August 26, 2025 • 43 mins
Crooked teeth have always been a thing, but it took us a long time to do something about it. Learn about the twisted history of orthodontics today!
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Speaker 1 (00:01):
Welcome to Stuff you Should Know, a production of iHeartRadio.
Speaker 2 (00:11):
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.
Speaker 1 (00:21):
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.
Speaker 2 (00:33):
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.
Speaker 1 (00:45):
Well, and I think I don't know. I think people
are interested in their.
Speaker 2 (00:49):
Bodies, especially when you say like that.
Speaker 1 (00:53):
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
(01:14):
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
(01:37):
you don't have to have perfect teeth. I like teeth
with a little personality. I like summer teeth.
Speaker 2 (01:42):
Yeah, I can't remember what they're what kind of teeth?
Speaker 1 (01:45):
Summer summer teeth.
Speaker 2 (01:46):
I've not heard that.
Speaker 1 (01:47):
You never heard that? Praise?
Speaker 2 (01:49):
No, what does it mean?
Speaker 1 (01:50):
Summer teeth? Summer here? Some are there?
Speaker 2 (01:52):
Oh, that's awesome, man, I love that. That's like a
what kind of dog is that? Sooner? Sooner? One kind
is another?
Speaker 1 (01:59):
Yeah, exactly.
Speaker 2 (02:01):
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
(02:21):
sort of like home or asylum for that yeah.
Speaker 1 (02:24):
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.
Speaker 2 (02:36):
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
(02:57):
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.
Speaker 1 (03:18):
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.
Speaker 2 (03:37):
Now, I did not know that that that was not
the way it was when we were young.
Speaker 1 (03:43):
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
(04:06):
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
(04:28):
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.
Speaker 2 (04:36):
Yeah, just give it another one hundred thousand years, chuck,
it'll work.
Speaker 1 (04:39):
Itself out exactly.
Speaker 2 (04:41):
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
(05:02):
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.
Speaker 1 (05:20):
Yeah, and less bone is happening there. So I mean
that's the history of my teeth is bone loss and
lack of bone.
Speaker 2 (05:28):
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,
(05:49):
so two fridays in a row, I went to the
endodontis and got root canals. How about that?
Speaker 1 (05:55):
Yeah, I've never had a root canal. Weirdly, that's the
one thing I haven't had.
Speaker 2 (06:00):
They're they're not fun, but they're well they're not fun.
Speaker 1 (06:04):
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
(06:24):
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.
Speaker 2 (06:37):
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.
Speaker 1 (06:57):
Yeah, good one.
Speaker 2 (06:59):
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
(07:20):
Pliny got in on it. Remember how much he used
to visit us in our podcast.
Speaker 1 (07:24):
Yeah, I mean I feel like Planning used to be
a firm entrant into the stuff you should know drinking game.
Speaker 2 (07:29):
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.
Speaker 1 (07:38):
Yeah, which is still a thing.
Speaker 2 (07:41):
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.
Speaker 1 (07:58):
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.
Speaker 2 (08:06):
How is that.
Speaker 1 (08:08):
What to get them filed?
Speaker 2 (08:10):
Does it hurt? Is it fir? Oh?
Speaker 1 (08:12):
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.
Speaker 2 (08:22):
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.
Speaker 1 (08:33):
Oh man, so sorry, sorry.
Speaker 2 (08:37):
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
(09:00):
that for that.
Speaker 1 (09:01):
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,
(09:21):
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
(09:43):
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.
Speaker 2 (09:53):
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?
Speaker 1 (10:06):
I think?
Speaker 2 (10:07):
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.
Speaker 1 (10:18):
Yeah, Yeah, that's what matters.
Speaker 2 (10:19):
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
(10:41):
space between them.
Speaker 1 (10:43):
Yeah, Like if if it's crooked, give it a little
more space and maybe it'll be able to straighten itself out.
Speaker 2 (10:48):
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.
Speaker 1 (10:58):
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
(11:18):
ideas that they will move right.
Speaker 2 (11:21):
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.
(11:43):
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
(12:03):
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.
Speaker 1 (12:24):
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
(12:45):
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.
Speaker 2 (13:00):
I can't believe there's just the one that people mention,
you know, I.
Speaker 1 (13:02):
Mean, that's the one on record. I'm sure it happened
more than that, you know.
Speaker 2 (13:05):
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.
(13:26):
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,
(13:46):
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
(14:06):
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.
Speaker 1 (14:19):
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
(14:40):
the teeth are all, you know, jacked up looking. Other
than that, you don't see teeth in paintings.
Speaker 2 (14:45):
You don't a dollar fifty everybody. Yeah, but just to
one of you, not all of you.
Speaker 1 (14:50):
Oh man, we're gonna get some. It's gonna start rolling in,
Buddy Jpeggs coming at you with toothie paintings.
Speaker 2 (14:58):
Should we take a break, Yeah, we should take a break.
Speaker 1 (15:00):
All right, we'll take a break and we're gonna jump
forward into the eighteen hundreds after this.
Speaker 2 (15:05):
So, like I said, Fauchard was working in the early
(15:27):
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
(15:48):
it like that. And in Greek, ortho means straight, Dante
is teeth, So straight teeth is what the word orthodonyx means.
Speaker 1 (15:57):
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
(16:18):
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.
Speaker 2 (16:37):
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.
Speaker 1 (16:47):
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.
Speaker 2 (16:56):
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,
(17:18):
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,
(17:41):
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.
Speaker 1 (18:00):
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.
Speaker 2 (18:14):
Somebody went bam.
Speaker 1 (18:16):
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.
Speaker 2 (18:33):
Yeah remember farmer Ted from sixteen Candles, He had to
wear one.
Speaker 1 (18:37):
Farmer Ted and I think, oh, no, junk Usuck had
the neck brace.
Speaker 2 (18:40):
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
(19:04):
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.
Speaker 1 (19:25):
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
(19:49):
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
(20:09):
it may not just be about like your bite health.
Speaker 2 (20:13):
Right exactly exactly. He was also supposed to be really nice.
He had a compliment for.
Speaker 1 (20:18):
Everyone he met, Oh that's nice.
Speaker 2 (20:20):
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
(20:41):
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
(21:02):
it slowly but surely over time. And press your jaw apart.
Speaker 1 (21:08):
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.
Speaker 2 (21:26):
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.
Speaker 1 (21:44):
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
(22:04):
its most. But they're basically just creating room for the future.
Speaker 2 (22:08):
Was the dentist like or the orthodonist like I've done
too much? No, you know, coming back now.
Speaker 1 (22:13):
He's like, I got a new record. Everyone get in here,
look at this.
Speaker 2 (22:16):
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
(22:37):
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.
Speaker 1 (22:51):
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
(23:13):
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.
Speaker 2 (23:24):
Yeah. What's worse though, is he wasn't experimenting on children.
He was experimenting on animals, which I picked, I.
Speaker 1 (23:29):
Mean dogs, Yeah, I guess.
Speaker 2 (23:33):
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.
Speaker 1 (23:47):
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
(24:10):
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.
Speaker 2 (24:22):
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
(24:45):
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
(25:09):
known today as tooth Fancy.
Speaker 1 (25:13):
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.
Speaker 2 (25:30):
Yeah, but yeah, he was revered. I'm sure he's still
revered in the halls of orthodontire.
Speaker 1 (25:37):
Certain halls.
Speaker 2 (25:39):
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
(26:01):
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.
Speaker 1 (26:13):
Yeah, a rift so wide. It was like the gap
between my daughter's teeth at maximum expansion.
Speaker 2 (26:19):
It's a ricker.
Speaker 1 (26:21):
Should we take another break? Yeah, all right, we'll come
back and finish up on braces right after this. Stop.
(26:45):
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.
Speaker 2 (27:02):
I thought the retainer was like post braces. That was
my experience.
Speaker 1 (27:05):
I think that can be true too. Okay, but I'm
pretty like my brother got a retainer and not braces
of course.
Speaker 2 (27:12):
Yeah, I'm sure his retainer somehow made him money too, accidentally.
Speaker 1 (27:18):
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.
Speaker 2 (27:35):
I could not find other than that he was Australian.
That's the best I can come.
Speaker 1 (27:39):
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
(28:00):
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.
Speaker 2 (28:08):
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
(28:29):
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.
Speaker 1 (28:47):
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,
(29:10):
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
(29:31):
were it was early enough where they were the wrap
around like an entire silver band around each tooth.
Speaker 2 (29:36):
M hm.
Speaker 1 (29:37):
It wasn't like glued on. Yeah, right.
Speaker 2 (29:40):
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.
Speaker 1 (30:00):
Oh well, yeah, sure, yeah.
Speaker 2 (30:01):
It was just a kind of bias I thought.
Speaker 1 (30:03):
Was great proximity bias.
Speaker 2 (30:05):
I looked and I could not figure out which one
it was. Maybe the frequency illusion is the best I
could go okay with.
Speaker 1 (30:12):
That makes sense. I didn't. Is it proximity bias even
a thing that I make that up?
Speaker 2 (30:17):
If it's not, it should because it's got a great,
great name. It really has legs.
Speaker 1 (30:21):
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.
Speaker 2 (30:31):
And then I guess those aren't invisible ligners. Those are just.
Speaker 1 (30:35):
Rear braces, right, yeah, party rear.
Speaker 2 (30:38):
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
(30:59):
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.
Speaker 1 (31:21):
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.
Speaker 2 (31:29):
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.
Speaker 1 (31:48):
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.
Speaker 2 (32:06):
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
(32:26):
this industry to discredit them. That's how that's how reviled
it is among mainstream orthodonics now.
Speaker 1 (32:32):
Is that because they genuinely think it's no good or
it's genuinely no good for their practice, no.
Speaker 2 (32:38):
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.
Speaker 1 (32:55):
I'm surprised they didn't think of a way to get
a piece of that business. You know.
Speaker 2 (32:59):
It happened. Happened while they were sleeping.
Speaker 1 (33:01):
Yeah, and I need to ask my brother how well
they worked for him, because I know he woren for
a little while.
Speaker 2 (33:06):
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
(33:27):
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.
Speaker 1 (33:42):
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.
Speaker 2 (34:00):
Yeah. I saw some article written by some square that
said non prescription glasses and fashion braces are the big
things right now.
Speaker 1 (34:11):
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.
Speaker 2 (34:21):
No, it doesn't make any sense, and I also kind
of suspect it might be an urban legend.
Speaker 1 (34:27):
I do too.
Speaker 2 (34:28):
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
(34:50):
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
(35:13):
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.
Speaker 1 (35:29):
I could see that. I mean, I you know, you
probably use rubber bands along with your braces.
Speaker 2 (35:33):
Right, I never had braces.
Speaker 1 (35:35):
Oh, you never had them at all.
Speaker 2 (35:36):
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.
Speaker 1 (35:43):
You got pretty good teeth, though, I've never noticed your
teeth being crooked or whatever.
Speaker 2 (35:47):
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
(36:08):
the way, Yeah, it was good.
Speaker 1 (36:10):
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
(36:32):
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.
Speaker 2 (36:40):
So kids like you were saying, it's just basically part
of being a kid today, you get braces at some point.
Speaker 1 (36:46):
It seems like it. I just I feel like Ruby
and most of her friends have braces.
Speaker 2 (36:51):
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.
Speaker 1 (37:12):
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
(37:33):
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.
Speaker 2 (37:54):
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
(38:17):
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
(38:38):
you the parent, don't have to pay for all of
it out of pocket. Maybe that's what's going on here.
Speaker 1 (38:44):
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
(39:06):
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.
Speaker 2 (39:17):
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?
Speaker 1 (39:36):
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
(39:56):
metal stumps there. Because I've spent quite a few without
going to the gist at one point.
Speaker 2 (40:02):
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
(40:23):
big secret to orthodonics and insurance. Yeah, and Chuck said, yeah,
so that means it's time for a listener mail.
Speaker 1 (40:31):
You're gonna wake up and Steve Martin's going to be
over you with a dental drill.
Speaker 2 (40:35):
God.
Speaker 1 (40:36):
By the way, highly highly highly recommend the two part
documentary on Steve Martin. Okay, it is great.
Speaker 2 (40:43):
I didn't even know it was out.
Speaker 1 (40:45):
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.
Speaker 2 (40:55):
I bet.
Speaker 1 (40:55):
Yeah, it's fun and I just recently rewatched Three Amigos
showed Ruby for the first time, which she thought was
very fun.
Speaker 2 (41:02):
I've never seen that one. Oh really, yeah, but.
Speaker 1 (41:05):
That seems like it would have been one on your list.
Speaker 2 (41:07):
I don't well, actually I do know why.
Speaker 1 (41:10):
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.
Speaker 2 (41:19):
I'll do my best, So I'd rather watch only murders
in the building.
Speaker 1 (41:22):
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
(41:43):
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
(42:07):
reads the notes. Obviously it's a little different in a
podcast setting, which I doubt listeners are often reading an
episode transcript.
Speaker 2 (42:13):
Oh yeah, well to go look that up. I figured this.
Speaker 1 (42:15):
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,
(42:36):
who says, Hey, come to ann Arbor, Michigan for a
live show, and we're maybe trying to work that out, Gabe.
Speaker 2 (42:42):
Yeah, we're batting around, Gabe. Good idea.
Speaker 1 (42:44):
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.
Speaker 2 (42:56):
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.
Speaker 1 (43:20):
Stuff you Should Know is a production of iHeartRadio. For
more podcasts my heart Radio, visit the iHeartRadio app, Apple Podcasts,
or wherever you listen to your favorite shows.
Welcome to Stuff you Should Know, a production of iHeartRadio.
Speaker 2 (00:11):
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.
Speaker 1 (00:21):
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.
Speaker 2 (00:33):
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.
Speaker 1 (00:45):
Well, and I think I don't know. I think people
are interested in their.
Speaker 2 (00:49):
Bodies, especially when you say like that.
Speaker 1 (00:53):
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
(01:14):
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
(01:37):
you don't have to have perfect teeth. I like teeth
with a little personality. I like summer teeth.
Speaker 2 (01:42):
Yeah, I can't remember what they're what kind of teeth?
Speaker 1 (01:45):
Summer summer teeth.
Speaker 2 (01:46):
I've not heard that.
Speaker 1 (01:47):
You never heard that? Praise?
Speaker 2 (01:49):
No, what does it mean?
Speaker 1 (01:50):
Summer teeth? Summer here? Some are there?
Speaker 2 (01:52):
Oh, that's awesome, man, I love that. That's like a
what kind of dog is that? Sooner? Sooner? One kind
is another?
Speaker 1 (01:59):
Yeah, exactly.
Speaker 2 (02:01):
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
(02:21):
sort of like home or asylum for that yeah.
Speaker 1 (02:24):
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.
Speaker 2 (02:36):
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
(02:57):
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.
Speaker 1 (03:18):
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.
Speaker 2 (03:37):
Now, I did not know that that that was not
the way it was when we were young.
Speaker 1 (03:43):
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
(04:06):
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
(04:28):
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.
Speaker 2 (04:36):
Yeah, just give it another one hundred thousand years, chuck,
it'll work.
Speaker 1 (04:39):
Itself out exactly.
Speaker 2 (04:41):
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
(05:02):
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.
Speaker 1 (05:20):
Yeah, and less bone is happening there. So I mean
that's the history of my teeth is bone loss and
lack of bone.
Speaker 2 (05:28):
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,
(05:49):
so two fridays in a row, I went to the
endodontis and got root canals. How about that?
Speaker 1 (05:55):
Yeah, I've never had a root canal. Weirdly, that's the
one thing I haven't had.
Speaker 2 (06:00):
They're they're not fun, but they're well they're not fun.
Speaker 1 (06:04):
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
(06:24):
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.
Speaker 2 (06:37):
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.
Speaker 1 (06:57):
Yeah, good one.
Speaker 2 (06:59):
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
(07:20):
Pliny got in on it. Remember how much he used
to visit us in our podcast.
Speaker 1 (07:24):
Yeah, I mean I feel like Planning used to be
a firm entrant into the stuff you should know drinking game.
Speaker 2 (07:29):
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.
Speaker 1 (07:38):
Yeah, which is still a thing.
Speaker 2 (07:41):
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.
Speaker 1 (07:58):
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.
Speaker 2 (08:06):
How is that.
Speaker 1 (08:08):
What to get them filed?
Speaker 2 (08:10):
Does it hurt? Is it fir? Oh?
Speaker 1 (08:12):
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.
Speaker 2 (08:22):
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.
Speaker 1 (08:33):
Oh man, so sorry, sorry.
Speaker 2 (08:37):
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
(09:00):
that for that.
Speaker 1 (09:01):
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,
(09:21):
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
(09:43):
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.
Speaker 2 (09:53):
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?
Speaker 1 (10:06):
I think?
Speaker 2 (10:07):
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.
Speaker 1 (10:18):
Yeah, Yeah, that's what matters.
Speaker 2 (10:19):
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
(10:41):
space between them.
Speaker 1 (10:43):
Yeah, Like if if it's crooked, give it a little
more space and maybe it'll be able to straighten itself out.
Speaker 2 (10:48):
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.
Speaker 1 (10:58):
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
(11:18):
ideas that they will move right.
Speaker 2 (11:21):
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.
(11:43):
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
(12:03):
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.
Speaker 1 (12:24):
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
(12:45):
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.
Speaker 2 (13:00):
I can't believe there's just the one that people mention,
you know, I.
Speaker 1 (13:02):
Mean, that's the one on record. I'm sure it happened
more than that, you know.
Speaker 2 (13:05):
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.
(13:26):
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,
(13:46):
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
(14:06):
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.
Speaker 1 (14:19):
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
(14:40):
the teeth are all, you know, jacked up looking. Other
than that, you don't see teeth in paintings.
Speaker 2 (14:45):
You don't a dollar fifty everybody. Yeah, but just to
one of you, not all of you.
Speaker 1 (14:50):
Oh man, we're gonna get some. It's gonna start rolling in,
Buddy Jpeggs coming at you with toothie paintings.
Speaker 2 (14:58):
Should we take a break, Yeah, we should take a break.
Speaker 1 (15:00):
All right, we'll take a break and we're gonna jump
forward into the eighteen hundreds after this.
Speaker 2 (15:05):
So, like I said, Fauchard was working in the early
(15:27):
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
(15:48):
it like that. And in Greek, ortho means straight, Dante
is teeth, So straight teeth is what the word orthodonyx means.
Speaker 1 (15:57):
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
(16:18):
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.
Speaker 2 (16:37):
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.
Speaker 1 (16:47):
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.
Speaker 2 (16:56):
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,
(17:18):
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,
(17:41):
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.
Speaker 1 (18:00):
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.
Speaker 2 (18:14):
Somebody went bam.
Speaker 1 (18:16):
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.
Speaker 2 (18:33):
Yeah remember farmer Ted from sixteen Candles, He had to
wear one.
Speaker 1 (18:37):
Farmer Ted and I think, oh, no, junk Usuck had
the neck brace.
Speaker 2 (18:40):
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
(19:04):
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.
Speaker 1 (19:25):
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
(19:49):
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
(20:09):
it may not just be about like your bite health.
Speaker 2 (20:13):
Right exactly exactly. He was also supposed to be really nice.
He had a compliment for.
Speaker 1 (20:18):
Everyone he met, Oh that's nice.
Speaker 2 (20:20):
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
(20:41):
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
(21:02):
it slowly but surely over time. And press your jaw apart.
Speaker 1 (21:08):
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.
Speaker 2 (21:26):
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.
Speaker 1 (21:44):
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
(22:04):
its most. But they're basically just creating room for the future.
Speaker 2 (22:08):
Was the dentist like or the orthodonist like I've done
too much? No, you know, coming back now.
Speaker 1 (22:13):
He's like, I got a new record. Everyone get in here,
look at this.
Speaker 2 (22:16):
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
(22:37):
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.
Speaker 1 (22:51):
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
(23:13):
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.
Speaker 2 (23:24):
Yeah. What's worse though, is he wasn't experimenting on children.
He was experimenting on animals, which I picked, I.
Speaker 1 (23:29):
Mean dogs, Yeah, I guess.
Speaker 2 (23:33):
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.
Speaker 1 (23:47):
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
(24:10):
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.
Speaker 2 (24:22):
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
(24:45):
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
(25:09):
known today as tooth Fancy.
Speaker 1 (25:13):
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.
Speaker 2 (25:30):
Yeah, but yeah, he was revered. I'm sure he's still
revered in the halls of orthodontire.
Speaker 1 (25:37):
Certain halls.
Speaker 2 (25:39):
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
(26:01):
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.
Speaker 1 (26:13):
Yeah, a rift so wide. It was like the gap
between my daughter's teeth at maximum expansion.
Speaker 2 (26:19):
It's a ricker.
Speaker 1 (26:21):
Should we take another break? Yeah, all right, we'll come
back and finish up on braces right after this. Stop.
(26:45):
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.
Speaker 2 (27:02):
I thought the retainer was like post braces. That was
my experience.
Speaker 1 (27:05):
I think that can be true too. Okay, but I'm
pretty like my brother got a retainer and not braces
of course.
Speaker 2 (27:12):
Yeah, I'm sure his retainer somehow made him money too, accidentally.
Speaker 1 (27:18):
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.
Speaker 2 (27:35):
I could not find other than that he was Australian.
That's the best I can come.
Speaker 1 (27:39):
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
(28:00):
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.
Speaker 2 (28:08):
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
(28:29):
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.
Speaker 1 (28:47):
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,
(29:10):
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
(29:31):
were it was early enough where they were the wrap
around like an entire silver band around each tooth.
Speaker 2 (29:36):
M hm.
Speaker 1 (29:37):
It wasn't like glued on. Yeah, right.
Speaker 2 (29:40):
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.
Speaker 1 (30:00):
Oh well, yeah, sure, yeah.
Speaker 2 (30:01):
It was just a kind of bias I thought.
Speaker 1 (30:03):
Was great proximity bias.
Speaker 2 (30:05):
I looked and I could not figure out which one
it was. Maybe the frequency illusion is the best I
could go okay with.
Speaker 1 (30:12):
That makes sense. I didn't. Is it proximity bias even
a thing that I make that up?
Speaker 2 (30:17):
If it's not, it should because it's got a great,
great name. It really has legs.
Speaker 1 (30:21):
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.
Speaker 2 (30:31):
And then I guess those aren't invisible ligners. Those are just.
Speaker 1 (30:35):
Rear braces, right, yeah, party rear.
Speaker 2 (30:38):
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
(30:59):
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.
Speaker 1 (31:21):
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.
Speaker 2 (31:29):
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.
Speaker 1 (31:48):
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.
Speaker 2 (32:06):
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
(32:26):
this industry to discredit them. That's how that's how reviled
it is among mainstream orthodonics now.
Speaker 1 (32:32):
Is that because they genuinely think it's no good or
it's genuinely no good for their practice, no.
Speaker 2 (32:38):
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.
Speaker 1 (32:55):
I'm surprised they didn't think of a way to get
a piece of that business. You know.
Speaker 2 (32:59):
It happened. Happened while they were sleeping.
Speaker 1 (33:01):
Yeah, and I need to ask my brother how well
they worked for him, because I know he woren for
a little while.
Speaker 2 (33:06):
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
(33:27):
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.
Speaker 1 (33:42):
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.
Speaker 2 (34:00):
Yeah. I saw some article written by some square that
said non prescription glasses and fashion braces are the big
things right now.
Speaker 1 (34:11):
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.
Speaker 2 (34:21):
No, it doesn't make any sense, and I also kind
of suspect it might be an urban legend.
Speaker 1 (34:27):
I do too.
Speaker 2 (34:28):
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
(34:50):
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
(35:13):
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.
Speaker 1 (35:29):
I could see that. I mean, I you know, you
probably use rubber bands along with your braces.
Speaker 2 (35:33):
Right, I never had braces.
Speaker 1 (35:35):
Oh, you never had them at all.
Speaker 2 (35:36):
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.
Speaker 1 (35:43):
You got pretty good teeth, though, I've never noticed your
teeth being crooked or whatever.
Speaker 2 (35:47):
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
(36:08):
the way, Yeah, it was good.
Speaker 1 (36:10):
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
(36:32):
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.
Speaker 2 (36:40):
So kids like you were saying, it's just basically part
of being a kid today, you get braces at some point.
Speaker 1 (36:46):
It seems like it. I just I feel like Ruby
and most of her friends have braces.
Speaker 2 (36:51):
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.
Speaker 1 (37:12):
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
(37:33):
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.
Speaker 2 (37:54):
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
(38:17):
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
(38:38):
you the parent, don't have to pay for all of
it out of pocket. Maybe that's what's going on here.
Speaker 1 (38:44):
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
(39:06):
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.
Speaker 2 (39:17):
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?
Speaker 1 (39:36):
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
(39:56):
metal stumps there. Because I've spent quite a few without
going to the gist at one point.
Speaker 2 (40:02):
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
(40:23):
big secret to orthodonics and insurance. Yeah, and Chuck said, yeah,
so that means it's time for a listener mail.
Speaker 1 (40:31):
You're gonna wake up and Steve Martin's going to be
over you with a dental drill.
Speaker 2 (40:35):
God.
Speaker 1 (40:36):
By the way, highly highly highly recommend the two part
documentary on Steve Martin. Okay, it is great.
Speaker 2 (40:43):
I didn't even know it was out.
Speaker 1 (40:45):
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.
Speaker 2 (40:55):
I bet.
Speaker 1 (40:55):
Yeah, it's fun and I just recently rewatched Three Amigos
showed Ruby for the first time, which she thought was
very fun.
Speaker 2 (41:02):
I've never seen that one. Oh really, yeah, but.
Speaker 1 (41:05):
That seems like it would have been one on your list.
Speaker 2 (41:07):
I don't well, actually I do know why.
Speaker 1 (41:10):
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.
Speaker 2 (41:19):
I'll do my best, So I'd rather watch only murders
in the building.
Speaker 1 (41:22):
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
(41:43):
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
(42:07):
reads the notes. Obviously it's a little different in a
podcast setting, which I doubt listeners are often reading an
episode transcript.
Speaker 2 (42:13):
Oh yeah, well to go look that up. I figured this.
Speaker 1 (42:15):
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,
(42:36):
who says, Hey, come to ann Arbor, Michigan for a
live show, and we're maybe trying to work that out, Gabe.
Speaker 2 (42:42):
Yeah, we're batting around, Gabe. Good idea.
Speaker 1 (42:44):
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.
Speaker 2 (42:56):
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.
Speaker 1 (43:20):
Stuff you Should Know is a production of iHeartRadio. For
more podcasts my heart Radio, visit the iHeartRadio app, Apple Podcasts,
or wherever you listen to your favorite shows.
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