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.

Angle School

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 Presumably, he even had the 6th edition of his book that still contained treatments involving extraction withdrawn from publication.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 by no means always good for the patients, because in the case of crowding and lack of space, the only option left was to widen and enlarge the dental arches, which often led to unaesthetic results, damage to the tooth-supporting apparatus and, above all, regularly to relapses after treatment.

Calvin S. Case

In contrast, another great teacher in American orthodontics, Calvin S. Case (1847 – 1923), claimed that tooth extraction was the best treatment in appropriate 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 bite shifting, 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.

Orthodontics – not for the Masses

At this time orthodontic treatment was extremely expensive and unaffordable 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 was only to change with increasing prosperity.