Oral history: how Tick Begg revolutionized braces and made Adelaide ‘the orthodontic center of the world’ in the 1920s
In medieval Europe, barber-surgeons could cut your hair, shave your face, do a little bloodletting, and tend to a broken limb.
They can also pull out a tooth with a ‘pelican’ – a rough beak-like shaft – or extract it with an iron.tooth key”. By the 17th century, they might be able to knock it out with a piece of steel punch lift.
It’s a winding, gruesome road from these early dental practitioners to today’s world of 3D printing, artificial intelligence and robots that can make dental implants.
Wayne Sampson, dental historian and professor emeritus at the University of Adelaide, says the history of dental work goes back much further than barber surgeons.
“If you look archaeologically, you will find evidence of something dental: the Etruscans used gold wire to secure a tooth, usually an animal tooth, but it could have been a human tooth,” he says.
Guardian Australia meets Sampson at the PR Begg Museum in central Adelaide, where he is surrounded by examples of dental molds and brackets, and equipment including a pedal-operated drill. There are elegantly shaped wires, an ashtray and a box full of teeth wrapped in various metals.
After discarding its connection with hairdressing, dentistry remained under medicine in many parts of the world before becoming its own specialty in the early 19th century. But for the next hundred years it was still a fairly crude practice.
Then comes Dr. Percy Raymond Begg, better known as Tick Begg, who modernized orthodontic techniques and transformed braces.
“The industry has changed dramatically,” says Sampson. “And I think Dr. Begg fits the turning point quite well. Because before him, orthodontics was very crude, with limited machines to move teeth… mainly with crowbars,” he jokes.
“It was characterized by not particularly well-directed heavy forces, which caused most of the tooth to fall over… and Dr. Begg changed all that.”
Begg studied in Melbourne before training with acclaimed American orthodontist Dr. Edward Hartley Angle. He treated his first patient in Adelaide in 1926.
“He wasn’t the first orthodontist in Australia… (but he was) one of the first real orthodontists trained or recognized in Australia, if not the world,” Sampson says.
The SA History Hub describes Begg as faithfully following Angle’s methods until 1928, when he “broke with established tradition and became the first orthodontist to extract selected teeth to correct pressure on the teeth”.
The Begg technique “used new types of braces, stainless steel wire, light forces and three well-organized treatment phases” to correct teeth more gently, more efficiently and less expensively.
“What he quickly realized was that Angle wasn’t right… about the fact that he was a non-extractionist and would never pull permanent teeth,” Sampson says.
“Begg tried practicing non-extraction for a few years and quickly realized it didn’t work. So then he came up with the revolutionary idea of pulling out some teeth to make room.”
He studied overcrowding, wear and tear and movement. His findings and technique were picked up worldwide.
“Adelaide became the orthodontic center of the world,” says Sampson. “People came to us from all kinds of places. Big names. As students you think: wow, they have visited here. Americans actually know where Adelaide is.
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“There aren’t many people in any field, at any stage of life, who can actually change the way things are done on a global scale.”
Sampson says the museum is a tribute to Begg. “He deserves the recognition.
“Modern orthodontics and the patients who receive it, at whatever level of technology, Begg has influenced all of this in some way. He revolutionized the way it was all done.
“He was truly a pioneer orthodontist.”
AI is moving forward
Now practices are changing faster than Begg could ever have anticipated.
Khaled Ahmed, associate professor of restorative dentistry and general medicine at Royal Melbourne Dental Hospital, says digital dentistry has brought “amazing” advances.
“We can… quickly take a highly accurate scan of the patient’s mouth, digitally design the filling or crown they need, and 3D print or mill the custom restoration and fit it through a very streamlined workflow that takes just a can take hours instead of days or weeks,” he says.
Are you missing a tooth and do you need a dental implant and crown? Soon, a robot will assist your oral surgeon in placing that implant accurately and efficiently.
The first of these, Yomi, has been approved in the US.
Ahmed says robotics will eventually expand to help with fillings and root canals. “These robots will also be controlled by artificial intelligence trained on massive patient data sets,” he says.
AI will be able to generate customized treatment plans, help dentists detect tooth decay and gum disease, help patients book appointments and even provide them with advice. But there will still be challenges around privacy, affordable access and upskilling, Ahmed says.
A promotional video for Yomi features a dentist placing six implants in 90 seconds. Another shows the robotic arm guiding the surgeon and drill to the correct position, where Yomi drills to a precise depth.
If that sounds even a little less terrifying than confronting a pelican, a dental wrench, or a punch lift, you can rest assured that the dentists who use it say patients are “more comfortable and satisfied” and that it “can reduce anxiety light up’.