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An anthropologist's message to orthodontists
Editorial An Anthropologist’s Message to Ortho,dontists F YOU have read Weston A. Price’s book, Nutrition and Physical Degen’erain order to record his clinical observations made on primitive people in various parts of the world, you noted that he believes that no problem is so important to modern civilization as the finding of the reason for the obvious narrowing of the face and dental arches that afflicts a considerable proportion of modernized people, contrasted with the arches and facial forms of primitive peoples. In reading Price, you soon sense that, as a result of his wide clinical experience, he believes that much of this is due to prenatal as well as to postnat,al nutritional conditions. In a word, it is largely a matter of food balance of the pregnant mother and also of the offspring subsequent to birth. You will note that he also believes there is a tie-in between poorly developed and small pelvic bones and the same condition as manifest in the bones of the face and jaws. To the everyday practicing orthodontist the approach to these problems of men in collateral fields never ceases to be a source of great interest. Orthodontic program committees are forever searching for scientific thinkers who can give a little more light on the subject. Commenting that “realization of ignorance is the beginning of wisdom,” Prof. Earnest A. Hooton, of the department of Anthropolo,q of Harvard University, proved to be a very interesting essayist at the Colorado Springs meeting of the American Association of Orthodontists, Sept. 30, Oct. 1, 2, and 3, 1946, in that he stresses many other important angles to the subject. He brought out that man is the creator of numerous gadgets of all kinds and that he now is in grave danger from some of the gadgets that he has created; and there can be no doubt about it. He observed that man, for the most part, has tried to substitute the use of machines and gadgets for the proper exercising and performance of work by his own body. Man uses powerful machinery for the grinding of his food, chemistry produces soft foods that need no grinding by the teeth, and then man wonders why his face, which is the stage setting for his teeth and jaws, get smaller as the generations go by. Such was the gist of some of his remarks, bringing out that functional stresses are important to dental and facial form and size. Dr. Hooton then followed with the observation that orthodontics is an applied science which has evolved largely as a result of the necessity of correcting so-called ‘‘crooked teeth, ’’ and that it has made a pretty good record in spite of its limitations. In doing this, the orthodontist has found, however, that not only the teeth needed correction, but many times the whole body has something wrong with it, and that orthodontic treatment constitutes only one
I tion, which was written
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of the needs for biologic rehabilitation of an entire ‘body. So reasoned Dr. Hooton, and there can be no contention that such is not exactly what h-as happened in orthodontic evolution. When they realized this, he went on, orthodontists turned to other sciences for help, for it did not take them ion, v to understand that if they stuck to mechanical devices alone, the entire perspective and progress of the work would begin with the teeth and end there. The orthodontist turned to the geneticist and to the physiologist, wanting to know why malocclusion ties in as a symptom with hypothyroidism. He tried questioning various and sundry other sources, only to become confused. The endocrine work by Howard and others opened the orthodontist’s eyes to a horizon far beyond the teeth and jaws, and made him realize that there is much to orthodontics beyond the oral .cavity. This endocrine work called the attention of the medical profession to the fact that malocclusion is sometimes a classical symptom in a syndrome involving the entire skeletal structure. The growth studies of the Brush foundation of Cleveland, to which Broadbent made important contributions pertaining to the growth of the face as related to the teeth, were mentioned as highly important to the over-all picture. Incidentally, Dr. Hooton paid tribute to the work of Broadbent, Hellman, Margolis, Baker, and Brodie (all orthodontists), and he stated that they have contributed more to scientific knowledge of the growth of the face, teeth, and their interrelationship, than have anthropologists and other growth workers, and that the next step forward in solving some of the orthodontic problems is plain. It is the widespread use of the plan of study started by the above workers in collaboration with anthropologists, pediatricians, and anatomists, in order to study the problem of total growth as related to the anatomy of parts in which orthodontists are particularly interested. The impression is quickly gained in listening to this authority on anthropology that it is his view that the problem of malocclusion is primarily both evolutionary and pathologic, and that in order to treat malocclusion intelligently much more knowledge needs to be spaded direct from the grass roots by comprehensive research of a high degree of efficiency. Other impressions were gotten; for instance, it seems that the orthodontist must decide as soon as possible whether in attempting to correct malocclusion he is combating a natural evolutionary trend or whether he is attempting to remedy a pathologic condition that is the result of infection or atrophy of function arising from too much dependence upon soft cooked foods, of subnormal bone development due to nutritional defects, or of all of these factors in combination. While paying respect to the mechanical dexterity of orthodontists, he leaves little doubt in the mind that, in his opinion, there is a limit to the possibilities of orthodontic treatment fro’m a retention standpoint and that there is a wide etiological field as yet practically unexplored. Such teachers and their views are good for orthodontists because it gives the viewpoint of a trained objective scientific mind from the outside looking ‘in: It keeps the workers thinking.
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EDITORIAL
When Dr. Hooton suggested that orthodontists must be the spark plug in sta.rting a comprehensive research problem on a level far and above the possibilities of the private practitioner in order to solve their problems, he no doubt suggested the only practical way these problems will ever be solved during the present generation at least. It can be added that it is amazing how far orthodontists have gone in the early years with what might be called, for the sake of a better descriptive term, a (‘popular mechanics” perspective of treatment and a very limited concept of etiological factors. After list,ening to Dr. Hooton, orthodontists will still be proud of their accomplishments, because they will more fully understand that they have gone so far with so little. It requires a fine technician to do a good job of correcting malocclusion, but added to that he should have a better knowledge of a number of other component influences. Hooton’s lecture and its publication will add much to constructive orthodontic thinking, but just exactly what it is all about from a primarily scientific standpoint, Hooton admits that there is, up to this time at least, little but supposition and speculative thinking upon many phases. H. C. P. Health
Insurance
OMPULSORY health insurance would harm rather than improve dental health inasmuch as it would place the nation’s health service in the hands of those who are not trained in the health professions.” This was the gist of remarks recently made by Dr. Sterling V. Mead of Washington, D. C., president of the American Dental Association. He put the American Dental Association on record as being opposed to any health plan where a portion of the earnings of the people would be used for inferior service and for the benefit primarily of political-minded bosses. This objection is not new, but its repetition again by the president of the American Dental Association is a sharp reminder that there is danger of the passage of the Wagner-Murray-Dingell bill in the Eightieth Congress, and that there are strong forces at work to pass such a bill. This bill proposes socialized medical care at a cost of a probable 3 to 6 per cent deduction on the wage earners’ pay. That, added to the present social security law on salaries and wages, will be a sizable amount. It seems, at this crucial period, that ways and means to offset this bill have not been at all effective. There is little doubt that the nation needs better medical and dental services for all of the people; however, it is ineffective to stop this movement simply to cry, “It’s Socialism,” and make no further practical moves to end the increasingly manifest momentum. The American Medical Association took an inadequate step forward in announcing a voluntary medical care plan organized on a regional basis. If the Wagner-Murray-Dingell bill is not to be passed in some form or other, substitutes heretofore not on the horizon will surely have to be created, and time is growing short.
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I tion, which was written
692
EDITORI4L
693
of the needs for biologic rehabilitation of an entire ‘body. So reasoned Dr. Hooton, and there can be no contention that such is not exactly what h-as happened in orthodontic evolution. When they realized this, he went on, orthodontists turned to other sciences for help, for it did not take them ion, v to understand that if they stuck to mechanical devices alone, the entire perspective and progress of the work would begin with the teeth and end there. The orthodontist turned to the geneticist and to the physiologist, wanting to know why malocclusion ties in as a symptom with hypothyroidism. He tried questioning various and sundry other sources, only to become confused. The endocrine work by Howard and others opened the orthodontist’s eyes to a horizon far beyond the teeth and jaws, and made him realize that there is much to orthodontics beyond the oral .cavity. This endocrine work called the attention of the medical profession to the fact that malocclusion is sometimes a classical symptom in a syndrome involving the entire skeletal structure. The growth studies of the Brush foundation of Cleveland, to which Broadbent made important contributions pertaining to the growth of the face as related to the teeth, were mentioned as highly important to the over-all picture. Incidentally, Dr. Hooton paid tribute to the work of Broadbent, Hellman, Margolis, Baker, and Brodie (all orthodontists), and he stated that they have contributed more to scientific knowledge of the growth of the face, teeth, and their interrelationship, than have anthropologists and other growth workers, and that the next step forward in solving some of the orthodontic problems is plain. It is the widespread use of the plan of study started by the above workers in collaboration with anthropologists, pediatricians, and anatomists, in order to study the problem of total growth as related to the anatomy of parts in which orthodontists are particularly interested. The impression is quickly gained in listening to this authority on anthropology that it is his view that the problem of malocclusion is primarily both evolutionary and pathologic, and that in order to treat malocclusion intelligently much more knowledge needs to be spaded direct from the grass roots by comprehensive research of a high degree of efficiency. Other impressions were gotten; for instance, it seems that the orthodontist must decide as soon as possible whether in attempting to correct malocclusion he is combating a natural evolutionary trend or whether he is attempting to remedy a pathologic condition that is the result of infection or atrophy of function arising from too much dependence upon soft cooked foods, of subnormal bone development due to nutritional defects, or of all of these factors in combination. While paying respect to the mechanical dexterity of orthodontists, he leaves little doubt in the mind that, in his opinion, there is a limit to the possibilities of orthodontic treatment fro’m a retention standpoint and that there is a wide etiological field as yet practically unexplored. Such teachers and their views are good for orthodontists because it gives the viewpoint of a trained objective scientific mind from the outside looking ‘in: It keeps the workers thinking.
694
EDITORIAL
When Dr. Hooton suggested that orthodontists must be the spark plug in sta.rting a comprehensive research problem on a level far and above the possibilities of the private practitioner in order to solve their problems, he no doubt suggested the only practical way these problems will ever be solved during the present generation at least. It can be added that it is amazing how far orthodontists have gone in the early years with what might be called, for the sake of a better descriptive term, a (‘popular mechanics” perspective of treatment and a very limited concept of etiological factors. After list,ening to Dr. Hooton, orthodontists will still be proud of their accomplishments, because they will more fully understand that they have gone so far with so little. It requires a fine technician to do a good job of correcting malocclusion, but added to that he should have a better knowledge of a number of other component influences. Hooton’s lecture and its publication will add much to constructive orthodontic thinking, but just exactly what it is all about from a primarily scientific standpoint, Hooton admits that there is, up to this time at least, little but supposition and speculative thinking upon many phases. H. C. P. Health
Insurance
OMPULSORY health insurance would harm rather than improve dental health inasmuch as it would place the nation’s health service in the hands of those who are not trained in the health professions.” This was the gist of remarks recently made by Dr. Sterling V. Mead of Washington, D. C., president of the American Dental Association. He put the American Dental Association on record as being opposed to any health plan where a portion of the earnings of the people would be used for inferior service and for the benefit primarily of political-minded bosses. This objection is not new, but its repetition again by the president of the American Dental Association is a sharp reminder that there is danger of the passage of the Wagner-Murray-Dingell bill in the Eightieth Congress, and that there are strong forces at work to pass such a bill. This bill proposes socialized medical care at a cost of a probable 3 to 6 per cent deduction on the wage earners’ pay. That, added to the present social security law on salaries and wages, will be a sizable amount. It seems, at this crucial period, that ways and means to offset this bill have not been at all effective. There is little doubt that the nation needs better medical and dental services for all of the people; however, it is ineffective to stop this movement simply to cry, “It’s Socialism,” and make no further practical moves to end the increasingly manifest momentum. The American Medical Association took an inadequate step forward in announcing a voluntary medical care plan organized on a regional basis. If the Wagner-Murray-Dingell bill is not to be passed in some form or other, substitutes heretofore not on the horizon will surely have to be created, and time is growing short.
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