The history of orthodontics dates back to ancient times and practices pioneered by early advanced civilizations, including the ancient Egyptians, Etruscans, Romans, and Greeks. While today, it is conceived of as a modern branch of dentistry that focuses on diagnosing and treating malocclusion (i.e., the misalignment of the teeth and bite of the mouth), much of the history of orthodontics exists as a facet of dental history. Still, through specific examples, we can carve out instances of orthodontic techniques that stand as signposts for significant moments in the history of orthodontics.
The History of Dentistry in the AlgerBlog
Those who have been reading the AlgerBlog have followed the historical recounting of dental history across multiple articles, including looks at Ancient Dentistry, Dentistry in the Age of Enlightenment, and Modern Dentistry of the 19th Century and 20th Century. In this latest blog series, we are focusing specifically on the orthodontic contributions to this shared dental history, beginning with the orthodontic turning points of the ancient world and concluding with modern milestones. This article initiates that history by plotting, first, the orthodontic contributions that predate the modern conceptualization of orthodontics, a notion that began to form in the 18th century. Subsequent articles will consider the advancements in modern orthodontic techniques and technologies and the development of orthodontics as a distinct dental specialty.
The Ancient Origins or Orthodontic History
The practice of straightening teeth and improving dental alignment has existed for millennia and has its roots in the practices of ancient civilizations. Evidence of early attempts to correct misaligned teeth and knowledge of malocclusions can be found in the tombs of ancient civilizations, where rudimentary dental appliances were used, and writings of early philosophers espoused new knowledge of orthodontic treatments.
The First Evidence of Teeth Correction
The Egyptians, along with the Etruscans, Greeks, and Romans, believed that dental care and facial aesthetics played a key role in personal health and beauty. Evidence suggesting early dental and orthodontic practices can be found in the tombs and tomes of these ancient cultures.
The Ancient Egyptians
The earliest known attempts to straighten teeth date back to ancient Egypt, starting around 4000 BCE. Archaeologists have unearthed mummies with rudimentary metal bands wrapped around their teeth, suggesting that Egyptians might have used these devices to correct dental misalignment or even to preserve bodies for the afterlife. This technique was first discovered by Egyptologist Hermann Junker, who found teeth connected by gold wire in an Egyptian tomb in 1914. While these early attempts were far from the sophisticated braces we use today, they represent humanity’s earliest known efforts to address dental irregularities through applied tools and techniques.
The Etruscans
The Etruscans were an ancient civilization that inhabited the Etruria region in ancient Italy from about 900 BC until they were formally incorporated into the Roman Empire in 27 BC. The Etruscans were pioneers of many early dental techniques, and their contributions laid the groundwork for some of the mainstays of modern orthodontics. Examples include their uses of early forms of dentures, utilization of both human teeth and animal teeth as prosthetics, and the practice of binding teeth together using gold. They were the first civilizations to apply gold in dentistry, using the precious metal to craft gold replacement teeth, which were seen as symbols of wealth and an early symbol of cosmetic dentistry.
The Birth of Dental Theory
Ancient Greek and Roman texts from around 400-300 BC contain some of the earliest philosophical reflections on dental health. While the tools and techniques described in these texts were not sufficiently advanced to allow for the creation of truly effective orthodontic treatments, they stand as important stepping stones toward the modern practices applied today.
The Ancient Greeks
Hippocrates, often referred to as the “Father of Medicine,” wrote about the alignment of teeth in his work Epidemics, which was written in the 5th century BC. Through his writing, Hippocrates not only acknowledged malocclusions but suggested that pressure might be used to move teeth into better positions, thus alleviating some of the resulting symptoms of the misalignment, such as headaches and otorrhea.
The Greek physician Galen also discussed the concept of oral health and dental care, noting that teeth could become misaligned due to the irregular growth of the jaw. While both Hippocrates and Galen laid the groundwork for understanding the importance of dental structure, the practice of orthodontics would not develop into a recognizable discipline until much later.
The Romans
The Roman encyclopedist and physician Aulus Cornelius Celsus also wrote about teeth alignment in his 1st-century medical treatise De Medicina. While acknowledging the replacement of deciduous teeth by permanent teeth, Celsus prescribed using one’s finger to direct the incoming tooth to the proper place in the mouth. He wrote:
In children too if a second tooth is growing up before the first one has fallen out, the tooth which ought to come out must be freed all round and extracted; the tooth which has grown up in place of the former one is to be pressed upwards with a finger every day until it has reached its proper height.
The Roman philosopher Pliny the Elder promoted another technique for aligning teeth: filing down “longer” teeth to ensure all teeth fell into a uniform line. This practice was echoed by Galen in Greece, who added that the process could be carried out over several sessions if filing down teeth was too painful to perform in a single go. The teeth alignment practices of finger pressure and teeth filing, while absurdly arcane by modern standards, remained in use as early orthodontic techniques until the 18th century.
The Middle Ages: A Period of Stagnation for Orthodontics
During the Middle Ages, interest in dental health waned as medical knowledge stagnated. The Early Middle Ages would be known as the “Dark Ages” in part because of the time’s regressive attitude toward knowledge and scientific study. This intellectual darkness would hinder scientific development for the majority of the Middle Ages. Thus, it should come as no surprise to learn that there were few significant advancements in the field of orthodontics during this time. Dentistry as a profession was rudimentary at best, and the study of teeth was largely neglected. However, with the dawn of the Renaissance, scientific curiosity was reignited, and the study of human anatomy, including the structure of the teeth, gained momentum. Despite this intellectual revival, it wasn't until the 18th century that orthodontics as we know it began to take shape.
Continuing to Chart the History of Orthodontics
In the next AlgerBlog, we will look at the advancements of modern orthodontics, starting with impactful contributions made by scholars and practitioners starting in the 18th century. This history will track the development and distinction of orthodontics as it refines and becomes distinguished as a formally recognized dental specialty.
Visit algerinc.com to continue your education of dental history, learn about other interesting topics, and--if you’re a practicing dentist or orthodontist--read about Alger Inc.’s prized piece of dental technology: the AlgerLight with LED.