Popular Science Monthly/Volume 75/July 1909/A Revolution in Dentistry

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A REVOLUTION IN DENTISTRY
By RICHARD COLE NEWTON, M.D.

HAVE the dentists waked up? Some of them have. A new order of the "Knights of the Forceps" has been formed, called the "Orthodontists" (tooth straighteners). At last accounts there were sixty of them in America, as compared to 50,000 simple dentists. And what does it all mean? If I can compress a great deal of information into a limited space I can, perhaps, explain it and I think that it may be possible to make it clear why the movement is so important. Dr. Osier has said that the question of preserving the teeth is more important than the liquor question. When one reflects that a great deal of intemperance is caused by dyspepsia, with its mental and physical deterioration, and that the underlying cause of much of the generally prevalent dyspepsia is the decayed and defective teeth, which preclude complete mastication of the food (even if anybody in America had the time to eat properly), the solid truth of Dr. Osier's remark begins to dawn upon us.

Now the dentists, like the doctors, have begun to realize that their true mission is not "a general repairing business," but a systematic and well-considered effort to prevent and forestall the wholesale decay and loss of human teeth. Perhaps some idea of the very general use of false teeth may be gathered from the statement that 20,000,000 of them are exported from America to England every year. When we consider that probably not more than half of the inhabitants of that country indulge in the luxury of false teeth, no matter how many "grinders" they may have lost, these figures would seem to indicate that nearly every one in England suffers from defective or missing teeth. Observations so far as they have been carried in the United States show the same deplorable state of affairs.

A great many more or less ingenious explanations have been advanced from time to time, to account for this, as well as for the fact that so few Americans have regularly disposed teeth and well-shaped jaws. Our English friends have made much sport of our "hatchet faces," "lantern jaws" and the nasal tones of our voices. We are told that such an admixture of races, as is gradually taking place in our country, is the cause of our poor teeth. Nobody seems to know why it should be so. In fact, such a result is directly opposite to nature's beneficent course in admixtures of different races and species, where the tendency is to preserve the best and strongest features and eliminate the weak and faulty ones. I remember an elaborate article in some magazine, some years ago, which explained the great prevalence of poor teeth in America by saying, that they are caused by our habit of shaving our faces, while the orientals have sore and weak eyes because they shave their heads. The filth in which the latter live was not taken into account, nor the fact that the American women, who do not shave, have as bad teeth as the men.

A rather ingenious explanation of the marked disproportion between the size of the teeth and that of the jaw in many Americans, as for example, large teeth in small jaws, so that the former are crowded out of position and overlap one another, is that the big teeth are inherited from one parent and the small jaws from the other. This sounds plausible and since no systematic effort has, so far as I know, been made to find out the truth of the matter, it has been tentatively accepted for want of a better explanation of an exceedingly common phenomenon.

Recently some good observers, notably Dr. Sim Wallace and Dr. Harry Campbell, of England, have said that the trouble is not hereditary at all, but begins in each person's babyhood, and that our teeth are poor and irregular and our jaws contracted because we do not exercise these parts sufficiently from infancy to manhood; especially from weaning until six years of age, when the permanent teeth begin to erupt. In support of this statement they point out that the first set of teeth is practically never irregular, never overlaps and is very seldom defective. The beautiful lines of a baby's face are not distorted by irregular or protruding teeth, nor sunken by reason of the non-support of sufficiently wide jaws. The teeth of savages, Hottentots and Esquimaux are almost invariably excellent, and their jaws and tongues are wider and stronger than ours. This has been proved by the measurement of thousands of skulls as well as by observations upon the living inhabitants of the tropics and the arctic regions.

Dr. Campbell also points out that the frequent occurrence of adenoids in young children is caused by feeding them chiefly "pap." He calls this the "pap age." The good old-fashioned plan of chewing sufficiently hard and dry food to properly exercise and develop the jaws and teeth, seems to have been abandoned in our effete civilization. Instead of the honest "johnny cake" (called in the south "corn pone" or "hoe cake") upon which such sturdy characters as Andrew Jackson and Abraham Lincoln were wont to subsist—and, by the way, the American negro had good teeth and practically escaped tuberculosis so long as he lived upon simple corn bread and bacon and the vegetables and fruits from the plantation. I started to say, however, instead of corn bread and Boston brown bread and rye and "injun" bread, the breads of our grandfathers, which required mastication and insalivation before they could be swallowed, our children now are fed on "previously cooked" breakfast foods, infant foods and other starchy viands, which may differ in name and flavor; but agree in two characteristics, viz., that they pander to lazy housekeeping, by requiring very little preparation for the table, and, secondly, require little or no mastication, before swallowing. Wetted with milk or cream they "slip down" very easily, and are landed in a stomach not prepared for a deluge of unchewed and non-insalivated starchy food. Hence the common cry of "starch indigestion." This is not wonderful because the proper digestion of starchy food must begin in the mouth, and is impossible without complete mastication. We are told in Science that in feeding meal to calves, "it must be spread" thinly upon the bottom of the troughs so that it will be eaten slowly and insalivated." This is only one instance out of many where man's commercial instinct has taught him an invaluable truth in regard to the rearing of stock, that has a market value, but which it never seems to have occurred to him is just as important in connection with the rearing of his own children.

So far as the improper development or non-development of our teeth, jaws, tongues and lips is concerned, the trouble begins with the nursing bottle from which the infant gets its nourishment too easily and too rapidly, so that these important structures are all more or less undeveloped, and this non-development is a continuous performance up to adult life. Of course removal of adenoids, regulation of the teeth, boring out the nasal cavities and so on, are resorted to with great benefit, to obviate defects that should have been prevented by mothers nursing their babies and then making the children chew their food as nature intended them to do. If a child will not chew its food, the despised habit of chewing gum, now known to have prevailed among the Indians, should be encouraged.

Dr. Robinson, an English writer, calls attention to the development of the jaws of English boys who were taken out of the streets of London and sent into the British navy. He says "undoubtedly the most noticeable improvement in them, next to their superior stature and healthy appearance, was the total change in the shape and expression of their faces. On analyzing this, one found that it was to be mainly accounted for by the increased growth and improved angle of the lower jaw." This change was due to the rations of "hard tack" and "salt junk" upon which these lads had subsisted. A very satisfactory diet from an orthodontological point of view at least. It is plain enough that ninety per cent, of dental work might have been avoided; just as ninety per cent, of the sickness and premature death in the world is needless and could be prevented. The dentists have made the astonishing discovery that they can alter and enlarge the jaws of any child by simple means and they have found out, moreover, that the teeth themselves and their arrangement are the pattern from which the jaw takes its shape. The teeth in different skulls differ so much, that it is extremely difficult, if not impossible, to "match" a missing tooth in one jaw with a tooth from any other one. The natural teeth then have an individuality in keeping with each particular face, and when they are in good condition and in their proper position, can not but add to the beauty, dignity and symmetry of the face. Three people out of four seem to lack in the proper development of the lower part of the face by reason of defective and misplaced teeth, and weak and ill-developed jaws. Hence we see that the "man of destiny," "the man with firm jaw, who knows his own mind," is presumably one who was made to chew properly in childhood, and was not allowed to wash down his food half chewed, or unchewed by gulps of liquid.

PSM V75 D056 Before and after photos of orthodontal jaw treatment.png
Before. After.

It is not true, that the teeth must fit into the jaws; the reverse is true, the jaws form themselves around the teeth. The bone grows around the roots of the teeth and forms a socket like the mortar or cement around the bricks in a fire-place. This is easily demonstrated; a tooth, for example, can be completely turned round or moved from one place to another, and, as we say, it grows "fast." For that matter, teeth, as is well known, can be extracted, cleaned and put back again, or teeth from one persons mouth can be put into the place of an extracted tooth in another's mouth and become firmly imbedded and do good service for years. The part of the jaw-bone that embraces the roots of the teeth is called the alveolar process, and it continues to grow and harden for some time after the teeth have been erupted, or after they have changed their places in the jaw. Upon this elemental truth is founded the art of orthodontia. Were the facts not as stated, it would do no good to alter the positions of teeth, since they would not retain their new positions after they had been moved into them. The fact that the jaws can be widened by spreading the teeth, taken in conjunction with the adaptibility of the "alveolar" process, make the remarkable results of the orthodontist possible. The size, shape and strength of the lower jaw, or mandible, depend in great part upon the work it has to do, and furthermore, the shape of the upper jaw is determined by that of the lower. The lower permanent teeth are erupted first, and by their repeated impactions upon their opponents in the upper jaw, aided by the constant restraining and forming action of the tongue and lips gradually force the upper teeth into their proper

PSM V75 D057 Before and after photos of orthodontal jaw treatment.png

After. Before.
 

places and keep them there. Provided, that the lower jaw and the tongue and lips are strong and well developed, made so by sufficient chewing, especially from the years of two to six, in a child's life. If the child's education in chewing, however, has been neglected, the dentist can and does spread the jaw as already stated, so that it will have room enough for all the teeth. In other words, orthodontia does what nature would accomplish unaided were her simple laws of development properly observed.

A full set of teeth forms a beautiful arch, no stone of which should be missing. The shape and span of this arch are greatly determined by the size and position of the four permanent first molars, "six-year old molars," the largest and most important teeth in the head. If these teeth are properly disposed in the jaws, the regulation of the remaining teeth is much easier than otherwise. If they are out of place, they must be brought back to where they belong, because it is essential that they should be in their proper position and serve as the guides for the regulation of all the other teeth. Then by measuring the width of one of the eye teeth and the two front teeth next to it, a diagram can be drawn which will show the exact shape and size which the jaw should have. A very simple arrangement of springs and wires, which need hardly annoy the child at all, will soon spread the jaws and give the teeth room, so that those that are out of alignment can be brought into their proper places in the arch.

In this arch, like the arch of a bridge over a stream, every tooth must bear its proper share of the pressure, and its loss can never be replaced. A moment's reflection will show the folly of extracting teeth to make room for those out of alignment, and modern dentistry has

PSM V75 D058 Before and after photos of orthodontal jaw treatment.png

Before. After.

proved that such extraction will defeat the object for which it is undertaken, viz., the restoration of the perfect denture. A man who will extract a tooth in regulating may be foolishly clinging to the old tradition, that was spoken of just now, that the unfortunate child had inherited large teeth from one parent, and small jaws from the other. I remember, by the way, in my own boyhood, I seriously thought that I had by mistake got somebody else's teeth, because my permanent teeth were so large and broad, that my jaws could not accommodate them, and were so crowded that several were extracted to make more room. Now I know that my "hatchet face" and "lean jaws" might easily have been prevented had some modern orthodontist, who would die before he would extract a sound tooth, given me the proper advice and care.

A little patient of my own (see photograph) was told by her dentist that her upper front teeth would have to be extracted, as they protruded so that she could not close her mouth. On hearing this, I was simply horrified. I induced the parents to consult a competent orthodontist, with the result that on meeting the child on the street about three months afterwards (see photograph), I didn't recognize her. Here are two pictures of a dentist's son "before and after taking" a course of treatment. His father regulated his teeth.

In orthodontia an inconceivably great advance has been made in preserving human beauty, health and efficiency. And the people who have been bewailing nature's inadequacy and asserting that our race is gradually deteriorating so that the coming man will be "edentulous" (toothless) are asked to take a back seat. They belong in the same category with the people in Philadelphia, who objected to opening some playgrounds to children, because the latter shouted when they played. Just as if play without shouting could be any good for young children; even in Philadelphia.

A great and beautiful truth has been taught us by these orthodontists. Every good man, every religious man, and every one who rejoices in beauty, in symmetry, in efficiency and in the comforting reflection that nature does not make mistakes—man makes the mistakes, and is sometimes blasphemous enough to lay the blame upon God—ought to rejoice at the clear proof that there was no mistake made in allotting thirty-two teeth to an adult human being. That the properly shaped jaw can hold all of these teeth, and that modern ideas of the fitness of things demand a full complement of teeth in a properly shaped jaw. That the firm well-rounded chin, the resolute jaw and symmetrical cheeks, and the appearance of decision, vigor and alertness so necessary for either male or female beauty of expression, belong by right to every American man and woman; not to mention the fact that the "laughing pearls" of perfect teeth can be possessed by any one, and some one has sinned, either the man or his parents, if the denture is defective and the jaws ill-developed.