How have orthodontic treatments changed over the years?

Just like mobile phones, braces, aligners, and other orthodontic treatments are pretty modern, right? 

While the treatments performed by orthodontists in London now will be quite different, most people are shocked to realise that orthodontic treatment and tooth straightening has in fact been in practice for thousands of years. 

So, how has orthodontist treatment changed over the years?

Ancient civilisations and their orthodontic treatments

Although it sounds far-fetched, orthodontic treatment has been found on human remains going back as far as the Ancient Egyptians. 

The Egyptians – 3,100- 332 BC 

Egyptian mummies have been found with metal posts and catgut* cords that acted as a kind of archwire now found in modern braces. 

Interestingly, archaeologists believe that braces were often applied to the dead rather than the living because of the importance of the afterlife within Egyptian culture and belief systems. 

*Catgut is a delightfully named material made from the intestines of sheep or horses. 

The Ancient Greeks – 2,500- 1,200 BC

Archaeologists have found several inhabitants of tombs with metallic bands wrapped around their teeth. 

These bands featured tiny holes and were tied with strings made from plant matter. These strings were then woven through the bands through the tiny holes, allowing for the rectification of tooth position. 

The Etruscans – 800- 300 BC

The Etruscans used devices made of gold, similar in style to modern mouthguards, to stop the facial collapse in their deceased women. 

These devices also preserved the spacing between the teeth, ensuring females would keep their smile long into the afterlife.

The Ancient Romans – 625 BC to 476 AD

Startlingly similar to modern braces, the Ancient Romans constructed orthodontal devices akin to those used by the Ancient Greeks. 

Instead of using plant matter to form strings, however, the Romans used metal wires, creating early archwires as we would know them now. 

Modern civilisations and their orthodontic treatments

Much more akin to the treatment we see carried out by orthodontists in London today than we might think, the orthodontic advancements from the 18th and 19th centuries directly influenced the dental treatments we receive today. 

18th-century advancements

The most famous of orthodontic advancements in the 18th century centred around four gentlemen: Matthaeus Gottfried Purmann, Phillip Pfaff,Pierre Fauchard, and Pierre Bourdet.

Matthaeus Gottfried Purmann pioneered the use of wax impressions at the beginning of the century, while Phillip Pfaff used beeswax to take impressions and made cast models of the teeth with the newly discovered plaster of Paris. 

These practices allowed dentists to see the size and relationship of the teeth and gums, as well as understand how your dental arches fit together. This information is necessary for the use of a wide range of treatments and most importantly, oral appliances. 

The largest advancement, however, came from the French physician Pierre Fauchard. Considered the father of modern dentistry, Fauchard invented an appliance designed to straighten teeth called the bandeau. 

The bandeau was a horseshoe-shaped piece of metal that was fitted around the teeth to expand the arch and correct alignment. To allow the teeth time to heal, dentists would then tie the moving teeth to their neighbours. 

Fauchard is also credited with the invention of other dental tools and instruments that allowed for much more precise treatment. These instruments include: 

• Needle-nose pliers for prosthodontics (prosthetics)
• Tooth files
• Pelican forceps for extracting teeth
• Dental fillings to treat cavities, using amalgams such as lead, tin, and sometimes gold*

*It should be mentioned that Italian professor of medicine and surgery, Johannes Arculanus, suggested this in the 15th century. 

Following and expanding on Fauchard’s earlier work, Pierre Bourdet, who was the dentist to the King of France, then published his book on dentistry which suggested that wisdom teeth in the back of the mouth could be extracted to prevent overcrowding. 

This was, and still is, a leading cause of misaligned teeth. 

As such, modern orthodontists in London owe a lot to Purmann, Pfaff, Fauchard, and Bourdet. Without these men, it is incredibly likely that the advancement of orthodontics would likely have been much harder, and progress far slower.

19th-century advancements 

Building on the advancements made in the previous century, 19th-century orthodontics became much more similar to the practice we are familiar with now. This was achieved thanks to key players such as Christophe-Francois Delabarre, J.S. Gunnell, Dr Edward Maynor, E.J. Tucker, and Dr Henry A. Baker. 

Early in the 19th century, the first modern brace, the wire crib, was created by Christophe-Francois Delabarre.

The woven crib was fitted over the upper and lower teeth in pairs and was worn for an extended period to straighten problematic alignment. 

Shortly after, J.S. Gunnell invented occipital anchorage, a form of headgear that fastens to the jaw from outside the mouth to exert gentle pressure on the teeth- think of Darla from Finding Nemo.

Dr Edward Maynor then furthered the technology of tooth movement by introducing gum elastics to help with jaw alignment. This process was quickly refined by E.J. Tucker, who changed gum elastics to small bands cut from rubber tubing that fit much more comfortably. 

Near the end of the 19th century, Dr Henry A. Baker introduced the Baker anchorage. This unified orthodontic treatment combined parts of the wire crib and rubber elastics, giving orthodontists the ability to straighten teeth without removing teeth needlessly- a common practice during straightening procedures of the time. 

20th-century advancements 

Straddling the 19th and stepping into the 20th century, the father of modern orthodontics, Edward Hartley Angle, nicknamed Hart or Hartley, entered. 

Hartley’s impact in the field of orthodontics is hard to ignore, and he:

• Developed the malocclusion classification, called the Angle Classification, which is still in use today.
• Created and improved orthodontic appliances, many of which are still in use in some form or another in our time.
• Designed and ran a postgraduate course to study the science of orthodontics.
• Established the American Society of Orthodontia and founded the first academic journal of orthodontics in 1907.

Also in the 20th century was a series of important material changes that had a far-reaching influence on the practice of modern orthodontists in London. These include:

• Using stainless steel instead of high-carat gold and silver, for wires, clasps, ligatures, and spurs made brace treatments more affordable.
• The introduction of dental adhesives meant that brackets could be stuck to the tooth’s surfaces instead of winding wires around each tooth, lessening pain and dental damage. 
• Self-ligating brackets which can ease discomfort associated with traditional braces, speed up orthodontist appointments, and are easier to keep clean. 
• Adding nickel-titanium to orthodontic wires, named Nitinol, as they have shape memory and super- elasticity- helping to move teeth more quickly. 
• Clear plastic or porcelain brackets have also helped to make brace treatments much more discreet.

It was also discovered that securing brackets and wires to the backs of the teeth instead of the front achieved the same results, creating more discreet, more comfortable orthodontic solutions. This led to the introduction of invisible teeth realignment, of the most popular forms of orthodontics used by orthodontists in London now- not to be confused with aligner-based treatments. 

Clear plastic aligner treatments, such as those used in Invisalign, also arrived towards the end of the 20th century, which now allow for easy, fast, ‘invisible’ treatment without the need for any wires and brackets. 

The future of orthodontics

It’s unarguable that the advances from the 18th century onwards have vastly influenced the science and field of orthodontics to date. 

As such, the possible future of orthodontics is potentially limitless. 

To see how orthodontists in London are using thoroughly modern orthodontic methods and materials to renovate smiles across the capital, contact The London Centre for Cosmetic Dentistry. 

With a passion for bright smiles and healthy teeth, we can help you create the smile of your dreams. 

For more advice about orthodontists in London, you can call us to speak to one of our friendly team, or fill in our enquiry form and we’ll be in touch as soon as we can to get your treatment journey underway.