TEETH TAKE A DETOUR
Buck teeth can drive you to crime or suicide, but modern dentistry knows how to put crooked ivories in their place
C. FRED BODSWORTH
ONCE upon a time a dentist was a man who mended damaged teeth. And if he couldn’t mend them he did the next best thing . . . ouch! But there’s a fasteexpanding branch of today’s dental profession whose members are working overtime at a new job they’re remodelling teeth. And sometimes, in doing so, they help remodel a personality.
Let me tell you about Johnnie. To almost everyone except his own parents he was known as “Tusky” because of his prominent, protruding upper front teeth. On his first day at school one of the older boys originated the nickname and from that day onward Johnnie was never one of the boys.
Johnnie’s case was so severe that when his back teeth were closed, his front teeth failed to meet, and all of his food had to be broken up into small pieces and put into his mouth by hand for chewing. He had never taken a bite out of an apple or sandwich. His fingers or penknife had to do the biting job that the normal individual does with his front teeth.
Teased by playmates, he became an outcast. Before he was seven he had a severe inferiority complex, but being big for his age Johnnie found a satisfying response to his feeling of inferiority in bullying smaller youngsters. At 10 Johnnie was an antisocial AÍ Capone-in-the-making, with one juvenile court appearance for petty theft already on his record.
But one day in his tenth year a gang of five smaller boys ambushed Johnnie and beat him badly. All four of his protruding upper front teeth were loosened and his mother next day took him
to a dentist—for the first time in his life—to find out what should be done.
“The teeth are not harmed, they’ll grow in solidly again,” the mother was told. “But they should receive straightening treatment while the boy is still young.”
The dentist referred Johnnie’s mother to an orthodontist. Orthodontists are dentists who specialize in the correction of irregularly placed teeth.
There are 41 practicing orthodontists in Canada. Two are women (Mias Anita Mendel, Montreal, and Miss Olive Cole, Winnipeg) and almost half of them practice in Toronto or Montreal. There are about 1,500 orthodontists in the U. S. In all cit ies and towns where there are no orthodontists, t he simpler forms of adjustment are made by general dent ists.
For a year Johnnie wore a brace across his front teeth, not the conspicuous, uncomfortable appliance which t he ort hodontists used a few years ago, but a small, nearly invisible band of stainless steel which exerted a backward pressure against his protruding teeth and forced them to recede gradually toward the position nature intended for them. Johnnie being young, the bone which held the roots of his teeth was still somewhat plastic and the moving job was comparatively easy.
Toward the end of his treatment Johnnie dashed into the orthodontist’s office and exclaimed: “Doctor, I ate an apple wit h the other fellows yest erday ! I never did before because they used to make fun of me when I cut apples up with a knife before I ate them.”
Eating an apple with the gang was a great and new achievement for Johnnie and it was his first step back toward a normal life with playmates who no longer jeered.
When the brace was removed after a year. Johnnie’s front teeth
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were back in a normal position, his lips and chin line had improved and his Andy Gump profile was gone. Today he is finishing high school, still big and tough, but not in the bullying way he had started out, for now he is the most popular junior rugby halfback in his city and a good-looking six-footer to boot.
Normal teeth should mesh together like the gears of a cogwheel when the jaws are closed. If one cog of a gear is bent out of place it interferes with the operation of the whole gear and, similarly, one misplaced or elongated tooth can do the same thing in a person’s mouth.
Any abnormality in the positioning or interlocking of teeth is termed malocclusion by dentists. Malocclusion may be a minor displacement of a single tooth, it may be a serious deformity such as Johnnie’s, or, in rare instances, it may reach circus-freak proport ions in which the tooth development has run completely wild. One recent patient of a dental clinic of a midwestern U. S. university had nine extra teeth sprouting out all over the roof of his mouth. There are cases of teeth having appeared in the nose, or even as far away as the eye socket. One Kansas City girl went, to a dentist with a toothache, had X-rays taken, and was then informed that she had 190 extra teeth, ranging in size from that of a pinhead to a grain of rice, imbedded throughout her gums and the roof of her mouth. Dentists say such superfluous tooth production results when the tooth-budding formation in the unborn embryo fails to stop its work on schedule.
One of Four Have It
Wlio has malocclusion? You have, j unless you are a rare person, for j orthodontists say that a perfect mouthful of human teeth is almost as rare tus those hen’s teeth we often hear about. Dental examinations in Canadian and U. S. schools have shown that about 95% of white children have malocclusion in some form. Negro children average slightly less, but dentists believe that this is because on the average they get less soft luxury foods. About one person in four has a tooth irregularity serious enough to threaten general health, to detract from his appearance or, if still in childhood, to interfere with the future development of the jaw and face generally. Millions of these persons do not realize that they have malocclusion.
The underlying cause of malocclu-
The orthodontist learned that when the young woman started teaching, self-consciousness caused a nervous breakdown and she was forced to give up her teaching position just three months after accepting it. Finally she went to a dentist and demanded that he extract all of her teeth and give her artificial dentures. Since her teeth were sound, the dentist refused and recommended that she go to an orthodontist for corrective treatment.
sion is that evolution is causing our jaws to grow smaller. Primitive man had massive, apelike jaws but as man started up the evolutionary ladder toward present-day civilization he developed a taste for soft, cooked foods and since this diet gave bis jaws less work they have continually grown smaller. As a result our jaws have grown smaller faster than our teeth have. Our teeth have got into a traffic jam, and are crowding and pushing each other out of place.
A few more thousand years of evolution will probably take care of all this by giving us fewer teeth—many individuals already possess no wisdom teeth-—but in the meantime we have to take our own remedial action.
The late Dr. Charles Mayo, cofounder of the famed Mayo clinic at Rochester, Minn., said proper care of the teeth—straightening where necessary and prompt attention for decay —could lengthen the human life span by 10 years.
Teeth that are out of their normal position are hard to keep clean and are much more subject to decay than normally placed teeth. Uneven alignment puts more work on some teeth than others and this abnormal strain on certain teeth and on the associated gums is frequently a cause of pyorrhea. In some children irregular teeth prevent proper chewing of food, which in turn causes chronic indigestion troubles and, in severe cases, even malnutrition. Crooked and misplaced teeth may prevent normal development of the jaw and roof of the mouth and, since the roof of the mouth is also the floor of the nose, this leads to poor nasal drainage and infected sinus.
The health factor is obviously important but so are the improvement in appearance and the resultant improvement in personality which can follow orthodontic treatment.
Many persons still regard the straightening of teeth as an operation that, has to be performed during childhood or youth. That’s wrong. It’s easier then, but teeth usually can be straightened or moved successfully in persons up to 40 years of age, occasionally much older, although longer treatment will be required than in childhood.
Saving a Life
Here’s a case history described to me by a Toronto orthodontist.
“The patient was a 34-year-old exschoolmistress from an Ontario town,” he told me. “Her two upper lateral incisors (second teeth from the centre) had never formed, although there was ample room for them. The two central incisors had spread out into this vacant
space, leaving a wide gap between them. The cuspids (eyeteeth) were also affected by the vacant space next to them, they were elongated and sharp like fangs and tilted outward. When she opened her mouth all you could see were these four widely separated teeth which seemed to be dripping from the upper gum.”
“She came to me expecting me to tell her that little or nothing could be done,” the orthodontist said, “and she admitted that frequently, since losing her teaching position, she had been on the verge of committing suicide.”
First the central incisors were moved together and the fanglike cuspids tipped back into proper position, trimmed, and covered with porcelain jacket crowns. To each crown was attached a dummy porcelain tooth to take the place of the two missing teeth. These dummy teeth served the double purpose of filling the vacant spaces and holding in line the four teeth which had been moved. The whole operation took about a year and a half and cost more than $500, but by the time it was completed she had bloomed into an attractive, smiling, self-confident young woman. She’s married now.
Until a decade or two ago, appliances for straightening the alignment of teeth were crude, cumbersome braces with jackscrews for pushing or pulling the teeth. These were large and uncomfortable, often leaving the mouth and tongue sore for a long time.
Modern appliances are so small that hundreds of Canadian children five and six years old are wearing them today and forgetting that they have them in their mouths. Where pain or discomfort is present it is a sign that something is wrong in connection with the teeth or that the appliances need readjustment. By using X-ray the orthodontist can keep a close watch on what is taking place around the roots of the moving teeth.
One of the most common appliances is a wire arch which fits the inside or the outside of the teeth and is anchored at each end to a band wrapped around one of the rear molars. To this wire is attached a short strip of spring metal
fitted so that it pushes only against the teeth which must be moved. This type of appliance will tilt teeth outward or inward but when it is desired to shift a tooth laterally—to close up spaces between teeth, for instance—a coil spring, anchored to a neighboring tooth, is usually used. The coil spring, worn for several months, gradually pulls the misplaced tooth toward the tooth to which the spring is anchored.
Sometimes teeth are moved by attaching a wire to them which protrudes outside the mouth and hooks up with an elastic band which is fitted to a strap harness surrounding the head. This is a very complicatedlooking head cage, but it is worn only at night or during periods of the day when you are not expecting visitors. (The metal spring appliances must be worn all of the time.) Another nightwear appliance is a mold of flexible plastic or rubber which fits over your teeth and is held in place during sleep by the lips. To produce this mold, the orthodontist makes a plaster cast of your teeth and then cuts the crooked teeth from the cast and replants them in their proper position. From this corrected cast of your teeth he makes the rubber or plastic mold. Worn every night for a year or two, it shifts your crooked teeth just as surely as the orthodontist shifted those of the plaster cast.
Frequently orthodontists prescribe the use of a rubber gadget called a “bite strap,” which can be chewed or pried between the teeth in numerous ways, exerting pressure on whatever teeth require treatment.
Some orthodontists extract one or two or even more teeth so that more space is available for those which remain. Usually they try to remove poor teeth—teeth which are starting to decay or are not properly developed. The other teeth are then spaced out into the gaps provided. Other orthodontists oppose this practice. They argue that nature gave man 32 teeth and that extraction of a tooth or teeth for the purpose only of straightening other teeth is an unjustified interference with nature. They also argue that teeth rearranged in this manner will rarely mesh properly with the teeth of the opposite jaw.
Straightening teeth has become a fine art but even the orthodontists admit that somewhere around 80% of it could be avoided—if parents keep a close watch for the appearance of those tooth-sabotaging habits and introduce junior to a dentist before toothaches drive him there.
Parents should also do all they can to promote development of their children’s jaws and thus minimize tooth crowding as much as possible.
It’s simple. Just give youngsters plenty of hard food like toast, meat, celery, raw carrots, raw apples, etc., and keep them chewing. This will stimulate development of the jaws by increasing the blood supply and furnishing additional nutrition to the bones and teeth. Dr. Roy G. Ellis, dean of the faculty of dentistry, University of Toronto, says those rubber bones frequently bought for the family dog would do far more service to mankind if they were kept sanitary and given to the children to chew instead.
If a child has been eating plenty of hard food and the jaws are developing properly, spaces will begin to appear between the teeth at the age of five. Don’t worry about this; you’d have something to be disturbed about if the gaps were not there. The spaces mean that the jaw is developing properly so that there will be room for the larger permanent teeth which will appear in the child a few years later.
Those Baby Teeth
There are numerous other factors which cause directly or contribute to the development of crooked teeth. Heredity seems to play a part. Some children are horn with a condition that will lead to irregular teeth development despite all the toast, rubber bones too, that their parents can give them. The Dionne quintuplets have had the best medical and dental supervision that modern science can give, yet two of them are undergoing orthodontic treatment for serious malocclusions. But most cases of crooked teeth are the result of conditions which come into play after birth and are therefore preventable.
One of the commonest causes is premature loss of baby teeth. Those
baby teeth are very important, for they are the foundation on which the later permanent teeth develop. If a baby tooth is allowed to decay and has to be extracted before it is due to loosen and drop out naturally, the neighboring teeth are likely to drift or lean into the vacant space that is left by the extracted tooth. A few years later, when the permanent tooth is ready to grow up into that vacant space, there is not sufficient room for it. 'Die permanent tooth must either push out to the side, or remain impacted in the jawbone.
Another common cause of malocclusion in children are habits such as thumb-sucking, lip-biting and chinresting (while lying on the floor reading, say) which exert pressure on the teeth or jaws and interfere with normal development. A child’s teeth and jaws are much more pliable than generally supposed and any pressure, even though very slight, if applied habitually over a long period and against the same teeth is likely to do drastic things to their alignment and growth. Thumbsucking pulls the upper front teeth forward and forces the. lower front teeth backward. Lip-sucking—drawing the lower lip up between the teeth— has the same effect. Dentists say parents need not worry about these habits unless they persist after the third or fourth year. “But don’t wait until the third year before taking steps to break these habits,” the orthodontist advised. “They are easiest to correct at the beginning.”
Sometimes parents and dentists have a hard time persuading teen-agers to have their teeth straightened when it is necessary. Teen-agers are often afraid the metal bands will spoil their looks. But usually, by the time they are 20, they have changed their views. They realize that wearing metal bands on the teeth for a year or two is infinitely better than displaying crooked teeth for a lifetime. And perhaps they gef some consolation from the knowledge that some 5,000 other Canadians w'ill have their teeth in cages getting them straightened at the same time.
In all Canadian provinces except Ontario any dentist can specialize in straightening teeth and call himself an orthodontist. In Ontario, however, before a dentist can specialize in orthodontics to the exclusion of all other dental work he must have at least three years’ experience as a general dental practitioner and must then take a one-year postgraduate course in orthodontics at the University of Toronto dental school. This is the only specialized course in orthodontics given in Canada, although Canada’s four other dental colleges — Dalhousie, McGill, University of Montreal and University of Alberta—teach orthodontics in a less specialized form.
The fees charged by orthodontists vary widely, usually it’s a case of the bigger the city, the bigger the fee. The average treatment takes around a year (although it can he anywhere from 10 days to three years) and the patient visits the orthodontist approximately
every three weeks. Treatment for adults takes longer and costs more than for children. Simple straightening of one or two teeth in a small child may he done for $50. Severe irregularities like Johnnie’s run to three or four times this amount. And occasionally crooked teeth in a child may demand lengthy and specialized straightening procedure so that the fee climbs up to $400; it’s rarely higher than this for children. For adults, though, the orthodontist’s account book tells quite a different story. The fee may go over $1,000 if it’s a big job, but. the average adult case costs $250 to $500.
If you are one of the thousands of women who are afraid of what the orthodontist’s metal bands will do to your appearance, here are some tips from a beauty expert as to how to wear them. First, admit honestly that they are no help to your looks, but think of them as a beauty treatment and resolve to make the best of them. Put away your glittering gold and silver earrings, necklaces and other jewelry (they’ll overemphasize the metal braces) and substitute pearl earrings, bead necklaces or jewelry of wood or plastic. Continue to use lipstick, but a conservative shade that will not draw attention to your mouth. Play up your good features—a permanent for your hair, clothes that show off your figure and carriage. Finally, be natural and smile whenever you feel like it; keeping your lips glued over those hated braces will only give you a stiff face and make you look and feel disagreeable, if