ST. LOUIS-More than one hundred years ago, in 1900, Dr. Edward H. Angle and a dozen colleagues came together to establish dentistry's first specialty. The formation of Dr. Angle's select group marks the genesis of the organization known as the American Association of Orthodontists (AAO) and the specialty today known as orthodontics and dentofacial orthopedics.

    As healthy, beautiful smiles are created by moving teeth with precise, gradual force expertly applied, so has the AAO developed: from a small, dedicated group in this Midwestern city to one of the most respected global organizations in health care. Comprised of more than 14,600 members in the United States, Canada and abroad, the AAO supports research and education leading to quality patient care and promotes increased public awareness of the need for and benefits of orthodontic treatment.

The AAO observed its year-long Centennial celebration from May 2000 to May 2001.

Humankind has tried to straighten teeth for thousands of years-long before orthodontics became a dental specialty.

       FROM CATGUT TO NASA TECHNOLOGY
    It used to take guts to straighten teeth-literally. Archaeologists have discovered mummified ancients with crude metal bands wrapped around individual teeth. To close gaps, it has been surmised that catgut did the work now done by today's space-age orthodontic wire.

"Hippocrates wrote of attempts to straighten teeth around 400 B.C.," says Dr. Michael Rennert of Montreal, a past AAO president.

       Well, what a difference a few millennia can make.

Dr. Rennert points out that recent advances make the treatment of just decades ago seem positively primitive. In the 1960s when Dr. Rennert was completing his orthodontic residency, the process of putting braces on could take nearly an entire day, he recalls. Bands were fitted around each tooth, which required forcing the teeth apart to accommodate the hardware. Nowadays, treatment is more comfortable.

"Typically, we affix brackets directly to the front of each tooth, and insert the tooth-moving wires through them," says Dr. David Turpin, an orthodontist in Auburn, WA and editor of the specialty's professional journal, The American Journal of Orthodontics and Dentofacial Orthopedics. "In the early 1900s, orthodontists used gold to make bands and wires. It was malleable, easy to shape, but because of its softness required adjustments more frequently than today."

"Treatment today certainly is more efficient," adds Dr. Rennert. "Thanks to the modern materials we use, patients usually don't need to come to the office as frequently."

NASA developed one of the late 20th century's most dramatic orthodontic breakthroughs, heat-activated nickel-titanium alloy wires.

"At room temperature, heat-activated nickel-titanium wires are very flexible," says Dr. Turpin. "They're very light, and as they warm to body temperature they become active and gradually move the teeth in the anticipated direction." Because of their high-tech properties, these wires retain their tooth-moving abilities longer than their predecessors.

In contrast, "passive" stainless steel wire needs more frequent attention from the orthodontist.

As technology has changed, so have treatment philosophies and approaches. Adults weren't likely to seek treatment just a few decades ago. And most parents wouldn't have dreamed of taking youngsters to an orthodontist until all the "baby" teeth were gone.

           AGE 7-A YEAR TO REMEMBER
      Researchers are investigating the advantages of guiding jaw growth-which, in some cases, may decrease a patient's need for more involved procedures later on.

Many parents assume they must wait until a child has all of his or her permanent teeth before visiting the orthodontist, only to find that treatment would have been much easier if started earlier. Some orthodontic problems are easier to correct before jaw growth has slowed. Therefore, the AAO recommends that every child have a check-up with an orthodontic specialist no later than age 7.

"An examination by an orthodontist by age 7 may be a real advantage," Dr. Rennert says. "Enough permanent teeth will have arrived for us to evaluate relationships developing between the teeth, jaws and face. We can determine if there seem to be any problems, and if there are, discuss the appropriate time for that child to begin treatment."

Most parents are glad they made the appointment, Dr. Rennert emphasizes. "This checkup can ease a parent's mind. Our recommendation may simply be 'let's wait and see' while the face and jaws continue to grow."Regardless of when treatment is recommended to start, orthodontics can ease physical and emotional trauma. A child whose teeth are crooked or jaws obviously are out of alignment may suffer more than the thoughtless teasing of other kids. Teeth that aren't in the right position are also prone to injury.

          BRACES COULD HELP THREE OUT OF FOUR PEOPLE
    The AAO estimates that up to 75 percent of people could benefit from orthodontic care. Nearly 5 million people in the United States and Canada are presently in orthodontic treatment, according to the AAO. One in five is over age 18. Some are as young as 2 or 3, and some are in their 50s, 60s, and older. Healthy teeth can be moved at almost any age.

             BRACES CHANGE LOOKS-AND OUTLOOKS
"A healthy, beautiful smile is the most obvious result of orthodontic treatment, but there's so much more to our specialty than meets the eye," points out Dr. Rennert. "As we improve a person's smile, self-esteem increases, too."Juliet didn't start treatment until she was in her 40s. She, like countless others who feel embarrassed about their crooked teeth, would reflexively cover her mouth whenever she laughed or smiled. Now she beams, and wonders what took her so long.Besides, a better-looking bite usually works better, too. Randy, a minister, got braces because he couldn't chew his food properly. Now he can relax and enjoy meals. An improved appearance was a plus, he found: "Now people don't stare at my teeth, which is fine with me-that just means they're normal!"