The fixed orthodontic appliance commonly known as “braces” has a history that extends far beyond its modern appearance. Modern braces are defined by a specific combination of materials and techniques that allow brackets to be directly secured to the teeth, offering precise, multi-directional control over tooth movement. This standardized system represents the culmination of centuries of attempts to correct dental alignment, moving from rudimentary devices to the efficient, fixed appliances used today. The invention of the modern brace was not a single moment but a series of breakthroughs that dramatically lowered costs and improved mechanics.
Foundations of Orthodontics
The desire to straighten teeth is an ancient practice, with evidence found in several early civilizations. Archaeologists have discovered mummified remains in Egypt with crude metal bands wrapped around the teeth, sometimes connected by materials like catgut, an attempt to close gaps or maintain alignment after death. The Romans also showed interest in dental alignment, with records mentioning methods for correcting teeth using finger pressure and gold wire ligatures found in tombs.
Formal study of the mouth began to emerge in the 18th century, largely credited to the French dentist Pierre Fauchard. In his 1728 text, The Surgeon Dentist, Fauchard described various methods for moving teeth, including an early appliance called the “Bandeau.” This horseshoe-shaped piece of metal was designed to expand the dental arch, though it was uncomfortable and lacked the mechanical precision needed for complex tooth movements. Early orthodontic efforts relied on basic materials like gold, silver, and silk threads.
The Establishment of Fixed Appliances
The 19th century brought a significant shift, establishing orthodontics as a distinct scientific discipline. This period saw the invention of devices like the wire crib, a precursor to modern bracket systems, and the introduction of rubber bands to apply continuous force for tooth movement. The field was fundamentally structured by the work of American dentist Edward Angle in the late 19th and early 20th centuries, who is often cited as the father of modern orthodontics.
Angle standardized the classification of malocclusion, categorizing bite problems into Class I, II, and III based on the relationship between the upper and lower first molars, a system still used for diagnosis today. His work focused on developing fixed appliances, moving from the E-arch, which tipped teeth, to the pin-and-tube and ribbon arch systems. His most significant contribution was the Edgewise appliance, first introduced in 1925, which featured a rectangular slot designed to accept a rectangular archwire. This design was revolutionary because it allowed for three-dimensional tooth control, including root movement.
Defining the Modern Brace
While Angle’s Edgewise system provided the fundamental mechanical design, the appliance was not yet the “modern brace” due to its cost and installation method. Angle’s early systems relied on expensive materials like gold and platinum, and required a complete metal band to be cemented around every tooth. The true invention of the modern, accessible brace occurred with two critical mid-20th-century material breakthroughs.
The first was the widespread adoption of stainless steel for brackets and archwires, largely replacing gold and silver by the 1950s and 1960s. Stainless steel was cheaper, more durable, and offered mechanical properties that drastically lowered the cost of treatment and made braces available to the general public. The second breakthrough was the development of composite resin adhesives in the 1970s. This new bonding technology allowed brackets to be glued directly to the front surface of the tooth enamel, eliminating the need for cumbersome full metal bands on every tooth.
The combination of stainless steel brackets and direct bonding transformed the procedure into the standardized method used today. Further refinement came in the early 1970s with Dr. Lawrence Andrews’ Straight-Wire Appliance, which incorporated specific angles and torques into the bracket design itself. These “pre-adjusted brackets” minimized the need for orthodontists to manually place complex bends in the archwire, making treatment more efficient and reproducible.
Contemporary Aesthetic Options
Since the establishment of the modern fixed appliance, subsequent innovations have focused primarily on aesthetics and patient comfort. In the 1970s, lingual braces were introduced, which involved bonding brackets to the back (tongue side) of the teeth to make them invisible from the front. This offered the mechanical control of fixed braces without the visible metal.
The 1980s saw the development of ceramic braces, which use clear or tooth-colored materials for the brackets. These function exactly like traditional metal braces but blend more seamlessly with the teeth, providing a popular option for adults. The late 1990s saw the commercial introduction of clear aligner systems, such as Invisalign. These systems use a series of custom-made, removable plastic trays to move the teeth, offering an option that is nearly invisible and does not rely on fixed brackets and wires.