Every year, millions of children and teenagers undergo a common growing-up ritual: getting braces. And it’s not just young people who are turning to metal braces to handle some common dental problems—the Cleveland Clinic estimates that 20% of new orthodontic patients are over 18 years old.
Braces, whether they are the classic metal brackets, the slightly less obvious ceramic versions, or even a clear aligner, solve a multitude of problems that many people face, from crowding, gaps, to crooked teeth. For the 93% of children and adolescents with a crossbite, underbite or overbite, braces may be just the solution.
The technology behind braces first emerged in the late 19th and early 20th centuries, he says Roger Forshawdental health specialist at the KNH Center for Biomedical Egyptology at the University of Manchester. In early iterations, metal bands, wires, and rudimentary braces were used to resolve severe crowding and misalignment of teeth to improve chewing function and relieve pain—almost the common cosmetic we think of today.
But what did people do before braces were invented? Well, it turns out, for much of human history, braces weren’t necessary. And it wasn’t because people were less concerned about their looks or bored of chewing better than their modern cousins. It’s a classic case of evolutionary mismatch, an indication of how much our lifestyles have changed in recent times, while the basic stuff of human existence simply hasn’t caught up.
Big jaws, small jaws
Let’s start with a metaphor. Get an old house, he says Peter Ungarbiological anthropologist and evolutionary biologist at the University of Arkansas. The door frames were much smaller and lower than would be comfortable for today’s humans, and this was not because humans were genetically shorter than today. Instead, people lacked the nutrients to reach their highest potential, Ungar explains. For our jaws, the story goes the other way around.
In the past, before farming and food processing became common, people had to chew very hard to convert their food into useful calories for their bodies. When you put this kind of chewing stress on the mandible (lower jaw) and maxilla (jaw), it “stimulates the cells that produce bone, [known as] osteoblasts, to grow the jaw in both thickness and height and length,” says Ungar. In other words, heavy chewing creates a strong, full-sized jaw.
On the other hand, there is no workout that will make your teeth grow. These little pearls of enamel, dentin and blood vessels are genetically predetermined in size, he adds.
No one gave the teeth the information that modern jaws chew less on wild game and more on applesauce, especially in their youth. When the teeth grow, they expect a full jaw from a hard-chewing hunter-gatherer.
So when your teeth finally come on stage, there just isn’t enough room for them. For many of us, the upper row of teeth protrudes in front of the lower set, and this lowered set turns into a confused pile of narrow teeth. Our third molars, also known as our wisdom teeth, either don’t grow, don’t erupt, or need to be removed. Our relatively small jaws opened the door to all sorts of other issues, Ungar adds, including sleep apnea epidemicwhich happens when our tongues don’t have enough room to move in our mouths.
Hug braces
Our ancestors had room for every tooth in their larger mouths. Their teeth were also more neatly stacked on top of each other. But that doesn’t mean our ancestors had smiles fit for a Colgate commercial.
“Early humans used sticks, twigs, bird feathers, animal bones and plant fibers to remove debris from their teeth,” adds Forshaw. “The earliest known example of possible surgical dental work dates to about 14,000 years ago in northern Italy.”
Although there are some references to misaligned teeth and the potentially painful solutions that followed, in Greco-Roman times, orthodontics did not take off until recently. “Early orthodontic treatments were slow, uncomfortable and often unpredictable because dentists didn’t fully understand how teeth moved,” says Forshaw.
The first tool for moving teeth by force was Pierre Fouchard’s Bandeaua horseshoe-shaped strip of metal that slowly expanded, straightening the teeth as it went. Then came the metal supportsthanks to EH Angle, who first introduced them around 1910. Braces were then modified over the following decades as scientists discovered how teeth moved, grew and responded better to smile-correcting technology.
Today, things are a little different and much less painful, thanks to digital imaging, advanced materials, and less invasive (and less obvious) techniques and tools. From an evolutionary and modern perspective, the solution to our small jaw problem begins in childhood. Still, you probably don’t want your kids gnawing on giant chunks of meat just to save their jaws, which poses a choking hazard. Instead, you might just get it orthodontist appointment in the calendar around their seventh birthday.
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