Orthodontics

Orthodontics is a specialized branch of dentistry dealing with "malocclusions," or bad bite. The "bandolet," created in 1723, was the first known orthodontic apparatus; the most common modern orthodontic appliances include braces,retainers, tooth guards, and splints, all used to correct tooth and jaw problems such as crossbite, protruding or misaligned teeth, protruding or retruding jaw, tooth grinding, speech difficulties, and temporomandibular joint dislocation. Teeth-straightening and extraction to improve alignment of remainingteeth has been practiced since early times (Leonardo Da Vinci perhaps made the first written observation regarding teeth and bite); today, approximately one in every 50 people (25% being adults), is being treated by an orthodontist.

Orthodontics as an independent science began developing in the l880s. The first comprehensive treatise on dentistry, The Surgeon Dentist, publishedin 1728 by Pierre Fauchard (1678-1761), devoted an entire chapter to tooth irregularities and ways to correct them. In 1757, French dentist Bourdet wroteThe Dentist's Art, devoting a chapter to tooth alignment; in 1771, John Hunter wrote the first English text on the subject entitledThe NaturalHistory of the Human Teeth ; and the term orthodontia was coined in 1841 by Lafoulon and appeared in a book by J. M. Alexis Schange on malocclusion. In 1858, the first article on orthodontics was written by Norman W. Kingsley. His 1880 Treatise on Oral Deformities served as the catalyst for the new dental science, earning him the title of "The Father of Orthodontics." J. N. Farrar who published the two volume, profusely illustrated A Treatise on the Irregularities of the Teeth and Their Corrections and was adept at designing orthodontic appliances, suggested the use of mild force atintervals to move teeth; he ultimately became known as "The Father of ModernOrthodontics." The third influential figure in orthodontics, Edward H. Angle(1855-1930), devised the first simple and logical classification system for malocclusions which is still used as the basis for orthodontic diagnosis. He contributed significantly to the design of orthodontic appliances, founded thefirst school and college of orthodontia, organized the American Society of Orthodontia in 1901, and founded the first orthodontic journal in 1907. His highly praised reference book, Malocclusion of the Teeth, went through seven editions. Other innovations in orthodontics in the late 1800s and early1900s included the first textbook on orthodontics for students, published byJ. H. Guilford in 1889; Eugene Solomon Talbot's (1847-1924) suggestion to useX-rays for orthodontic diagnosis; and the use of rubber elastics, pioneeredby Calvin S. Case (or perhaps H. A. Baker).

Developments in orthodontics include more convenient, comfortable and less noticeable appliances such as tiny brackets instead of bands; "space age" wiresfor braces and bands developed through NASA, which require fewer replacements; braces with clear, tooth-colored, or multi-colored brackets with matchingor interchangeable colored elastics; retainers with a favorite logo or photo;tiny magnets attached to upper and lower molars instead of head gear to realign teeth; "lingual" braces connected to the back of teeth for completely invisible treatment; and computer technology to diagnose and plan treatment, andproduce images of the end results.

For more extreme problems, such as a jaw too narrow to accommodate a full mouth of adult teeth, expanders--devices used to widen upper and lower jaws--prevent overcrowding. Most effective when applied before puberty, upper expanders fit over the roof of the mouth and connect to the back teeth on either sideexerting outward pressure. A tiny key turned periodically further expands the frame, opening the sutures (the juncture where the bones of the mouth roofmeet) allowing new bone to grow into that opening. As there is no lower suture to open, lower expanders, which fit under the tongue, are designed to upright tipped teeth.

Disorders of the temporomandibular joint (TMJ), located immediately infront of the ears where the jaw bone connects to the skull, affect 60 million or more Americans and has many origins--from injury to high levels of stress. Symptoms include difficulty opening and closing the mouth--often the jaw will lock in one position; pain and noise when chewing; ear, temple, head, orface pain; debilitating headaches; loss of hearing or ringing in the ears; nausea; blurred vision; and dizziness. Diagnosis is difficult, as pain often emulates that caused by other problems. Treatments include reversible (splints,physical therapy, psychotherapy to relieve stress, chiropractic adjustments,and massage therapy), and non-reversible (crowns, surgery, and bite adjustment). Splints allow joints, muscles, and ligaments to rest, heal, and functionmore normally, and also reduce the damaging effects of clenching and grinding teeth, usually a stress-related activity.

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