Speaker 1: Welcome to Stuff you Should Know, a production of iHeartRadio.
Speaker 2: Hey, and welcome to the podcast. I'm Josh and there's Chuck.
Speaker 2: Jerry's here too, and we're just sitting around cutting the
Speaker 2: insides of our mouths up here on stuff you should know.
Speaker 1: Yeah, the history of orthodonture, which if I had been
Speaker 1: using my brain, would have paired this with the history
Speaker 1: of dentistry, because that's, you know, kind of makes sense.
Speaker 2: Sure, I feel like we would have had seen a
Speaker 2: real decline in listenership that week, but you know, you
Speaker 2: think so, No, just kidding, just being a punk. I
Speaker 2: remember our dentistry one was amazing.
Speaker 1: Well, and I think I don't know. I think people
Speaker 1: are interested in their.
Speaker 2: Bodies, especially when you say like that.
Speaker 1: Yeah, and then teeth and stuff, because we all have teeth,
Speaker 1: and it's interesting that bad you know, teeth, I say
Speaker 1: bad teeth. I have bad teeth, but what I mean
Speaker 1: by bad teeth is teeth that grow in in funky ways.
Speaker 1: But I'd like to kind of break that cycle as
Speaker 1: well of kind of talking about it like that, because
Speaker 1: even though I have gotten my teeth fixed, it's just
Speaker 1: because they were falling out of my head. It's not
Speaker 1: because I wanted perfect white chicklets in my mouth. And
Speaker 1: I think there's a big trend that we've seen over
Speaker 1: the past, you know, twenty years, and really I feel
Speaker 1: like even the last ten years where Hollywood, especially people
Speaker 1: in the media all have perfect, perfect, perfect teeth, and
Speaker 1: you don't have to have perfect teeth. I like teeth
Speaker 1: with a little personality. I like summer teeth.
Speaker 2: Yeah, I can't remember what they're what kind of teeth?
Speaker 1: Summer summer teeth.
Speaker 2: I've not heard that.
Speaker 1: You never heard that? Praise?
Speaker 2: No, what does it mean?
Speaker 1: Summer teeth? Summer here? Some are there?
Speaker 2: Oh, that's awesome, man, I love that. That's like a
Speaker 2: what kind of dog is that? Sooner? Sooner? One kind
Speaker 2: is another?
Speaker 1: Yeah, exactly.
Speaker 2: Yeah. They're in Japan. They have a name for like
Speaker 2: a wonky tooth. Usually it's one of your canines and
Speaker 2: it'll be like kind of pressed out or crooked or
Speaker 2: something like that. You may have one, but there's a
Speaker 2: term for it, and it's like basically a term of endearment.
Speaker 2: They just find that very cute. Here in the US,
Speaker 2: it'd be like we you would be put in some
Speaker 2: sort of like home or asylum for that yeah.
Speaker 1: I mean you get as an actor, you get news
Speaker 1: articles written about you when you don't get your thing fixed.
Speaker 1: That's how commonplace it is to just you know, the
Speaker 1: expectation to look perfect, right.
Speaker 2: And that's a big criticism of the entire field of
Speaker 2: orthodonics is, you know, they might not be the ones
Speaker 2: out there like, you know, pumping the media up like yeah,
Speaker 2: keep talking about how great teeth are supposed to be.
Speaker 2: But they're the ones who are there like, hey, come
Speaker 2: on over, we're going to fix you up. Tough to
Speaker 2: blame them for that, but the criticism goes even further
Speaker 2: because the feel of orthodonics is like, forget about all that,
Speaker 2: we're actually helping cure health issues, right, And critics of
Speaker 2: the field are like, it's not even established that there
Speaker 2: are health issues from having wonky teeth, so you guys
Speaker 2: should probably stop saying all that. In the field of
Speaker 2: orthodonic said no, yeah, I.
Speaker 1: Mean, for sure there can be health issues. We're not
Speaker 1: saying that's not possible. But I feel like it's almost
Speaker 1: a given now, especially now that I have a human
Speaker 1: child that like, yeah, you absolutely get bracest. That's just
Speaker 1: what happens. You go to the dentist. Really around six
Speaker 1: or seven years old, they say, all right, you need
Speaker 1: to go to your orthodonos.
Speaker 2: Now, I did not know that that that was not
Speaker 2: the way it was when we were young.
Speaker 1: No, I mean I had braces twice, did you. Yeah,
Speaker 1: but you know I've got bad bite. I have a
Speaker 1: host of problems. But yeah, let's dive into it, because
Speaker 1: this is not a new thing. People have always had
Speaker 1: wonky teeth. And the reason is because we have the
Speaker 1: same amount of teeth in our head that we did
Speaker 1: when we were still, you know, walking on all fours,
Speaker 1: and we began to walk upright, and the size of
Speaker 1: our our brain changed, and that meant the size of
Speaker 1: our jaw got smaller to make room for our bigger brain.
Speaker 1: It's not like they were like, all right, they whoever
Speaker 1: decides this, you know, the panel God. It's not like
Speaker 1: the god panel said all right, let's take out five
Speaker 1: or six teeth because we don't have room for him. Now.
Speaker 1: They were the same amount of teeth with less space
Speaker 1: to put them, and that's why they started coming in
Speaker 1: in all crazy ways.
Speaker 2: Yeah, just give it another one hundred thousand years, chuck,
Speaker 2: it'll work.
Speaker 1: Itself out exactly.
Speaker 2: Even more recent than that, the teeth were Orthodonics was
Speaker 2: probably not an issue for one hunter gatherers because the
Speaker 2: diet they had was more much more challenging to their
Speaker 2: teeth and jaw, the bone that held their teeth in
Speaker 2: place because of the chewing they had to do well.
Speaker 2: Since we picked up agriculture, and especially since the Industrial
Speaker 2: Revolution where we started mass processing food, everything's gotten much softer.
Speaker 2: So we're challenging the bone in our jaw less. Therefore
Speaker 2: our teeth are more prone to go wonky rather than
Speaker 2: coming in straight.
Speaker 1: Yeah, and less bone is happening there. So I mean
Speaker 1: that's the history of my teeth is bone loss and
Speaker 1: lack of bone.
Speaker 2: Hey man, I just got two root canals. I was
Speaker 2: in the chair for two and the dentist was like,
Speaker 2: you could go either way. On the one it just
Speaker 2: got a lot of cold sensitivity, and I was like, oh,
Speaker 2: I'll just get one. Spent the next couple of days
Speaker 2: like realizing how bad the cold sensitivity on the other
Speaker 2: one was. The following week I got the other one done. Yeah,
Speaker 2: so two fridays in a row, I went to the
Speaker 2: endodontis and got root canals. How about that?
Speaker 1: Yeah, I've never had a root canal. Weirdly, that's the
Speaker 1: one thing I haven't had.
Speaker 2: They're they're not fun, but they're well they're not fun.
Speaker 1: Yeah. So early on, you know, in ancient times, people
Speaker 1: started to kind of look at this issue. In fact,
Speaker 1: Hippocrates even wrote of crowded teeth potentially producing headaches and
Speaker 1: problems with the palette and stuff like that discharge from
Speaker 1: the ear, which is super gross. And there were have
Speaker 1: been mummies, like Egyptian mummies that look like they may
Speaker 1: have had some kind of braces, Like they had these
Speaker 1: gold bands around some of their teeth and they were
Speaker 1: connected with catgut and it appeared as if they were,
Speaker 1: you know, being kind of used like braces to pull
Speaker 1: the teeth in one direction or the other.
Speaker 2: Yep, which is I mean pretty interesting. Again, this is
Speaker 2: post agriculture, so don't don't email us. Yeah. And also
Speaker 2: there's good band and album name in there, Hippocrates and
Speaker 2: the Egyptian mummies. The album is discharged from the ear.
Speaker 2: Oh god, okay, just waiting for us.
Speaker 1: Yeah, good one.
Speaker 2: There was another couple people from the ancient world, Celsus,
Speaker 2: who was a Roman writer. He talked about how if
Speaker 2: you were worried about adult teeth coming in. You pluck
Speaker 2: the baby tooth out and then press it with your
Speaker 2: finger every day. Yeah, And it turned out that was
Speaker 2: a pretty good idea because that was adopted later on
Speaker 2: in Orthodontrea when it really became a thing, and even
Speaker 2: Pliny got in on it. Remember how much he used
Speaker 2: to visit us in our podcast.
Speaker 1: Yeah, I mean I feel like Planning used to be
Speaker 1: a firm entrant into the stuff you should know drinking game.
Speaker 2: Yeah. Well he moved on to the dough boys. Oh okay,
Speaker 2: but he said that if you don't like the alignment
Speaker 2: of your teeth, just file them.
Speaker 1: Yeah, which is still a thing.
Speaker 2: It is. That's another I think thing that I'm like, wait, really,
Speaker 2: you guys are still doing this, And it's true, like
Speaker 2: a lot of the inventions and techniques and ideas that
Speaker 2: came along from the very beginning of orthodontire are I
Speaker 2: guess they got them right right out of the gate,
Speaker 2: because they're still doing them today.
Speaker 1: Yeah. For sure. I've had my teeth down in a
Speaker 1: lot of ways to keep the bite from pressing on
Speaker 1: other teeth, to make them, you know, keep them from
Speaker 1: becoming weakend. You know, still a thing.
Speaker 2: How is that.
Speaker 1: What to get them filed?
Speaker 2: Does it hurt? Is it fir? Oh?
Speaker 1: No, no, no, it doesn't hurt at all. It's just
Speaker 1: that only. Yeah, and then you smell the smoke and
Speaker 1: you know that part's all horrific. But there's no pain
Speaker 1: in ball because they're not hitting nerves or anything.
Speaker 2: Okay, yeah, Now imagine doing that through the middle interior
Speaker 2: of the tooth to scrape out the root to the nerve.
Speaker 2: That's a root canal.
Speaker 1: Oh man, so sorry, sorry.
Speaker 2: So I guess really the first person, i mean, plain
Speaker 2: of the elder, makes a pretty good case, but not really.
Speaker 2: It wasn't until the very beginning of the eighteenth century
Speaker 2: that a Frenchman, the French, would actually really have a
Speaker 2: lot to do with establishing orthodontire. Same was Pierre Fauchard,
Speaker 2: and he basically said, check this out, everybody, I'm going
Speaker 2: to work on wonky teeth. I'm gonna make my name
Speaker 2: that for that.
Speaker 1: Yeah, for sure, And as it is today, children and
Speaker 1: young adults were kind of the likeliest candidates for that,
Speaker 1: and he designed the very first appliances for moving teeth around.
Speaker 1: The first thing he would do is measure the length
Speaker 1: of the teeth and file them down if they were
Speaker 1: you know, if he had one that was exceptionally longer,
Speaker 1: then it's little buddy next to it. He would file
Speaker 1: it down, then do so on the other side to
Speaker 1: kind of balance things out. That's called bite adjustment. Like
Speaker 1: I said, they still do those, including on me. That's
Speaker 1: an occlusional occlusal sorry, equilibration. Equilibration, Yeah, that's not an
Speaker 1: easy one. And again that's to I mean, sometimes I
Speaker 1: guess it's to help out the aesthetic, but in my case,
Speaker 1: and in most cases, it's to keep teeth from grinding
Speaker 1: against another tooth in a way that causes harm.
Speaker 2: Yeah, I've realized it as an adult. My bite is
Speaker 2: way over to the I guess the bottom is Yeah,
Speaker 2: the bottoms to the right and to the left. Is
Speaker 2: that what it's called?
Speaker 1: I think?
Speaker 2: So, Oh my man, I got a terrible cross bite.
Speaker 2: But I mean, I'm I'm making my way in the
Speaker 2: world today. Takes everything I've got, but I'm still able
Speaker 2: to chew pretty well.
Speaker 1: Yeah, Yeah, that's what matters.
Speaker 2: Sure. So let's talk a little bit more about Fauchard,
Speaker 2: because he hasn't left yet. He's he really kind of
Speaker 2: got into this and laid the groundwork. He did the
Speaker 2: same thing that Pliny suggested that, like you said, you
Speaker 2: went to the same procedure. He called it inner proximal stripping,
Speaker 2: which is essentially just filing down teeth to make more
Speaker 2: space between them.
Speaker 1: Yeah, Like if if it's crooked, give it a little
Speaker 1: more space and maybe it'll be able to straighten itself out.
Speaker 2: Yeah, Or like you can file it down for the
Speaker 2: space and then you apply some sort of appliance to
Speaker 2: it too, straighten that tooth too, But you gotta make
Speaker 2: the space first.
Speaker 1: He came up with that, yeah. Or what he did
Speaker 1: was was push on the teeth, just like Celsus suggested,
Speaker 1: like every day, you know, and this you know, this
Speaker 1: makes sense. It's essentially what rubber bands and braces do.
Speaker 1: Just you're applying pressure to your teeth at a regular interval,
Speaker 1: like so many times a day and so many the
Speaker 1: ideas that they will move right.
Speaker 2: And it's true. Like that's one of the amazing things
Speaker 2: to me, is like if you apply even like a
Speaker 2: gentle bit of pressure over a long enough time span,
Speaker 2: your teeth will go where you want them to. Yeah.
Speaker 2: So one of the other reasons why Fauchard is remembered
Speaker 2: is because he essentially came up with the idea for braces.
Speaker 2: He basically used a waxed piece of silk or a
Speaker 2: wire or something, and he would wrap a tooth that's say,
Speaker 2: crooked to the neighbor next to it, and that would
Speaker 2: apply pressure to straighten out the crooked tooth. I'm sure
Speaker 2: in the worst case scenario make the other tooth crooked
Speaker 2: in the bar again, so you really had to keep
Speaker 2: an eye on it. Yeah, and sometimes he would use
Speaker 2: a plate too to connect a crooked tooth to one
Speaker 2: that you wanted to use a pressure, maybe a couple
Speaker 2: of them to use his pressure to straighten it out.
Speaker 2: And this eventually was like, this is the basis of
Speaker 2: what braces do for your teeth. This guy was inventing
Speaker 2: it in the early seventeen hundreds.
Speaker 1: Yeah. He also used a specific torture device called a pelican.
Speaker 1: It had been around before, I think since the at
Speaker 1: least the fourteenth century. It was used for pulling teeth,
Speaker 1: but he kind of rejiggered it and redesigned it to
Speaker 1: where it was basically a forcep that could pull a tooth.
Speaker 1: Pull a tooth like, not out of your body, but
Speaker 1: in a certain direction, and if it sounds like awful
Speaker 1: and could lead to bad things, that very much could,
Speaker 1: because at least once on record, he fractured a tooth
Speaker 1: of a young woman that he was working on, and
Speaker 1: I imagine that was extremely unpleasant.
Speaker 2: I can't believe there's just the one that people mention,
Speaker 2: you know, I.
Speaker 1: Mean, that's the one on record. I'm sure it happened
Speaker 1: more than that, you know.
Speaker 2: Yeah, the girl was quoted as saying, yeow exactly. He
Speaker 2: also was smart enough to know that you could get
Speaker 2: infections from some of these techniques and procedures he was performing,
Speaker 2: so he recommended a mouthwash of wine and a specific
Speaker 2: kind of honey with some rose essence to it. Yeah.
Speaker 2: I mean, this guy just he just laid it down.
Speaker 2: And what's interesting is he was doing this in the
Speaker 2: early seventeen hundreds, and it wasn't really until the mid
Speaker 2: nineteenth century that really started to become picked up again.
Speaker 2: And one reason why is because we viewed teeth much differently,
Speaker 2: at least in the West, than we do today. Like
Speaker 2: you were saying, thanks to Hollywood and magazines and all that,
Speaker 2: you want to show off your teeth and you're going
Speaker 2: to be perfect. Back then, you did not show off
Speaker 2: your teeth. It was grossly impolite to let anyone see
Speaker 2: your teeth. Go back and look at any portrait from
Speaker 2: the eighteenth century. I will pay you a dollar fifty
Speaker 2: if you find one single portrait of a gentry or
Speaker 2: aristocrat man or woman who's showing their teeth in a painting.
Speaker 2: You can't find it because that was really rude and
Speaker 2: day class a.
Speaker 1: Yeah, I mean almost any painting you think about, like,
Speaker 1: it didn't occur to me until I, you know, did
Speaker 1: this research and you go to any museum, and if
Speaker 1: you see teeth, it's probably to depict someone who is unhinged,
Speaker 1: or like a prisoner escaping from prison, or someone a pirate, Yeah,
Speaker 1: a pirate or an asylum or something like that, and
Speaker 1: the teeth are all, you know, jacked up looking. Other
Speaker 1: than that, you don't see teeth in paintings.
Speaker 2: You don't a dollar fifty everybody. Yeah, but just to
Speaker 2: one of you, not all of you.
Speaker 1: Oh man, we're gonna get some. It's gonna start rolling in,
Speaker 1: Buddy Jpeggs coming at you with toothie paintings.
Speaker 2: Should we take a break, Yeah, we should take a break.
Speaker 1: All right, we'll take a break and we're gonna jump
Speaker 1: forward into the eighteen hundreds after this.
Speaker 2: So, like I said, Fauchard was working in the early
Speaker 2: seventeen hundreds. By the mid nineteenth century, I guess people's
Speaker 2: thoughts on teeth were changing and they were like, Okay,
Speaker 2: we can show our teeth, but think I'll look good.
Speaker 2: So let's get back into orthodonture. Another Frenchman, Pierre joaquim
Speaker 2: Le Foulon, he's the one who came up with the
Speaker 2: word orthodonyx, actually called it orthodontice. You have to say
Speaker 2: it like that. And in Greek, ortho means straight, Dante
Speaker 2: is teeth, So straight teeth is what the word orthodonyx means.
Speaker 1: You know, I love that when that happens the too, Yeah,
Speaker 1: when I can't even have follow that. So they didn't
Speaker 1: call themselves that yet in most cases at the time.
Speaker 1: That kind of caught on more and more as things
Speaker 1: went on, But dentists started to do this stuff. They
Speaker 1: weren't like specialists that only did orthodontics. Yet it was
Speaker 1: just part of dentistry, and too, straightening was part of dentistry,
Speaker 1: and you were an apprentice who learned that kind of thing.
Speaker 1: Dental colleges started being organized in the mid nineteenth century.
Speaker 1: But I mean when was the first orthod's orthodontire school?
Speaker 1: That was in the twentieth century, right.
Speaker 2: Yeah, either the very beginning of the twentieth or the
Speaker 2: very early or no, yeah, very late nineteenth century. I
Speaker 2: think it was an angle.
Speaker 1: Yeah, nineteen hundreds. The Angle school of orthodontia was the
Speaker 1: first sort of standalone thing where it wasn't just part
Speaker 1: of a dental school precisely, all.
Speaker 2: Right, So some of the other advancements that thenineteenth century
Speaker 2: contributed it can all be kind of lumped together under
Speaker 2: the umbrella term of headgear or uh uh if you're
Speaker 2: a teenager, which is you're using your skull and the
Speaker 2: substance of your skull as a as a Oh, I mean,
Speaker 2: I wish I knew classical physics terms a little better,
Speaker 2: but essentially sure, Yes, an anchor, a counterbalance, how about
Speaker 2: that to provide the pressure needed to pull, say, like
Speaker 2: your jaw back. There's something called the chin cup that
Speaker 2: you can use. I've actually seen modern pictures of it
Speaker 2: still in use in some cases to where there's a well,
Speaker 2: the cup for your chin. There's straps that go back
Speaker 2: to the back of your head and around it, and
Speaker 2: it's meant to just slowly, over time pull your lower
Speaker 2: jaw back towards your well, you're the rest of your head,
Speaker 2: and it can correct an underbyte. And that's as far
Speaker 2: back as I think eighteen oh two.
Speaker 1: I love that idea, though they were like, oh, we
Speaker 1: need some kind of like, we need some leverage to
Speaker 1: pull this jaw back, and we can't just have a
Speaker 1: kid stand by a wall and attach them to a wall.
Speaker 1: And somebody's like, well, what about their skull? Yeah, it's
Speaker 1: right there.
Speaker 2: Somebody went bam.
Speaker 1: They don't use headgear as much anymore. Like you said,
Speaker 1: it still can be used, but not like it was
Speaker 1: used in the eighties. Luckily I never had to go
Speaker 1: through the head gear trauma, but it was quite dramatic
Speaker 1: when you showed up to school having to wear one
Speaker 1: of those.
Speaker 2: Yeah remember farmer Ted from sixteen Candles, He had to
Speaker 2: wear one.
Speaker 1: Farmer Ted and I think, oh, no, junk Usuck had
Speaker 1: the neck brace.
Speaker 2: Yes, yeah, okay, I thought that too, but no, it
Speaker 2: was neck brace. There's a couple other people we need
Speaker 2: to mention. Another French dentist Christophe Francois de la bar
Speaker 2: He created the wire crib, which was I think we
Speaker 2: said Fouchard was the one who really kind of started
Speaker 2: the idea of braces. There's a distinct progression of linear
Speaker 2: progression from Fouchard onward and de la Barr came up
Speaker 2: with the wire crib, which is essentially exactly what it
Speaker 2: sounds like. Like you take a piece of chicken wire,
Speaker 2: fowl it over like the teeth in question, tighten it
Speaker 2: up the way you want it, and there's your wire crib.
Speaker 2: It's not exactly like the braces of today, but the outline,
Speaker 2: the contours are there in it for sure.
Speaker 1: Yeah. It started to become in the nineteenth I guess
Speaker 1: the second half of the nineteenth century a little more scientific,
Speaker 1: and they started to kind of put a little more
Speaker 1: rigor into like, you know, figuring out how to do
Speaker 1: this the right way. A guy named Norman Kingsley from
Speaker 1: New York City, it was a very early, very popular orthodonist.
Speaker 1: He had a treatment for cleft pallets. It was very
Speaker 1: popular and wrote a very influential guide called a Treatise
Speaker 1: on Oral Deformities in eighteen eighty. But and this is
Speaker 1: something that you mentioned early on that will kind of
Speaker 1: keep talking about a little bit here and there, is
Speaker 1: that he was an artist and he was very interested
Speaker 1: in facial symmetry and aesthetic. So he was, if not
Speaker 1: the first, one of the sort of early leading guys
Speaker 1: that was like, we want you to look good, and
Speaker 1: it may not just be about like your bite health.
Speaker 2: Right exactly exactly. He was also supposed to be really nice.
Speaker 2: He had a compliment for.
Speaker 1: Everyone he met, Oh that's nice.
Speaker 2: So I just made that up, but I want to
Speaker 2: believe it about it. So there's some other stuff that
Speaker 2: kind of came along little by little. They were like, oh, okay,
Speaker 2: well let's tackle this. One thing that you can be
Speaker 2: born with is a narrow maxillary arch. That is the
Speaker 2: jawline on the top of your mouth. The row of
Speaker 2: your row of top teeth are connected to your maxillary arch.
Speaker 2: Yeah about that, the roof of your mouth, yeah, the
Speaker 2: lower set of teeth is connected to the mandibular arch.
Speaker 2: Either way, you can be born with one or both
Speaker 2: of them narrowed. So they figured out you can put
Speaker 2: essentially an appliance of stick in between them and adjust
Speaker 2: it slowly but surely over time. And press your jaw apart.
Speaker 1: Yeah, I mean that is still a thing. My daughter
Speaker 1: has that. It's called an expander. I guess it was
Speaker 1: called that back then too, but and like her two
Speaker 1: friends abracist both had it too, so I think that
Speaker 1: maybe way more regular now. I don't know anyone from
Speaker 1: my our days in high school that had something like that, So.
Speaker 2: I think the original one was they would put the
Speaker 2: screw bar in between, say, your back molars, because they're
Speaker 2: pretty substantial and just over time slowly adjusted. I guess
Speaker 2: probably every visit, and that would press the whole arch apart.
Speaker 2: Is that essentially what they're doing still today.
Speaker 1: Yeah, it's like a wire cage that lives on the
Speaker 1: roof of your mouth. It's attached to those rear molars
Speaker 1: and they yeah, you go in there and they crank
Speaker 1: it out and make more room like the and it
Speaker 1: really works because the space between her front two teeth
Speaker 1: got comically large, like you could fit a whole extra
Speaker 1: tooth in between. Oh wow when this thing was at
Speaker 1: its most. But they're basically just creating room for the future.
Speaker 2: Was the dentist like or the orthodonist like I've done
Speaker 2: too much? No, you know, coming back now.
Speaker 1: He's like, I got a new record. Everyone get in here,
Speaker 1: look at this.
Speaker 2: Carder, right, So I think you said we talked about
Speaker 2: how the first orthodontial school was established by Edward Engel
Speaker 2: in nineteen hundred. Even before that, most of the people
Speaker 2: practicing orthodontire were now not only MD's but also doctors
Speaker 2: of dental surgery DDS, so they were really well trained
Speaker 2: in medicine. And the reason why not coincidentally is this
Speaker 2: is because of a shift of direction that orthodontire went
Speaker 2: in to basically say like, let's get even more scientific
Speaker 2: about this, and well they did.
Speaker 1: Yeah. There was a guy named John Nutting Farrar who
Speaker 1: some people called the father of American orthodontics or modern orthodontics.
Speaker 1: House I was raising, he was the guy that was like, hey,
Speaker 1: let me do some actual experiments and on animals and things,
Speaker 1: and let me see, like that thing that we crank
Speaker 1: apart your teeth, let me see how much the human
Speaker 1: body can like how much pain they can endure to
Speaker 1: move those teeth like and I'm the kind of kidding,
Speaker 1: but basically like, let's find a happy medium between how
Speaker 1: far we can expand and how much like a child
Speaker 1: can take.
Speaker 2: Yeah. What's worse though, is he wasn't experimenting on children.
Speaker 2: He was experimenting on animals, which I picked, I.
Speaker 1: Mean dogs, Yeah, I guess.
Speaker 2: Yeah, So yeah that's for our What about Edward Angle
Speaker 2: who we talked about. This guy is probably the one,
Speaker 2: I mean my dad at least always called the house
Speaker 2: father of American orthodonics.
Speaker 1: Yeah, I mean he's the guy that definitely made it
Speaker 1: such a bona fide business. And I think he found
Speaker 1: out much like a lot of different ways to make
Speaker 1: a lot of money. And you know, one way was
Speaker 1: like developing devices and patenting devices. Another way was creating
Speaker 1: like ready made appliances. He created the Angle system in
Speaker 1: eighteen eighty seven. So it's like instead of like building
Speaker 1: these things from scratch for every patient, like I can
Speaker 1: just sell you this system that has all these prefab
Speaker 1: parts that can be combined in different ways to suit
Speaker 1: your needs.
Speaker 2: Yeah, because I mean there's only so many ways that
Speaker 2: your teeth can be wonky, right, So yeah, that was revolutionary.
Speaker 2: I'm sure that just immediately pushed the field forward. And
Speaker 2: if that wasn't enough, he also came up with a
Speaker 2: measurement system called the occlusal classification system that's still in
Speaker 2: use today one hundred and thirty something years later, that
Speaker 2: they uses the basis like that is the norm. Yeah,
Speaker 2: and that's what they used to measure anything in a
Speaker 2: patient's mouth that's deviated from the norm. He also, in
Speaker 2: addition to founding that first school of orthodontia, he founded
Speaker 2: the Society of Orthodonists, which is now the American Association
Speaker 2: of Orthodonists. He founded the first orthodonic journal, which is
Speaker 2: known today as tooth Fancy.
Speaker 1: Oh man, what a nightmare magazine for me. It would
Speaker 1: be somebody, just you can punk me and give me
Speaker 1: subscription to tooth Fancy. All right, this guy had so
Speaker 1: many income streams. Who's you know, clearly a great orthodonists
Speaker 1: and dentist, but also a seemingly pretty savvy business guy.
Speaker 2: Yeah, but yeah, he was revered. I'm sure he's still
Speaker 2: revered in the halls of orthodontire.
Speaker 1: Certain halls.
Speaker 2: Oh there's another This apparently is a debate that still
Speaker 2: rages today. At some point somebody said, hey, you know,
Speaker 2: we usually try to step in earlier in development, like
Speaker 2: to work on younger kids, I think is the way
Speaker 2: they put it. But sometimes adults need help too. So
Speaker 2: a lot of us are just pulling teeth maybe to
Speaker 2: make space or whatever. Should we be doing that? And
Speaker 2: some people said yes, some people said no, and a
Speaker 2: rift was formed that again still exists today in the
Speaker 2: orthodonic field.
Speaker 1: Yeah, a rift so wide. It was like the gap
Speaker 1: between my daughter's teeth at maximum expansion.
Speaker 2: It's a ricker.
Speaker 1: Should we take another break? Yeah, all right, we'll come
Speaker 1: back and finish up on braces right after this. Stop.
Speaker 1: All right. If we're talking modern tooth straightening, we're talking
Speaker 1: about braces generally. I mean, I guess they still have
Speaker 1: retainers and stuff, but I feel like I see less
Speaker 1: and less of that, and it's more just sort of
Speaker 1: straight into braces. I feel like when we were kids,
Speaker 1: so like, yeah, we can probably fix this with a retainer.
Speaker 2: I thought the retainer was like post braces. That was
Speaker 2: my experience.
Speaker 1: I think that can be true too. Okay, but I'm
Speaker 1: pretty like my brother got a retainer and not braces
Speaker 1: of course.
Speaker 2: Yeah, I'm sure his retainer somehow made him money too, accidentally.
Speaker 1: Oh man, God bless him. So a lot of people
Speaker 1: had kind of shipped in to come up with things
Speaker 1: were basically like brace's one guy that was pretty key
Speaker 1: was name doctor Raymond Beg. His nickname was Tick. Do
Speaker 1: you know why I didn't find out why.
Speaker 2: I could not find other than that he was Australian.
Speaker 2: That's the best I can come.
Speaker 1: Up with, all right. But he was a student of Angle,
Speaker 1: I guess, at that school of orthodontia. Orthodontia, Yeah, Orthodontia.
Speaker 1: And he moved to Australia or I guess went back
Speaker 1: to Australia where he practiced in Adelaide, Lovely area. And
Speaker 1: this was in the nineteen thirties, and he developed like
Speaker 1: using stainless steel wire instead of precious metals, And I
Speaker 1: think didn't they use precious metals because they were malleable
Speaker 1: but that caused problems.
Speaker 2: Yeah, well, they're they're very expensive and gold like you
Speaker 2: can't make a crown out of gold because eventually it'll
Speaker 2: it'll mash. But they were prized because they don't react
Speaker 2: with other stuff, Like you can need all the cheetos
Speaker 2: you want and your gold's not going to rust. It's
Speaker 2: not poisonous like mercury, which apparently they still use in
Speaker 2: fillings in some places. Oh okay, yeah, so it But
Speaker 2: they're they're expensive, so people came up with alloys now today,
Speaker 2: although sometimes you still will see like gold or platinum
Speaker 2: or silver alloy sometimes fused with ceramic for implants and stuff. Yeah.
Speaker 1: Well, the stainless steel, I mean, that's still that came
Speaker 1: about in what nineteen fifty six here in the States,
Speaker 1: and racist became you know, really more popular over that time,
Speaker 1: kind of starting in the fifties, but really in the
Speaker 1: seventies and eighties. I think an estimate from the AAO
Speaker 1: found the number of Americans who wear braces doubled between
Speaker 1: eighty two and two thousand and eight. Yeah, and you know,
Speaker 1: they've evolved over the years they had. I was not
Speaker 1: one of the first, but it was pretty early on.
Speaker 1: My second set of braces were ceramic that like the
Speaker 1: clear braces, which was a little bit better, but it
Speaker 1: was not you know, you still had brace face, just
Speaker 1: a little less obvious. It's not like, you know, you
Speaker 1: couldn't tell or anything like that. Whereas my first braces
Speaker 1: were it was early enough where they were the wrap
Speaker 1: around like an entire silver band around each tooth.
Speaker 2: M hm.
Speaker 1: It wasn't like glued on. Yeah, right.
Speaker 2: One thing though about that huge increase the doubling of
Speaker 2: people with braces between eighty two and two thousand and eight.
Speaker 2: I was like, that doesn't track with my experience. For me,
Speaker 2: it was the eighties where everybody's wearing braces. And then
Speaker 2: I realized that that's because I knew the most people
Speaker 2: wearing braces in the eighties, because that's when I was
Speaker 2: in elementary and middle school.
Speaker 1: Oh well, yeah, sure, yeah.
Speaker 2: It was just a kind of bias I thought.
Speaker 1: Was great proximity bias.
Speaker 2: I looked and I could not figure out which one
Speaker 2: it was. Maybe the frequency illusion is the best I
Speaker 2: could go okay with.
Speaker 1: That makes sense. I didn't. Is it proximity bias even
Speaker 1: a thing that I make that up?
Speaker 2: If it's not, it should because it's got a great,
Speaker 2: great name. It really has legs.
Speaker 1: They also have braces that go in the back of
Speaker 1: your teeth. One of my good friends had those, and those,
Speaker 1: you know, can't be used in all cases, but that's
Speaker 1: the ones where you really score as a teenager for sure.
Speaker 2: And then I guess those aren't invisible ligners. Those are just.
Speaker 1: Rear braces, right, yeah, party rear.
Speaker 2: Well, before we get onto invisible liners, which also created
Speaker 2: quite a rift in orthodonics. There's something that I guess
Speaker 2: it's the new standard maybe today, called self ligating braces.
Speaker 2: So with traditional braces, you have that wire's been around
Speaker 2: since Fouchard, you have the brackets that actually attached to
Speaker 2: your teeth, and then you have little tiny rubber bands
Speaker 2: that attack the brackets to the wire. Right, With self
Speaker 2: ligating braces, there's just the wire and the brackets, and
Speaker 2: apparently it makes it way easier to clean. It makes
Speaker 2: it way easier to adjust when you switch out the
Speaker 2: wire for a thicker wire over time, because there's a
Speaker 2: little snap in the bracket that holds that wire in place.
Speaker 2: And they just look like the future to me.
Speaker 1: Yeah. You can also get colored braces now too, which
Speaker 1: is a big thing if you get them young, like
Speaker 1: my daughter, she has purple braces.
Speaker 2: Oh that's cool, loud proud. I guess. Now onto invisible
Speaker 2: ligners because this was kind of a big deal to Caltech.
Speaker 2: They might have been students at the time. Zia Chishti
Speaker 2: and Kelsey Worth invented them all the way back in
Speaker 2: nineteen ninety seven, and within just three years we had
Speaker 2: in visi line on the market.
Speaker 1: Yeah, my brother used these for a while too, and
Speaker 1: this is something that you it's to avoid going to
Speaker 1: the orthodonists, I guess, and paying like a lot of
Speaker 1: money for permanent or not permanent but you know, temporarily
Speaker 1: glued on braces. This is something that you can you know,
Speaker 1: it fits over your teeth and you can take them
Speaker 1: on and off.
Speaker 2: Sure any involvement in this industry, it's been pushed so
Speaker 2: far outside of traditional orthodonics that any orthodontist who is
Speaker 2: a critic of orthodonture and it's like questionable scientific basis,
Speaker 2: they they the orthodonic community will use their involvement with
Speaker 2: this industry to discredit them. That's how that's how reviled
Speaker 2: it is among mainstream orthodonics now.
Speaker 1: Is that because they genuinely think it's no good or
Speaker 1: it's genuinely no good for their practice, no.
Speaker 2: Good for their practice, because it's not so much the
Speaker 2: invisible liners. It's the fact that you can order them
Speaker 2: yourself online and they'll like you're they're just totally cut
Speaker 2: out of the loop. So it's that's it's specifically the
Speaker 2: online ordering version that they have such an aversion to.
Speaker 1: I'm surprised they didn't think of a way to get
Speaker 1: a piece of that business. You know.
Speaker 2: It happened. Happened while they were sleeping.
Speaker 1: Yeah, and I need to ask my brother how well
Speaker 1: they worked for him, because I know he woren for
Speaker 1: a little while.
Speaker 2: I think they work if you have just slight adjustments
Speaker 2: you need to make. But if you have like a
Speaker 2: really like a big deal in the wonky department, then
Speaker 2: you should go with braces. One other big check in
Speaker 2: the favor of braces over invisible liners. You can adjust
Speaker 2: the braces throughout the treatment. I need a little more
Speaker 2: pressure here, a little less here. You can't do that
Speaker 2: with invisible liners. Once you send them the mold of
Speaker 2: your mouth, they send you the braces back, and that's that.
Speaker 2: I think you get multiple ones, but it's much less
Speaker 2: precise over time as braces.
Speaker 1: Right. Livia found this, and I didn't know this is
Speaker 1: a thing, but apparently she found that there are some
Speaker 1: anecdotal evidence at least of young people wanting braces as
Speaker 1: a fashion statement, like a decorative fashion brace that you
Speaker 1: can get online.
Speaker 2: Yeah. I saw some article written by some square that
Speaker 2: said non prescription glasses and fashion braces are the big
Speaker 2: things right now.
Speaker 1: Man, oh man, I mean, I were you know very
Speaker 1: famously were fake glasses to seem smarter when I was younger,
Speaker 1: But you couldn't have caught me dead with fake braces.
Speaker 2: No, it doesn't make any sense, and I also kind
Speaker 2: of suspect it might be an urban legend.
Speaker 1: I do too.
Speaker 2: One thing that doesn't seem to be an urban legend
Speaker 2: that I saw there was gap bands, apparently people kind
Speaker 2: of but with an S on the end of band,
Speaker 2: where you use like a kind of like a really
Speaker 2: strong rubber band. You put it on the tooth you
Speaker 2: want to straighten out, and then connect the other one
Speaker 2: to a straight tooth to use it as leverage, and
Speaker 2: apparently it works really fast. Again, the orthodontric communities like
Speaker 2: don't do those. Supposedly with some eight year old boy
Speaker 2: in grease who had done this himself, but the rubber
Speaker 2: band went up into his gums, and according to these people,
Speaker 2: he didn't notice, and it just ate away at the
Speaker 2: tissue up there and he ended up losing the very teeth,
Speaker 2: I think, his front teeth that he was trying to
Speaker 2: straighten in the first place. That too, sounds a bit
Speaker 2: like an urban legend, but I saw it in enough
Speaker 2: places that I wonder if it might be based on
Speaker 2: some sort of legitimate story somewhere.
Speaker 1: I could see that. I mean, I you know, you
Speaker 1: probably use rubber bands along with your braces.
Speaker 2: Right, I never had braces.
Speaker 1: Oh, you never had them at all.
Speaker 2: I did not need them as a kid. It wasn't
Speaker 2: until I was an adult that I started to kind
Speaker 2: of need them for my lower teeth.
Speaker 1: You got pretty good teeth, though, I've never noticed your
Speaker 1: teeth being crooked or whatever.
Speaker 2: That's because I don't smile and show my lower teeth
Speaker 2: number one, because I'm not insane. But number two, because
Speaker 2: those are the ones that are crooked. Luckily, it's my
Speaker 2: top row that's pretty straight. So when I smile, it
Speaker 2: looks like my teeth are great. But if I hey,
Speaker 2: they really Yeah, with the a lot on there, just
Speaker 2: kind of that was pretty good play acting too, by
Speaker 2: the way, Yeah, it was good.
Speaker 1: All right. So let's talk about some stats. A few
Speaker 1: years ago, in twenty twenty two, three point one five
Speaker 1: million kids between eight and seventeen were getting orthodonic treatment.
Speaker 1: This sounds way low to me. Seven point four percent
Speaker 1: of that age group is all that was. There were
Speaker 1: other estimates that say about half of kids receive some
Speaker 1: kind of orthodonic treatment at some point. That seems low
Speaker 1: to me too, just based on anecdotal what I'm seeing
Speaker 1: around me. But you know, maybe that's right.
Speaker 2: So kids like you were saying, it's just basically part
Speaker 2: of being a kid today, you get braces at some point.
Speaker 1: It seems like it. I just I feel like Ruby
Speaker 1: and most of her friends have braces.
Speaker 2: I mean that tracks I found a statistic that in
Speaker 2: the US alone, out of pocket spending amounts to five
Speaker 2: almost five and a half billion dollars a year. I'm orthodonture,
Speaker 2: and then insurance and medicaid covers an additional four point
Speaker 2: two billion, So it's like a ten billion dollar industry
Speaker 2: just in the United States alone.
Speaker 1: Yeah, I mean, and you know, kind of going back
Speaker 1: as we'll finish up here to the beginning of like
Speaker 1: is this a medical issue or is it just to create, like,
Speaker 1: you know, kids without self esteem problems because they're maybe
Speaker 1: have crooked teeth. And certainly the rise of Hollywood and
Speaker 1: it used to say something sort of about class. I
Speaker 1: think it's still still can unfortunately, and you know, with
Speaker 1: with movies and advertisements and TV and stuff like that, YouTube,
Speaker 1: social media, straight teeth is the thing. And you know,
Speaker 1: starting the post war era, like especially with young girls,
Speaker 1: they were saying, hey, you got little self esteem, it's
Speaker 1: probably because of your teeth.
Speaker 2: I wonder though, so that that class thing, the socioeconomic
Speaker 2: part of it, that actually makes it hard to study orthodonics,
Speaker 2: because if you want to study people with say braces
Speaker 2: or something like that, you're automatically working from another kind
Speaker 2: of bias, a selection bias, because they are probably from
Speaker 2: a higher socioeconomic class than that average person who doesn't
Speaker 2: have braces, because so much of it is paid for
Speaker 2: out of pocket. But it occurred to me just now, Chuck,
Speaker 2: Well you're saying that that I wonder if that whole
Speaker 2: thing about them fixing health issues or whatever is essentially
Speaker 2: made up to get insurance companies to cover what otherwise
Speaker 2: would be considered cosmetic. So they're actually doing it strictly
Speaker 2: for esthetic purposes, but they're trying to make it so
Speaker 2: you the parent, don't have to pay for all of
Speaker 2: it out of pocket. Maybe that's what's going on here.
Speaker 1: Maybe. I mean, this is the kind of thing that's
Speaker 1: really hard to study as far as whether or not
Speaker 1: there is a medical benefit or need, because and Lvia
Speaker 1: points us out. You know, you've got to conduct randomized trials,
Speaker 1: So you have to find a large group of people
Speaker 1: who have, you know, pretty similar dental profiles, and you
Speaker 1: got to have one group that you get braces to
Speaker 1: and then a control group that you don't, and then
Speaker 1: follow them over a long period of time to see
Speaker 1: what kind of problems developed, like headaches or something. And
Speaker 1: that's just really that's a tough study to pull off.
Speaker 2: Yeah, and again, I mean the study population you're drawing from, like,
Speaker 2: nobody's going to do that. So if you're studying people
Speaker 2: who already have braces, you're automatically working with that selection
Speaker 2: bias because they're more likely to be from a higher
Speaker 2: socioeconomic group. Yeah, totally, you got anything else about braces?
Speaker 1: The only thing I'll add I had the two kinds
Speaker 1: of braces. Oh, For many years after the braces, I
Speaker 1: had this bar put on the back of my lower
Speaker 1: teeth that span like the front five and that was
Speaker 1: supposedly to keep them in place neat and that eventually
Speaker 1: broke off, and I just went for years with those
Speaker 1: metal stumps there. Because I've spent quite a few without
Speaker 1: going to the gist at one point.
Speaker 2: Yeah, I'm guessing college years and maybe immediately after bing
Speaker 2: bing bing. That's how it goes. Man, Let's see, well,
Speaker 2: you don't have anything else about braces. I don't either.
Speaker 2: Thanks to all the orthodonists out there for listening, uh
Speaker 2: and everyone. If I turn up assassinated in the next
Speaker 2: couple of weeks is because I did figure out the
Speaker 2: big secret to orthodonics and insurance. Yeah, and Chuck said, yeah,
Speaker 2: so that means it's time for a listener mail.
Speaker 1: You're gonna wake up and Steve Martin's going to be
Speaker 1: over you with a dental drill.
Speaker 2: God.
Speaker 1: By the way, highly highly highly recommend the two part
Speaker 1: documentary on Steve Martin. Okay, it is great.
Speaker 2: I didn't even know it was out.
Speaker 1: Yeah, it's been out for a little bit. It's it's
Speaker 1: really really good, and it kind of makes me realize
Speaker 1: what a I mean. I've always been a Steve Martin fan,
Speaker 1: but it really knocks home what a treasure he is
Speaker 1: as a human.
Speaker 2: I bet.
Speaker 1: Yeah, it's fun and I just recently rewatched Three Amigos
Speaker 1: showed Ruby for the first time, which she thought was
Speaker 1: very fun.
Speaker 2: I've never seen that one. Oh really, yeah, but.
Speaker 1: That seems like it would have been one on your list.
Speaker 2: I don't well, actually I do know why.
Speaker 1: Why you don't watch vy Chase. Of course, he's the
Speaker 1: least funny part of the movie. You need to watch
Speaker 1: it for Martin Short and Steve Martin.
Speaker 2: I'll do my best, So I'd rather watch only murders
Speaker 2: in the building.
Speaker 1: No, I'm with you. I'm with you, all right, Hey, guys,
Speaker 1: this is what is this about? This is well, this
Speaker 1: is kind of about medical school, so it fits. I've
Speaker 1: been listening for nearly a decade. Was very excited to
Speaker 1: have an occasion to write in. During the episode on cigarettes,
Speaker 1: you mentioned an early physician who observed nasal swellings and
Speaker 1: excretiences and immoderate users of snuff, and Josh interprets this
Speaker 1: as puffy pussy lumps in their noses. I recently graduated
Speaker 1: from medical school, and it's a rite of passage for
Speaker 1: medical students to describe a wound with puss as pussy,
Speaker 1: only to realize this word appears rather crass when written out. Instead,
Speaker 1: we use the word p U r u l E
Speaker 1: and purulent to avoid any potential misunderstanding. If a patient
Speaker 1: reads the notes. Obviously it's a little different in a
Speaker 1: podcast setting, which I doubt listeners are often reading an
Speaker 1: episode transcript.
Speaker 2: Oh yeah, well to go look that up. I figured this.
Speaker 1: Little nugget of knowledge might be helpful. I'm sure you
Speaker 1: hear this every day, but I want to say thanks
Speaker 1: for all the great work you do. Suffie Schnow has
Speaker 1: been a constant source of joy for me as I've
Speaker 1: navigated college, med school, marriage, fatherhood, and now residency training
Speaker 1: and pathology. You brought my perspective on a basterray of issues,
Speaker 1: and I always look forward to listening to new and
Speaker 1: old episodes alike on my commute. And that is from Gabe,
Speaker 1: who says, Hey, come to ann Arbor, Michigan for a
Speaker 1: live show, and we're maybe trying to work that out, Gabe.
Speaker 2: Yeah, we're batting around, Gabe. Good idea.
Speaker 1: Yeah, And I tell you what, Gabe, if we come
Speaker 1: to ann Arbor, write us back from that very same
Speaker 1: thread in you and your friends and family or whatever,
Speaker 1: you know, not like twenty people, but you can get
Speaker 1: on the guest list.
Speaker 2: Yeah, good idea, Chuck, that's a fool proof plan, no
Speaker 2: possible way for identity theft. That's right, And congratulations Gabe.
Speaker 2: On all of your academic and medical success, and thanks
Speaker 2: for listening to us that entire time. If you want
Speaker 2: to be like Gabe and send us a cool email,
Speaker 2: you can do that too, Send it off to stuff
Speaker 2: podcast at iHeartRadio dot com.
Speaker 1: Stuff you Should Know is a production of iHeartRadio. For
Speaker 1: more podcasts my heart Radio, visit the iHeartRadio app, Apple Podcasts,
Speaker 1: or wherever you listen to your favorite shows.