The ancient Egyptians and Etruscans are said to have pioneered orthodontics, using delicate gold wires and catgut (a type of wire made from animal guts) to straighten teeth. It’s a story that has been found in dentistry textbooks for decades, presenting our ancestors as surprisingly modern in their quest for the perfect smile. But when archaeologists and dental historians finally took a close look at the evidence, they discovered that much of it was myth.
Consider the restraint of El-Qattah in Egypt, dated around 2500 BC. The gold thread found with the ancient remains did not at all fulfill the function that was imagined. Rather than pulling teeth into alignment, these wires were used to stabilize loose teeth or hold replacement teeth in place. In other words, they functioned like prosthetics, not braces.
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Gold bands discovered in Etruscan tombs tell a similar story. These were likely dental braces intended to support teeth weakened by gum disease or injury, not devices intended to move teeth into new positions.
There are also quite convincing practical reasons why these ancient devices could not have functioned as orthodontic appliances anyway. Tests carried out on Etruscan devices revealed that the gold used was 97% pure, but pure gold is remarkably soft.
It bends and stretches easily without breaking, making it unusable in orthodontics. Braces work by applying continuous pressure over long periods of time, which requires a metal that is both strong and elastic. Pure gold simply cannot do this. Try to stretch it enough to straighten a tooth and it will warp or break.
Copy of an Etruscan dental prosthesis, made at the beginning of the 20th century. These original two-toothed dentures were discovered in a tomb in ancient Etruria (present-day regions of Tuscany and Umbria), Italy. | Wellcome Collection Gallery / Science Museum A622194 / CC BY 4.0 / Wikimedia Commons
Then there remains the intriguing question of the identity of the people who wore these gold bands. Many were found on female skeletons, suggesting that they may have been status symbols or decorative jewelry rather than medical devices. Tellingly, none were found in the mouths of children or adolescents, precisely where one would expect to find them if they were real braces.
No real need at the time
But perhaps the most fascinating revelation is this: ancient populations did not experience the same dental problems that we face today. Malocclusion – the crowding and misalignment of teeth, so common today – was extremely rare in the past. Studies carried out on Stone Age skulls show a virtual absence of overlapping teeth. The difference is in the diet.
Our ancestors ate tough, fibrous foods that required intense chewing. All this jaw work favored the development of strong, wide jaws, perfectly capable of accommodating all their teeth.
Conversely, modern diets are soft and processed, providing little exercise for the jaws. The result: our jaws are often smaller than those of our ancestors, while our teeth remain the same size, leading to the crowding we see today. Since crooked teeth were virtually non-existent in ancient times, there was little reason to develop methods for straightening them.
First rudimentary treatments
That said, ancient populations sometimes attempted simple interventions to correct certain dental irregularities. The Romans provide one of the first reliable references to what can be considered true orthodontic treatment.
Aulus Cornelius Celsus or Celse, Roman physician and author of the Iis century AD, indicated that when a child’s tooth grew crooked, it should be gently pushed back each day with a finger until it moved to the correct position. Although rudimentary, this method is based on the same principle used today: gentle, continuous pressure can move a tooth.
True scientific orthodontics began with the work of the French dental surgeon Pierre Fauchard in 1728.
After Roman times, progress was minimal for centuries. However, in the 18the century, interest in straightening teeth resurfaced, at the cost of sometimes particularly painful methods.
Lacking access to modern dental instruments, some resorted to wooden “bulging wedges” to create space between crowded teeth. A small wooden wedge was inserted between the teeth; by absorbing saliva, the wood expanded and forced the teeth apart. Rudimentary and excruciating, no doubt, but the practice was a step toward understanding that teeth could be moved by pressure.
Beginning of scientific orthodontics in the 18th century
True scientific orthodontics began with the work of French dentist Pierre Fauchard in 1728. Often considered the father of modern dentistry, he published a founding work in two volumes, The Dental Surgeon, or Treatise on Teeth (1728), which contains the first detailed description of the treatment of malocclusions.
The dental surgeon, or Treatise on teeth (volume 2), by the French dentist Pierre Fauchard (1679-1761). Second edition published in 1746. | Public domain / Source gallica.bnf.fr / Bibliothèque nationale de France
He developed the “headband”, a curved metal strip placed around the teeth to widen the dental arch. It is the first instrument specifically designed to move teeth using controlled force.
Pierre Fauchard also describes the use of wires to support teeth after their repositioning. His work marks a watershed, moving orthodontics from ancient myths and painful experiments to a scientific approach that will ultimately lead to modern braces and clear aligners.
A specialty in its own right
With the progress of dentistry in the 19the and 20e centuries, orthodontics became a specialty in its own right. Metal rings, archwires, elastics, then stainless steel make treatments more reliable.
Later innovations – ceramic braces, lingual appliances and transparent aligners – then made the process more discreet. Today, orthodontics relies on digital scans, computer models and 3D printing for remarkably precise treatment planning.
The image of ancient populations wearing gold and catgut braces is certainly seductive and spectacular, but it does not correspond to the facts. Ancient civilizations were aware of certain dental problems and sometimes tried simple solutions. However, they had neither the need nor the technology to move teeth as we do today.
The true history of orthodontics does not begin in Antiquity, but with the scientific advances of the 18th century.e century and beyond. A story already exciting enough without the need to add myths.
The Dr Saroash Shahid is a Senior Lecturer in Dental Biomaterials at the Institute of Dentistry, Queen Mary University of London (UK).
This article is republished from The Conversation under a Creative Commons license. Read the original article.
