Dental Braces 1900 – 1925
Virtually all over the world during the first decades of the twentieth century orthodontics, still in its infancy, was dominated by the Angle School. This meant that treatment with fixed braces in most developed countries, including Germany, became more widespread through Angle’s pupils Körbitz, Grünberg und Oppenheim.
On the one hand, the dominance of the Angle School led to the development of a scientific approach to orthodontics and to the prevalence of Angle’s Edgewise-braces. But on the other hand, it also helped Angle’s uncompromising dogma to prevail. After he himself had spent a long time occasionally extracting teeth to make room for other teeth that were too close together, he declared a total ban on extraction in the 7th edition of his book, albeit on religious grounds. Presumably, he even had the 6th edition of his book that still contained treatments involving extraction withdrawn from publication. This was not necessarily good news for the patients, because the only treatment that remained for crowding or overlapping teeth was the tooth bracket which often led to unsightly results, caused damage to the periodontium or, more often than not, led to relapses after treatment.
However, another great teacher in American orthodontics, Calvin S. Case (1847 – 1923), claimed that, from an evolutionary/biological point of view, the best treatment was actually tooth extraction – in certain cases. Unlike Angle who above all else occupied himself with occlusion (i.e. the fitting together of the teeth of the upper and lower jaws), Case also took into account the aesthetic appearance of the whole face. Case also wrote textbooks and was the first person to use elastic in the mouth for ‘jumping the bite’, something that is still practised today. But unfortunately, Angle was far more influential from a scientific point of view which meant that on the question of extraction, blind dogma still prevailed over scientific argumentation. It wasn’t until the 1940’s that Angle’s dogma of preserving all the teeth that had been followed for decades finally lost its validity.
At this time orthodontic treatment was extremely expensive and unattainable for the masses, because it demanded a great deal of medical time to produce bespoke fixed braces using expensive materials including, amongst other things, gold wire. This was a luxury reserved for a small number of affluent patients. This situation would only change when people gradually became better-off.