The History of Orthodontics

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1:01John Polk story on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hi, I'm Dr. Priyanka Wally. And I'm Hari Kondabolu. It's a new year. And on the podcast Health Stuff, we're resetting the way we talk about our health. Which means being honest about what we know, what we don't know, and how messy it can all be. I like to sleep in late and sleep early. Is there a chronotype for that or am I just depressed? Health stuff is about learning, laughing, and feeling a little less alone. Listen on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Welcome to Stuff You Should Know, a production of iHeartRadio.

1:49Hey, and welcome to the podcast. I'm Josh, and there's Chuck. Jerry's here too. We're just sitting around cutting the insides of our mouths up here on Stuff You Should Know. Yeah, the history of orthodonture, which if I had been using my brain, I would have paired this with the history of dentistry. Because that kind of makes sense. Sure. I feel like we would have seen a real decline in listenership that week, but you know. You think so? No, I'm just kidding. Just being a punk. I remember our dentistry one was amazing. Well, and I think, I don't know, I think people are interested in their bodies.

2:30Especially when you say it like that. Yeah, and then teeth and stuff. Because we all have teeth. And it's interesting that bad, you know, teeth, I say bad teeth, I have bad teeth. But what I mean by bad teeth is teeth that grow in funky ways. But I'd like to kind of break that cycle as well of kind of talking about it like that. because even though I have gotten my teeth fixed, it's just because they were falling out of my head. It's not because I wanted perfect white chiclets in my mouth. And I think there's a big trend that we've seen over the past 20 years and really I feel like even the last 10 years where Hollywood especially and people in the media all have perfect, perfect, perfect teeth.

3:16And you don't have to have perfect teeth. I like teeth with a little personality. I like summer teeth. Yeah, I can't remember what kind of teeth? Summer? Summer teeth. I've not heard that. You never heard that phrase? No, what does it mean? Summer teeth. Some are here, some are there. Oh, that's awesome, man. I love that. That's like a, what kind of dog is that? Sooner? Sooner one kind is another? Yeah, exactly. Yeah, in Japan they have a name for like a wonky tooth. Usually it's one of your canines and it'll be like kind of pressed out or crooked or something like that. Yumi has one. But there's a term for it, and it's like basically a term of endearment.

3:54They just find that very cute. Here in the U.S., it'd be like you would be put in some sort of like home or asylum for that. Yeah. I mean, you get, as an actor, you get news articles written about you when you don't get your thing fixed. That's how commonplace it is to just, you know, the expectation to look perfect. Right. And that's a big criticism of the entire field of orthodontics. Yeah. You know, they might not be the ones out there like, you know, pumping the media up like, yeah, keep talking about how great teeth are supposed to be. But they're the ones who are there like, hey, come on over.

4:31We're going to fix you up. Tough to blame them for that. But the criticism goes even further because the field of orthodontics is like, forget about all that. We're actually helping cure health issues. And critics of the field are like, it's not even established that there are health issues from having wonky teeth. So you guys should probably stop saying all that. And the field of orthodontics said no. Yeah, I mean, for sure there can be health issues. We're not saying that's not possible, but I feel like it's almost a given now, especially now that I have a human child, that like, yeah, you absolutely get braces.

5:10That's just what happens. You go to the dentist. Really? Around six or seven years old. They say, all right, you need to go see your orthodontist now. I did not know that. That was not the way it was when we were young. No. I mean, I had braces twice. Did you? Yeah. I never did. But, you know, I've got bad bite. I have a host of problems. But, yeah, let's dive into it because this is not a new thing. People have always had wonky teeth. And the reason why is because we have the same amount of teeth in our head that we did when we were still, you know, walking on all fours. and we began to walk upright and the size of our brain changed and that meant the size of our jaw got smaller to make room for our bigger brain.

5:57But it's not like they were like, all right, they, whoever decides this, you know, the panel. It's not like the God panel said, all right, let's take out five or six teeth because we don't have room for them now. They were the same amount of teeth with less space to put them and that's why they started coming in in all crazy ways. Yeah, just give it another 100 ,000 years, Chuck. It'll work itself out. Even more recent than that, orthodontics is probably not an issue for hunter-gatherers because the diet they had was much more challenging to their teeth and jaw, the bone that held their teeth in place because of the chewing they had to do.

6:37Well, since we picked up agriculture, and especially since the Industrial Revolution, where we started mass processing food, everything's gotten much softer. So we're challenging the bone in our jaw less. Therefore, our teeth are more prone to go wonky rather than coming in straight. Yeah, and less bone is happening there. So, I mean, that's the history of my teeth is bone loss and lack of bone. Hey, man, I just got two root canals. I was in the chair for two, and the dentist was like, you could go either way on the one. It just got a lot of cold sensitivity, and I was like, oh, I'll just get one.

7:21Spent the next couple days realizing how bad the cold sensitivity on the other one was. The following week, I got the other one done. So two Fridays in a row, I went to the endodontist and got root canals. How about that? Yeah, I've never had a root canal, weirdly. That's the one thing I haven't had. They're not fun, but they're, well, they're not fun. Yeah. So early on, you know, in ancient times, people started to kind of look at this issue. In fact, Hippocrates even wrote of crowded teeth, potentially producing headaches and problems with the palate and stuff like that, discharged from the ear, which is super gross.

7:59And there were, have been mummies, like Egyptian mummies, that looked like they may have had some kind of braces, Like they had these gold bands around some of their teeth and they were connected with cat gut. And it appeared as if they were, you know, being kind of used like braces to pull the teeth in one direction or the other. Yeah. Which is, I mean, pretty interesting. Again, this is post-agriculture, so don't don't email us. Yeah. And also there's a good band and album name in there. Hippocrates and the Egyptian Mummies. The album is Discharged from the Ear. Oh, God. Okay. Just waiting for us, Joe.

8:36Yeah, good one. There was another couple people from the ancient world, Celsus, who was a Roman writer. He talked about how if you were worried about adult teeth coming in, you pluck the baby tooth out and then press it with your finger every day. Yeah. And it turned out that was a pretty good idea because that was adopted later on in orthodontra when it really became a thing. And even Pliny got in on it. Remember how much he used to visit us in our podcast? Yeah, I mean, I feel like Planny used to be a firm entrant into the Stuff You Should Know drinking game. Yeah, well, he moved on to the Doughboys.

9:10Oh, okay. But he said that if you don't like the alignment of your teeth, just file them. Yeah, which is still a thing. It is. That's another, I think, thing that I'm like, wait, really, you guys are still doing this? And it's true. Like a lot of the inventions and techniques and ideas that came along from the very beginning of orthodonture are, I guess they got them right, right out of the gate because they're still doing them today. Yeah, for sure. I've had my teeth ground down in a lot of ways to keep the bite from pressing on other teeth to make them, you know, keep them from becoming weakened.

9:44You know, it's still a thing. How is that? What, to get them filed? Does it hurt? Is it free teeth? Oh, no, no, no. It doesn't hurt at all. It's just that. And then you smell the smoke and, you know, that part's all horrific, but there's no pain involved because they're not hitting nerves or anything. Okay. Now imagine doing that through the middle interior of the tooth to scrape out the root to the nerve. That's a root canal. Oh, man. So sorry. Sorry. So I guess really the first person, I mean, plenty of the elder makes a pretty good case, but not really. It wasn't until the very beginning of the 18th century that a Frenchman, the French would actually really have a lot to do with establishing orthodonture.

10:30His name was Pierre Fauchard. And he basically said, check this out, everybody. I'm going to work on wonky teeth. I'm going to make my name for that. Yeah, for sure. And as it is today, children and young adults were kind of the likeliest candidates for that. and he designed the very first appliances for moving teeth around. The first thing he would do is measure the length of the teeth and file them down. If you had one that was exceptionally longer than its little buddy next to it, he would file it down, then do so on the other side to kind of balance things out. That's called bite adjustment.

11:07Like I said, they still do those, including on me. That's an occlusal, sorry, equilibration. Equilibration. Yeah, that's not an easy one. And again, that's to, I mean, sometimes I guess it's to help out the aesthetic, but in my case, and in most cases, it's to keep teeth from grinding against another tooth in a way that causes harm. Yeah. I've realized as an adult, my bite is way over to the, I guess the bottom is, yeah, the bottom's to the right. Crossbite? is to the left. Is that what it's called? I think so. Oh, my man. I got a terrible crossbite. But I mean, I'm making my way in the world today.

11:52Takes everything I've got. That's true. But I'm still able to chew pretty well. Yeah, yeah. That's what matters. Sure. So let's talk a little bit more about Fauchard, because he hasn't left yet. He really kind of got into this and laid the groundwork. He did the same thing that Pliny suggested that, like you said, you went to the same procedure. He called it interproximal stripping, which is essentially just filing down teeth to make more space between them. Yeah, like if it's crooked, give it a little more space and maybe it'll be able to straighten itself out. Yeah, or like you can file it down for the space and then you apply some sort of appliance to it to straighten that tooth too.

12:35But you got to make the space first. He came up with that. Yeah. Or what he did was push on the teeth, just like Celsus suggested. Like every day, you know, and this, you know, this makes sense. It's essentially what rubber bands and braces do. Just you're applying pressure to your teeth at a regular interval, like so many times a day. And so many. The idea is that they will move. Right. And it's true. Like, that's one of the amazing things to me is, like, if you apply even, like, a gentle bit of pressure over a long enough time span, your teeth will go where you want them to. So, one of the other reasons why Fauchard is remembered is because he essentially came up with the idea for braces.

13:22he basically used a waxed piece of silk or a wire or something and he would wrap a tooth that's say crooked to the neighbor next to it and that would apply pressure to straighten out the crooked tooth i'm sure in the worst case scenario it would make the other tooth crooked in the bargain so you really had to keep an eye on it yeah um and sometimes he would use a plate too to connect a crooked tooth to one that you wanted to use as pressure, or maybe a couple of them to use as pressure to straighten it out. And this eventually was like, this is the basis of what braces do for your teeth. This guy was inventing it in the early 1700s.

14:03Yeah, he also used a specific torture device called a Pelican. It had been around before, I think since at least the 14th century, It was used for pulling teeth, but he kind of rejiggered it and redesigned it to where it was basically a forcep that could pull a tooth, pull a tooth, like not out of your body, but in a certain direction. And if it sounds like awful and could lead to bad things, it very much could, because at least once on record, he fractured a tooth of a young woman that he was working on. And I imagine that was extremely unpleasant. I can't believe there's just the one that people mention, you know?

14:41I mean, that's the one on record. I'm sure it happened more than that, you know? Yeah. The girl was quoted as saying, yeah. Yeah, exactly. He also was smart enough to know that you could get infections from some of these techniques and procedures he was performing. So he recommended a mouthwash of wine and a specific kind of honey with some rose essence to it. Yeah. Um, he, I mean, this guy just, he just laid it down. And what's interesting is, um, he was doing this in the early 1700s and it wasn't really until the mid 19th century that it really started to become picked up again. And one reason why is because we viewed teeth much differently, at least in the West than we do today.

15:28Like you were saying, thanks to Hollywood and magazines and all that, you want to show off your teeth and you're going to be perfect. Back then, you did not show off your teeth. It was grossly impolite to let anyone see your teeth. Go back and look at any portrait from the 18th century. I will pay you$1.50 if you find one single portrait of a gentry or aristocrat, man or woman, who's showing their teeth in a painting. You can't find it because that was really rude and de classe. Yeah. I mean, almost any painting you think about, like it didn't occur to me until I, you know, did this research and you go to any museum and if you see teeth, it's probably to depict someone who is unhinged or like a prisoner escaping from prison or someone.

16:16Maybe a pirate. Yeah, a pirate or an asylum or something like that. And the teeth are all, you know, jacked up looking. Other than that, you don't see teeth in paintings. You don't? $1.50, everybody. But just the one of you, not all of you. Oh, man. We're going to get some—it's going to start rolling in, buddy. JPEGs coming at you with toothy paintings. Should we take a break? Yeah, we should take a break. All right, we'll take a break, and we're going to jump forward into the 1800s after this. Stuff, stuff, stuff.

16:50Stuff, stuff, stuff. New year, new goals, and in this economy, a better money plan is more necessary than ever. I am Matt. And I'm Joel. We are from the How to Money podcast, and every week we help you to spend smarter, save more, and make sense of what's going on out there. If you want 2026 to be the year you finally feel in control of your money, we're here to give you the tools and advice to help you make it happen. Listen to How to Money on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hi, I'm Dr. Priyanka Wally. And I'm Hari Kondabolu. It's a new year. And on the podcast Health Stuff, we're resetting the way we talk about our health.

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19:28So like I said, Fouchard was working in the early 1700s. By the mid-19th century, I guess people's thoughts on teeth were changing. And they were like, okay, we can show our teeth, but they got to look good. So let's get back into orthodonture. Another Frenchman, Pierre Joaquin Le Foulon, he's the one who came up with the word orthodontics. Actually, he called it orthodontici. You have to say it like that. And in Greek, ortho means straight. Dante is teeth. So straight teeth is what the word orthodontics means. You know, I love that when that happens. Pretty on the tooth. Yeah. I can't even follow that.

20:10So they didn't call themselves that yet in most cases at the time. That kind of caught on more and more as things went on. But dentists started to do this stuff. There weren't like specialists that only did orthodontics yet. It was just part of dentistry. And tooth straightening was part of dentistry. And you were an apprentice who learned that kind of thing. Dental colleges started being organized in the mid-19th century. But, I mean, when was the first orthodontic school? That was in the 20th century, right? Yeah, either the very beginning of the 20th or the very early, or no, yeah, very late 19th century.

20:50I think it was Edward Engel. Yeah, 1900s, the Engel School of Orthodontia was the first sort of standalone thing where it wasn't just part of a dental school. Precisely. All right. So some of the other advancements that the 19th century contributed can all be kind of lumped together under the umbrella term of headgear. Yeah. Or, uh-uh, if you're a teenager. Yeah. Which is you're using your skull and the substance of your skull as a, oh, man, I wish I knew classical physics terms a little better. An anchor? Essentially, sure, yes. An anchor, a counterbalance. How about that? Okay. To provide the pressure needed to pull, say, like your jaw back.

21:37Yeah. There's something called a chin cup that you can use. I've actually seen modern pictures of it still in use in some cases to where there's a, well, the cup for your chin, there's straps that go back to the back of your head and around it. And it's meant to just slowly over time, pull your lower jaw back toward your, well, your, the rest of your head. Yeah. And it can correct an underbite. And that's as far back as, I think, 1802. Yeah. I love that idea, though. They were like, oh, we need some kind of like, we need some leverage to pull this jaw back. And we can't just have a kid stand by a wall and attach them to a wall.

22:14And somebody's like, what about their skull? Yeah. It's right there. Somebody went, bam! They don't use headgear as much anymore. Like you said, it still can be used, but not like it was used in the 80s. Luckily, I never had to go through the headgear trauma, but it was quite dramatic when you showed up to school having to wear one of those. Yeah, I remember Farmer Ted from 16 Candles. He had to wear one. Farmer Ted. And I think, oh, no, Joan Cusack had the neck brace. Yes. Yeah, okay. I thought that too, but no, it was neck brace. There's a couple other people we need to mention. another French dentist, Christophe Francois Delabarre.

22:54He created the wire crib, which was, I think we said Fouchard was the one who really kind of started the idea of braces. There's a distinct progression, a linear progression from Fouchard onward. And Delabarre came up with the wire crib, which is essentially exactly what it sounds like. Like you take a piece of chicken wire, fold it over like the teeth in question, tighten it up the way you want it, and there's your wire crib. It's not exactly like the braces of today, but the outline, the contours are there in it for sure. Yeah. It started to become in the 19th, I guess the second half of the 19th century, a little more scientific, and they started to kind of put a little more rigor into like, you know, figuring out how to do this the right way.

23:42A guy named Norman Kingsley from New York City was a very early, very popular orthodontist. He had a treatment for cleft palates that was very popular. and wrote a very influential guide called A Treatise on Oral Deformities in 1880. But, and this is something that you mentioned early on that we'll kind of keep talking about a little bit here and there, is that he was an artist, and he was very interested in facial symmetry and aesthetics. So he was, if not the first, one of the sort of early leading guys that was like, we want you to look good, and it may not just be about, like, your bite health.

24:17Right, exactly, exactly. He was also supposed to be really nice. He had a compliment for everyone he met. Oh, that's nice. So I just made that up, but I want to believe it about him. So there's some other stuff that kind of came along. Little by little, they were like, oh, okay, well, let's tackle this. One thing that you can be born with is a narrow maxillary arch. That is the jawline on the top of your mouth. your the row of your your row of top teeth are connected to your maxillary arch yeah about that the roof of your mouth yeah the lower um side of teeth is connected to the mandibular arch either way you can be born with one or both of them narrowed so they figured out you can put essentially an appliance a stick in between them and adjust it slowly but surely over time and press your jaw apart.

25:13Yeah. I mean, that is still a thing. My daughter has that. It's called an expander. I guess it was called that back then too. But, and like her two friends had braces, both had it too. So I think that may be way more regular now. I don't know anyone from my, our days in high school that had something like that. So I think the original one was they would put the screw bar in between, say your back molars because they're pretty substantial and just over time slowly adjust it i guess probably every visit and um that would press the the whole arch apart is that essentially what they're doing still today yeah it's like a wire cage that lives on the roof of your mouth it's attached to those rear molars uh and they yeah you go in there and they crank it out and make more room like the and it really works because the space between her front two teeth got comically large like You could fit a whole extra tooth in between when this thing was at its most.

26:10But they're basically just creating room for the future. Was the dentist like, or the orthodontist like, I've done too much? No, he's like, I've got a new record. Everyone get in here. Look at this girl. So I think you said, we talked about how the first orthodontist school was established by Edward Engel in 1900. Even before that, most of the people practicing orthodonture were now not only MDs, but also doctors of dental surgery, DDS. So they were really well-trained in medicine. And the reason why, not coincidentally, is this is because of a shift of direction that orthodonture went in to basically say, like, let's get even more scientific about this.

26:54And well, they did. Yeah, there was a guy named John Nutting Farrar, who some people call the father of American orthodontics or modern orthodontics. Not in the house I was raised in. He was the guy that was like, hey, let me do some actual experiments on animals and things. And let me see like that thing that we crank apart your teeth. Let me see how much the human body can like how much pain they can endure to move those teeth. like, and I'm kind of kidding, but basically like, let's find a happy medium between how far we can expand and how much like a child can take. Yeah. What's worse though, is he wasn't experimenting on children.