Welcome to Stuff you Should Know, a production of iHeartRadio.
Hey, and welcome to the podcast. I'm Josh and there's Chuck. Jerry's here too, and 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, would have paired this with the history of dentistry, because that's, you know, kind of makes sense.
Sure, I feel like we would have had seen a real decline in listenership that week, but you know, you think so, No, 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, especially when you say 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 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 chicklets in my mouth. And I think there's a big trend that we've seen over the past, you know, twenty years, and really I feel like even the last ten years where Hollywood, especially people in the media all have perfect, perfect, perfect teeth, and 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 they're what kind of teeth?
Summer summer teeth.
I've not heard that.
You never heard that? Praise?
No, what does it mean?
Summer teeth? Summer 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. They're 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. You may have one, but there's a term for it, and it's like basically a term of endearment. They just find that very cute. Here in the US, it'd be like we 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 orthodonics is, 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, we're going to fix you up. Tough to blame them for that, but the criticism goes even further because the feel of orthodonics is like, forget about all that, we're actually helping cure health issues, right, 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. In the field of orthodonic 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 bracest. That's just what happens. You go to the dentist. Really around six or seven years old, they say, all right, you need to go to your orthodonos.
Now, I did not know that that that was not the way it was when we were young.
No, I mean I had braces twice, did you. Yeah, 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 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 our brain changed, and that meant the size of our jaw got smaller to make room for our bigger brain.
It's not like they were like, all right, they whoever decides this, you know, the panel God. 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 him. 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 one hundred thousand years, chuck, it'll work.
Itself out exactly.
Even more recent than that, the teeth were Orthodonics was probably not an issue for one hunter gatherers because the diet they had was more much more challenging to their teeth and jaw, the bone that held their teeth in place because of the chewing they had to do well. 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. Spent the next couple of days like realizing how bad the cold sensitivity on the other one was. The following week I got the other one done. Yeah, so two fridays in a row, I went to the endodontis 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 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 palette and stuff like that discharge from
the ear, which is super gross. And there were have been mummies, like Egyptian mummies that look 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 catgut 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.
Yep, which is I mean pretty interesting. Again, this is post agriculture, so don't don't email us. Yeah. And also there's 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.
Yeah, 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 Orthodontrea 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 Planning used to be a firm entrant into the stuff you should know drinking game.
Yeah. Well he moved on to the dough boys. Oh 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 orthodontire 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 down in a lot of ways to keep the bite from pressing on other teeth, to make them, you know, keep them from becoming weakend. You know, still a thing.
How is that.
What to get them filed?
Does it hurt? Is it fir? Oh?
No, no, no, it doesn't hurt at all. It's just that only. Yeah, and then you smell the smoke and you know that part's all horrific. But there's no pain in ball because they're not hitting nerves or anything.
Okay, yeah, 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, plain of the elder, makes a pretty good case, but not really. It wasn't until the very beginning of the eighteenth century that a Frenchman, the French, would actually really have a lot to do with establishing orthodontire. Same was Pierre Fauchard, and he basically said, check this out, everybody, I'm going to work on wonky teeth. I'm gonna make my name that 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 they were you know, if he had one that was exceptionally longer, then it's 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. Like
I said, they still do those, including on me. That's an occlusional 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 it as an adult. My bite is way over to the I guess the bottom is Yeah, the bottoms to the right and to the left. Is that what it's called?
I think?
So, Oh my man, I got a terrible cross bite. But I mean, I'm I'm making my way in the world today. Takes everything I've got, 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's 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 inner proximal stripping, which is essentially just filing down teeth to make more space between them.
Yeah, Like if 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 too, straighten that tooth too, But you gotta make the space first.
He came up with that, yeah. Or what he did was 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 ideas 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. Yeah. So one of the other reasons why Fauchard is remembered is because he essentially came up with the idea for braces. He 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 make the other tooth crooked in the bar again, so you really had to keep an eye on it. Yeah, and sometimes he would use a plate too to connect a crooked tooth to one that you wanted to use a pressure, maybe a couple of them to use his 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 seventeen hundreds.
Yeah. He also used a specific torture device called a pelican. It had been around before, I think since the at least the fourteenth 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, that 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, I.
Mean, that's the one on record. I'm sure it happened more than that, you know.
Yeah, the girl was quoted as saying, yeow 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. I mean, this guy just he just laid it down.
And what's interesting is he was doing this in the early seventeen hundreds, and it wasn't really until the mid nineteenth century that 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. Like 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 eighteenth century. I will pay you a dollar fifty 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 day class a.
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 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 a dollar fifty everybody. Yeah, but just to one of you, not all of you.
Oh man, we're gonna get some. It's gonna start rolling in, Buddy Jpeggs coming at you with toothie paintings.
Should we take a break, Yeah, we should take a break.
All right, we'll take a break and we're gonna jump forward into the eighteen hundreds after this.
So, like I said, Fauchard was working in the early seventeen hundreds. By the mid nineteenth century, I guess people's thoughts on teeth were changing and they were like, Okay, we can show our teeth, but think I'll look good. So let's get back into orthodonture. Another Frenchman, Pierre joaquim Le Foulon, he's the one who came up with the word orthodonyx, actually called it orthodontice. You have to say
it like that. And in Greek, ortho means straight, Dante is teeth, So straight teeth is what the word orthodonyx means.
You know, I love that when that happens the too, Yeah, when I can't even have follow that. So 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. They weren't like specialists that only did orthodontics. Yet it was just part of dentistry, and too, straightening was part of dentistry, and you were an apprentice who learned that kind of thing.
Dental colleges started being organized in the mid nineteenth century. But I mean when was the first orthod's orthodontire school? That was in the twentieth century, right.
Yeah, either the very beginning of the twentieth or the very early or no, yeah, very late nineteenth century. I think it was an angle.
Yeah, nineteen hundreds. The Angle 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 thenineteenth century contributed it can all be kind of lumped together under the umbrella term of headgear or uh uh if you're a teenager, which is you're using your skull and the substance of your skull as a as a Oh, I mean, I wish I knew classical physics terms a little better, but essentially sure, Yes, an anchor, a counterbalance, how about that to provide the pressure needed to pull, say, like
your jaw back. There's something called the 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 towards your well, you're the rest of your head, and it can correct an underbyte. And that's as far back as I think eighteen oh two.
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. And somebody's like, well, 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 eighties. Luckily I never had to go through the head gear trauma, but it was quite dramatic when you showed up to school having to wear one of those.
Yeah remember farmer Ted from sixteen Candles, He had to wear one.
Farmer Ted and I think, oh, no, junk Usuck 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 de la bar He 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 of linear progression from Fouchard onward and de la Barr came up with the wire crib, which is essentially exactly what it
sounds like. Like you take a piece of chicken wire, fowl 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 nineteenth I guess the second half of the nineteenth 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. A guy named Norman Kingsley from New York City, it was a very early, very popular orthodonist. He had a treatment for cleft pallets. It was very popular and wrote a very influential guide called a Treatise
on Oral Deformities in eighteen eighty. But and this is something that you mentioned early on that will 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 aesthetic. 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.
Right 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 it. 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. The row of your row of top teeth are connected to your maxillary arch. Yeah about that, the roof of your mouth, yeah, the lower set 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 of stick in between them and adjust it slowly but surely over time. And press your jaw apart.
Yeah, 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 abracist both had it too, so I think that maybe 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 adjusted. I guess probably every visit, and that would press 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 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. Oh wow when this thing was at its most. But they're basically just creating room for the future.
Was the dentist like or the orthodonist like I've done too much? No, you know, coming back now.
He's like, I got a new record. Everyone get in here, look at this.
Carder, right, So I think you said we talked about how the first orthodontial school was established by Edward Engel in nineteen hundred. Even before that, most of the people practicing orthodontire were now not only MD's 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 orthodontire went in to basically say like, let's get even more scientific about this, and well they did.
Yeah. There was a guy named John Nutting Farrar who some people called the father of American orthodontics or modern orthodontics.
House I was raising, he was the guy that was like, hey, let me do some actual experiments and 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 the 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. He was experimenting on animals, which I picked, I.
Mean dogs, Yeah, I guess.
Yeah, So yeah that's for our What about Edward Angle who we talked about. This guy is probably the one, I mean my dad at least always called the house father of American orthodonics.
Yeah, I mean he's the guy that definitely made it such a bona fide business. And I think he found out much like a lot of different ways to make a lot of money. And you know, one way was like developing devices and patenting devices. Another way was creating like ready made appliances. He created the Angle system in
eighteen eighty seven. So it's like instead of like building these things from scratch for every patient, like I can just sell you this system that has all these prefab parts that can be combined in different ways to suit your needs.
Yeah, because I mean there's only so many ways that your teeth can be wonky, right, So yeah, that was revolutionary. I'm sure that just immediately pushed the field forward. And if that wasn't enough, he also came up with a measurement system called the occlusal classification system that's still in use today one hundred and thirty something years later, that they uses the basis like that is the norm. Yeah, and that's what they used to measure anything in a
patient's mouth that's deviated from the norm. He also, in addition to founding that first school of orthodontia, he founded the Society of Orthodonists, which is now the American Association of Orthodonists. He founded the first orthodonic journal, which is known today as tooth Fancy.
Oh man, what a nightmare magazine for me. It would be somebody, just you can punk me and give me subscription to tooth Fancy. All right, this guy had so many income streams. Who's you know, clearly a great orthodonists and dentist, but also a seemingly pretty savvy business guy.
Yeah, but yeah, he was revered. I'm sure he's still revered in the halls of orthodontire.
Certain halls.
Oh there's another This apparently is a debate that still rages today. At some point somebody said, hey, you know, we usually try to step in earlier in development, like to work on younger kids, I think is the way they put it. But sometimes adults need help too. So a lot of us are just pulling teeth maybe to make space or whatever. Should we be doing that? And some people said yes, some people said no, and a rift was formed that again still exists today in the orthodonic field.
Yeah, a rift so wide. It was like the gap between my daughter's teeth at maximum expansion.
It's a ricker.
Should we take another break? Yeah, all right, we'll come back and finish up on braces right after this. Stop. All right. If we're talking modern tooth straightening, we're talking about braces generally. I mean, I guess they still have retainers and stuff, but I feel like I see less and less of that, and it's more just sort of straight into braces. I feel like when we were kids, so like, yeah, we can probably fix this with a retainer.
I thought the retainer was like post braces. That was my experience.
I think that can be true too. Okay, but I'm pretty like my brother got a retainer and not braces of course.
Yeah, I'm sure his retainer somehow made him money too, accidentally.
Oh man, God bless him. So a lot of people had kind of shipped in to come up with things were basically like brace's one guy that was pretty key was name doctor Raymond Beg. His nickname was Tick. Do you know why I didn't find out why.
I could not find other than that he was Australian. That's the best I can come.
Up with, all right. But he was a student of Angle, I guess, at that school of orthodontia. Orthodontia, Yeah, Orthodontia. And he moved to Australia or I guess went back to Australia where he practiced in Adelaide, Lovely area. And this was in the nineteen thirties, and he developed like using stainless steel wire instead of precious metals, And I think didn't they use precious metals because they were malleable but that caused problems.
Yeah, well, they're they're very expensive and gold like you can't make a crown out of gold because eventually it'll it'll mash. But they were prized because they don't react with other stuff, Like you can need all the cheetos you want and your gold's not going to rust. It's not poisonous like mercury, which apparently they still use in
fillings in some places. Oh okay, yeah, so it But they're they're expensive, so people came up with alloys now today, although sometimes you still will see like gold or platinum or silver alloy sometimes fused with ceramic for implants and stuff. Yeah.
Well, the stainless steel, I mean, that's still that came about in what nineteen fifty six here in the States, and racist became you know, really more popular over that time, kind of starting in the fifties, but really in the seventies and eighties. I think an estimate from the AAO found the number of Americans who wear braces doubled between eighty two and two thousand and eight. Yeah, and you know, they've evolved over the years they had. I was not one of the first, but it was pretty early on.
My second set of braces were ceramic that like the clear braces, which was a little bit better, but it was not you know, you still had brace face, just a little less obvious. It's not like, you know, you couldn't tell or anything like that. Whereas my first braces were it was early enough where they were the wrap around like an entire silver band around each tooth.
M hm.
It wasn't like glued on. Yeah, right.
One thing though about that huge increase the doubling of people with braces between eighty two and two thousand and eight. I was like, that doesn't track with my experience. For me, it was the eighties where everybody's wearing braces. And then I realized that that's because I knew the most people wearing braces in the eighties, because that's when I was in elementary and middle school.
Oh well, yeah, sure, yeah.
It was just a kind of bias I thought.
Was great proximity bias.
I looked and I could not figure out which one it was. Maybe the frequency illusion is the best I could go okay with.
That makes sense. I didn't. Is it proximity bias even a thing that I make that up?
If it's not, it should because it's got a great, great name. It really has legs.
They also have braces that go in the back of your teeth. One of my good friends had those, and those, you know, can't be used in all cases, but that's the ones where you really score as a teenager for sure.
And then I guess those aren't invisible ligners. Those are just.
Rear braces, right, yeah, party rear.
Well, before we get onto invisible liners, which also created quite a rift in orthodonics. There's something that I guess it's the new standard maybe today, called self ligating braces. So with traditional braces, you have that wire's been around since Fouchard, you have the brackets that actually attached to your teeth, and then you have little tiny rubber bands that attack the brackets to the wire. Right, With self ligating braces, there's just the wire and the brackets, and
apparently it makes it way easier to clean. It makes it way easier to adjust when you switch out the wire for a thicker wire over time, because there's a little snap in the bracket that holds that wire in place. And they just look like the future to me.
Yeah. You can also get colored braces now too, which is a big thing if you get them young, like my daughter, she has purple braces.
Oh that's cool, loud proud. I guess. Now onto invisible ligners because this was kind of a big deal to Caltech. They might have been students at the time. Zia Chishti and Kelsey Worth invented them all the way back in nineteen ninety seven, and within just three years we had in visi line on the market.
Yeah, my brother used these for a while too, and this is something that you it's to avoid going to the orthodonists, I guess, and paying like a lot of money for permanent or not permanent but you know, temporarily glued on braces. This is something that you can you know, it fits over your teeth and you can take them on and off.
Sure any involvement in this industry, it's been pushed so far outside of traditional orthodonics that any orthodontist who is a critic of orthodonture and it's like questionable scientific basis, they they the orthodonic community will use their involvement with this industry to discredit them. That's how that's how reviled it is among mainstream orthodonics now.
Is that because they genuinely think it's no good or it's genuinely no good for their practice, no.
Good for their practice, because it's not so much the invisible liners. It's the fact that you can order them yourself online and they'll like you're they're just totally cut out of the loop. So it's that's it's specifically the online ordering version that they have such an aversion to.
I'm surprised they didn't think of a way to get a piece of that business. You know.
It happened. Happened while they were sleeping.
Yeah, and I need to ask my brother how well they worked for him, because I know he woren for a little while.
I think they work if you have just slight adjustments you need to make. But if you have like a really like a big deal in the wonky department, then you should go with braces. One other big check in the favor of braces over invisible liners. You can adjust the braces throughout the treatment. I need a little more pressure here, a little less here. You can't do that with invisible liners. Once you send them the mold of your mouth, they send you the braces back, and that's that.
I think you get multiple ones, but it's much less precise over time as braces.
Right. Livia found this, and I didn't know this is a thing, but apparently she found that there are some anecdotal evidence at least of young people wanting braces as a fashion statement, like a decorative fashion brace that you can get online.
Yeah. I saw some article written by some square that said non prescription glasses and fashion braces are the big things right now.
Man, oh man, I mean, I were you know very famously were fake glasses to seem smarter when I was younger, But you couldn't have caught me dead with fake braces.
No, it doesn't make any sense, and I also kind of suspect it might be an urban legend.
I do too.
One thing that doesn't seem to be an urban legend that I saw there was gap bands, apparently people kind of but with an S on the end of band, where you use like a kind of like a really strong rubber band. You put it on the tooth you want to straighten out, and then connect the other one to a straight tooth to use it as leverage, and apparently it works really fast. Again, the orthodontric communities like
don't do those. Supposedly with some eight year old boy in grease who had done this himself, but the rubber band went up into his gums, and according to these people, he didn't notice, and it just ate away at the tissue up there and he ended up losing the very teeth, I think, his front teeth that he was trying to straighten in the first place. That too, sounds a bit like an urban legend, but I saw it in enough places that I wonder if it might be based on some sort of legitimate story somewhere.
I could see that. I mean, I you know, you probably use rubber bands along with your braces.
Right, I never had braces.
Oh, you never had them at all.
I did not need them as a kid. It wasn't until I was an adult that I started to kind of need them for my lower teeth.
You got pretty good teeth, though, I've never noticed your teeth being crooked or whatever.
That's because I don't smile and show my lower teeth number one, because I'm not insane. But number two, because those are the ones that are crooked. Luckily, it's my top row that's pretty straight. So when I smile, it looks like my teeth are great. But if I hey, they really Yeah, with the a lot on there, just kind of that was pretty good play acting too, by the way, Yeah, it was good.
All right. So let's talk about some stats. A few years ago, in twenty twenty two, three point one five million kids between eight and seventeen were getting orthodonic treatment. This sounds way low to me. Seven point four percent of that age group is all that was. There were other estimates that say about half of kids receive some kind of orthodonic treatment at some point. That seems low to me too, just based on anecdotal what I'm seeing around me. But you know, maybe that's right.
So kids like you were saying, it's just basically part of being a kid today, you get braces at some point.
It seems like it. I just I feel like Ruby and most of her friends have braces.
I mean that tracks I found a statistic that in the US alone, out of pocket spending amounts to five almost five and a half billion dollars a year. I'm orthodonture, and then insurance and medicaid covers an additional four point two billion, So it's like a ten billion dollar industry just in the United States alone.
Yeah, I mean, and you know, kind of going back as we'll finish up here to the beginning of like is this a medical issue or is it just to create, like, you know, kids without self esteem problems because they're maybe have crooked teeth. And certainly the rise of Hollywood and it used to say something sort of about class. I think it's still still can unfortunately, and you know, with with movies and advertisements and TV and stuff like that, YouTube,
social media, straight teeth is the thing. And you know, starting the post war era, like especially with young girls, they were saying, hey, you got little self esteem, it's probably because of your teeth.
I wonder though, so that that class thing, the socioeconomic part of it, that actually makes it hard to study orthodonics, because if you want to study people with say braces or something like that, you're automatically working from another kind of bias, a selection bias, because they are probably from a higher socioeconomic class than that average person who doesn't have braces, because so much of it is paid for
out of pocket. But it occurred to me just now, Chuck, Well you're saying that that I wonder if that whole thing about them fixing health issues or whatever is essentially made up to get insurance companies to cover what otherwise would be considered cosmetic. So they're actually doing it strictly for esthetic purposes, but they're trying to make it so you the parent, don't have to pay for all of it out of pocket. Maybe that's what's going on here.
Maybe. I mean, this is the kind of thing that's really hard to study as far as whether or not there is a medical benefit or need, because and Lvia points us out. You know, you've got to conduct randomized trials, So you have to find a large group of people who have, you know, pretty similar dental profiles, and you got to have one group that you get braces to and then a control group that you don't, and then follow them over a long period of time to see
what kind of problems developed, like headaches or something. And that's just really that's a tough study to pull off.
Yeah, and again, I mean the study population you're drawing from, like, nobody's going to do that. So if you're studying people who already have braces, you're automatically working with that selection bias because they're more likely to be from a higher socioeconomic group. Yeah, totally, you got anything else about braces?
The only thing I'll add I had the two kinds of braces. Oh, For many years after the braces, I had this bar put on the back of my lower teeth that span like the front five and that was supposedly to keep them in place neat and that eventually broke off, and I just went for years with those metal stumps there. Because I've spent quite a few without going to the gist at one point.
Yeah, I'm guessing college years and maybe immediately after bing bing bing. That's how it goes. Man, Let's see, well, you don't have anything else about braces. I don't either. Thanks to all the orthodonists out there for listening, uh and everyone. If I turn up assassinated in the next couple of weeks is because I did figure out the big secret to orthodonics and insurance. Yeah, and Chuck said, yeah, so that means it's time for a listener mail.
You're gonna wake up and Steve Martin's going to be over you with a dental drill.
God.
By the way, highly highly highly recommend the two part documentary on Steve Martin. Okay, it is great.
I didn't even know it was out.
Yeah, it's been out for a little bit. It's it's really really good, and it kind of makes me realize what a I mean. I've always been a Steve Martin fan, but it really knocks home what a treasure he is as a human.
I bet.
Yeah, it's fun and I just recently rewatched Three Amigos showed Ruby for the first time, which she thought was very fun.
I've never seen that one. Oh really, yeah, but.
That seems like it would have been one on your list.
I don't well, actually I do know why.
Why you don't watch vy Chase. Of course, he's the least funny part of the movie. You need to watch it for Martin Short and Steve Martin.
I'll do my best, So I'd rather watch only murders in the building.
No, I'm with you. I'm with you, all right, Hey, guys, this is what is this about? This is well, this is kind of about medical school, so it fits. I've been listening for nearly a decade. Was very excited to have an occasion to write in. During the episode on cigarettes, you mentioned an early physician who observed nasal swellings and excretiences and immoderate users of snuff, and Josh interprets this
as puffy pussy lumps in their noses. I recently graduated from medical school, and it's a rite of passage for medical students to describe a wound with puss as pussy, only to realize this word appears rather crass when written out. Instead, we use the word p U r u l E and purulent to avoid any potential misunderstanding. If a patient reads the notes. Obviously it's a little different in a podcast setting, which I doubt listeners are often reading an episode transcript.
Oh yeah, well to go look that up. I figured this.
Little nugget of knowledge might be helpful. I'm sure you hear this every day, but I want to say thanks for all the great work you do. Suffie Schnow has been a constant source of joy for me as I've navigated college, med school, marriage, fatherhood, and now residency training and pathology. You brought my perspective on a basterray of issues, and I always look forward to listening to new and
old episodes alike on my commute. And that is from Gabe, who says, Hey, come to ann Arbor, Michigan for a live show, and we're maybe trying to work that out, Gabe.
Yeah, we're batting around, Gabe. Good idea.
Yeah, And I tell you what, Gabe, if we come to ann Arbor, write us back from that very same thread in you and your friends and family or whatever, you know, not like twenty people, but you can get on the guest list.
Yeah, good idea, Chuck, that's a fool proof plan, no possible way for identity theft. That's right, And congratulations Gabe. On all of your academic and medical success, and thanks for listening to us that entire time. If you want to be like Gabe and send us a cool email, you can do that too, Send it off to stuff podcast at iHeartRadio dot com.
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