhat higher than many simple dental procedures. Traditional braces will cost anywhere between three and six thousand dollars in the United States. While insurance coverage of orthodontic coverage was a rarity years ago and is still not included in many policies, some insurance companies do pay a portion of orthodontic care.
Before Braces Were Known as Braces
Orthodontic braces weren‘t invented until the early 1800s, but people‘s preoccupation with straight teeth, and/or proper jaw alignment dates back to the time of the ancient Egyptians. The methods of teeth straightening varied from culture to culture, but the intent was clear — people wanted straight teeth for a perfect smile. Exploring the history of orthodontic braces can not only relieve some of the fear and emotions surrounding this sometimes intimidating dental device, but it can also be interesting to see just how braces have progressed and improved over the years.
Braces-Like Appliances for Egyptian Mummies
Archaeologists discovered many mummified remains in and around Egypt, with what researchers believe could have been an early attempt to close gaps in teeth. These remains have a cord made from animal intestines (known as catgut) wrapped or run along the teeth in a very similar style to how modern orthodontists run orthodontic wire along the teeth in an effort to close off gaps.
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Etruscan Dental Devices for the Afterlife
According to the American Association of Orthodontists [AAO], archaeologists discovered Greek and Etruscan dental appliances (the first known “bridge”) that indicate humans began practicing orthodontics as early as 1000 B.C.
The Etruscans lived in and around Italy sometime between 770 BC and 270 BC, and were the predecessors to the ancient Romans. Etruscans had extensive burial rituals that involved preparing the body for the afterlife, before burying it in a tomb.
Archaeologists discovered that part of the burial ritual included the placement of a device that was similar to a mouth guard into the deceased’s mouth. This was done to preserve the spacing and to prevent an inward collapse of the teeth, so the deceased looked good when they entered the afterlife. The bridges were made from pure gold excavated from the ancient site of Satricum in central Italy. A significant discovery is that the Etruscan bridges were worn only by women, hinting that cosmetics and vanity were important dental concerns.
Image Courtesy of Wikimedia Commons
Use of Finger Pressure by an Ancient Roman Encyclopaedist
Aulus Cornelius Celsus was an ancient Roman who dedicated his life to studying and discovering new medical procedures. Celsus kept detailed accounts of his work, and holds the first recorded attempt to straighten or move teeth by use of finger pressure. Celsus documented a case that involved applying finger pressure to the teeth at regular intervals. Through detailed notes and recordings it was hypothesized by Celsus that the teeth were slowly moving and realigning themselves due to the extended exposure to the finger pressure.
Early Roman Attempts at Braces
Romans invented a dental device resembling modern orthodontic dental devices. Many Roman tombs were opened up by archaeologists only to discover that some teeth of the deceased had a small gold wire, known as a ligature wire, that was used to affix the arch wire to the bracket. The wire was bound to the teeth in an effort to force the teeth to move and close off noticeable gaps. Although there is no date documented, this process was most likely before the start of our era.
Image Courtesy of Wikimedia Commons
The Dawning of Braces in Dental Research
Before dental braces could be introduced to the general public, extensive medical and dental research needed to be conducted. Dental braces and the concept of orthodontic braces started to appear in medical journals and books around 1770.
“The Surgeon Dentist”
The Surgeon Dentist is a medical book published in 1728 by Pierre Fauchard. Fauchard was a French dental surgeon notorious for his out of the box approach to dentistry. The Surgeon Dentist documented numerous general dentistry topics, but what made the book stand out in the world was a particular chapter devoted to orthodontics. The chapter explored various ways to straighten teeth, but focused mostly on a relatively new concept involving the “Bandeau.” The “Bandeau” is a dental device that looks like a horseshoe. This device was inserted into a patient‘s mouth to keep the natural arch of the teeth and mouth in place.
“The Dentist‘s Art”
The Dentist‘s Art is a medical book penned in 1757 by the dentist to the King of France. Pierre Bourdet dedicated a section of the book to exploring various methods that could be used to improve tooth alignment. Two medical theories were monumental in The Dentist”s Art. The first monumental discovery was the theory that teeth in the back of the mouth (wisdom teeth) could be extracted to prevent overcrowding, which was the leading cause of tooth misalignment. The second discovery was the improvement of the “Bandeu” device. Pierre Bourdet wrote extensively on how the device could be improved from its original concept.
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