Setting the stage for the AJO-DO: The haphazard times before orthodontic specialty journals

The professional distinction of “surgeon-dentist,” created in France in the 18th century, stimulated dentistry’s early advance as a learned profession. By 1841, Pierre-Joachim Lefoulon coined the term “orthodontosie,” which was the root of “orthodontics and dentofacial orthopedics” as a distinct academic field and a specialty. In 1907, the American Orthodontist became the first scientific journal in the world completely devoted to orthodontics. Its failure after 5 years of publication prompted former editor Martin Dewey to find a new publisher for an orthodontic specialty journal. In 1915, the International Journal of Orthodontia was created with Dewey as editor. After some years, its name was changed to the American Journal of Orthodontics , which later became the American Journal of Orthodontics and Dentofacial Orthopedics , or AJO-DO . Today, the AJO-DO at 100 years is a mainstay of scientific advancement in orthodontics.

Highlights

  • France’s 18th-century ”surgeon-dentist” stimulated dentistry’s early academic advance.

  • By 1841, the term “orthodontosie” was coined, the root of orthodontics as a distinct field.

  • In 1907, the American Orthodontist became the world’s first orthodontic specialty journal.

  • Today, the AJO-DO at 100 years is a mainstay of scientific advancement in orthodontics.

We are proud to celebrate 100 years of a major intellectual resource for the advancement of orthodontics: the centennial of the American Journal of Orthodontics and Dentofacial Orthopedics . We orthodontists haven’t always had it this good.

What would we have done without the scientific literature in biology, in medicine, in dentistry, and in orthodontics? Most likely, our orthodontic specialty would be hobbling along, largely based on personal claims and pseudoscience. When did the written record of scientific experimentation and discussion take its roots for our field? This is an interesting story that has much modern value.

The history of orthodontics as a significant clinical and medical science is a story of its evolution from an incidental subject in early medicine to its position now as a distinct specialty with a dedicated body of literature and evidence.

If we venture as far back as prehistoric times, before the written record, we learn little about early mankind’s understanding of teeth, tooth positions, and the variations. There are no cave paintings showing dental customs and concepts. However, because of the visual primacy of teeth, it is likely that tooth ablation and decorative mutilation were practiced by early Homo sapiens for reasons of tribal ritual and superstition. Based on fossil remains, these primitive folks usually possessed solidly serviceable teeth. The dental arches and jaws were broad and robust in the preagriculturists 50,000 or more years before the present. Most Paleolithic people had excellent Angle Class I dental occlusions and severely worn but remarkably straight teeth.

The first writings in medicine, including dentistry, have come to us as handwritten manuscripts preserved from ancient Egypt, the Middle East, India, China, and the Greco-Roman cultures. They often recorded magical and occult healing practices and remedies going back 5000 years or more.

Around 1500, a few decades after the introduction of movable type and the printing press, books on medical practice and human anatomy began appearing more frequently. These early printed volumes often had specificity in their scope. Some were specifically concerning the mouth and the teeth. Zene Artzney (dental therapeutics), a brief compendium of essays in German about dental problems and solutions, first appeared in 1530. It was popular among the cadre of itinerant healers of toothache, the most painful medical complaint of the sugar-consuming Europeans of that time. A version printed in 1532 contained an essay on the problem of tooth irregularities, possibly the first such orthodontic reference in the world medical literature. In 1563, a small book by Bartolomeo Eustachi, Le Libellus de Dentibus (the book of teeth), was published in Italy. Its explanations and new observations about teeth (eg, identifying 2 layers of tooth structure—enamel and dentin) helped add learned importance to this neglected area of early medicine.

Yet it took nearly another 200 years until the early dentists in France made a compelling case for dentistry to be considered a significant branch of medicine. By the early 18th century, France was primed for advancing the cause of dentistry when the government officially created the professional distinction of surgeon-dentist. In this nurturing environment, Pierre Fauchard of Paris applied the written word in brilliant ways to give dentistry a broad scientific and artistic scope of practice. His 2-volume treatise, Le Chirurgien Dentiste , published in 1728, included perceptive discussions of tooth irregularity, and he was the first to describe mechanical appliances fabricated specifically to straighten the teeth. Fauchard’s groundbreaking ideas stimulated a century of progress in dental practice. By 1841, Frenchman Pierre-Joachim Lefoulon in his innovative book on new theories and practices in dentistry coined the term “orthodontosie” for the specific realm of studying and treating deformities of the mouth. His insight can be credited as the root of “orthodontics and dentofacial orthopedics” as a cohesive sphere of academic and clinical pursuit today. Defining and naming a field is often an essential first step on the pathway of focused inquiry, growth, and advancement.

The 1800s were a dynamic time for dentistry worldwide. In the mid-19th century, the image of dentistry as a rigorous academic discipline was dramatically enhanced with 3 landmark events in America: (1) the establishment of the first dedicated educational program in dentistry in 1840 at the Baltimore College of Dental Surgery, founded by 2 dentists with medical degrees; (2) the first public demonstration of inhalation anesthesia in Boston in 1846, administered by a dentist; and (3) the first university-based degree program in dental medicine, established at Harvard University in 1867.

With these progressive developments in dentistry and concomitant advances in medicine, the then-rare scientific periodicals and journals began to perk up. In the early to mid-1800s, the essential literature in medicine and dentistry was still largely in the form of books and pamphlets. Periodicals and journals were used to disseminate what were considered less important communications, such as transactions and records of meetings, and to carry advertisements and notices from hospitals, schools, and societies. Periodicals also invited correspondence from readers. The letter writers frequently shared brief reports of experiments, observations, and discoveries from their patient-care experiences or from their laboratories. These letters soon became highly valued by readers, often stimulating written responses and discussions. Thus, the popular correspondence and discussion sections of early journals were expanded over time. This unexpected growth direction eventually led to original reports of research becoming the key feature of scientific journals as we know them today.

In the years immediately preceding the age of scientific journalism in orthodontics, inventive vocal practitioners sought to get their technical methods adopted as standard orthodontic procedures. These aggressive appliance promoters wrote illustrated essays for generalist journals, such as Dental Cosmos and Items of Interest , to convince readers that “my mechanical appliance is better than your appliance.” By 1900, a dichotomy had sprung up in the fledgling specialty: those who were certain that orthodontics should be advanced by mechanical concepts, and others who argued that a biological approach, the medical model, was the way to advance orthodontics. This polarity may even be found today. But now, we generally understand that progress in orthodontics demands attention to both perspectives, mechanical and biological. Norman William Kingsley of New York, considered a founder of modern orthodontics along with Edward Hartley Angle, aptly integrated these 2 perspectives by calling orthodontics “mechanical surgery” in his pioneering volume published in 1880.

Angle’s dream in 1900 was to make “orthodontia” a self-standing division of medicine. He sought to do this in 3 ways: by creating a specialty school of orthodontia, organizing a society of orthodontic specialists, and initiating a scientific journal exclusively for the new specialty. In 1900, the Angle School of Orthodontia in St Louis admitted its first class for a 5-week postdoctoral residency in orthodontics, the first such training program in the world. A year later, Angle inaugurated what became the American Society of Orthodontists, the world’s first orthodontic specialty association (forerunner of the American Association of Orthodontists). And in 1906, Angle inspired the founding of the first scientific journal completely devoted to orthodontics, the American Orthodontist .

The American Orthodontist was published quarterly by the newly formed Alumni Society of the Angle School of Orthodontia. Its first issue, dated June 1907, contained papers read at the Alumni Society’s first meeting, held December 1906 in St Louis. Editor Martin Dewey, one of Angle’s ablest graduates, fashioned the new journal of orthodontics to be “scientific and practical, and not popular and practical.” Its secondary banner proudly proclaimed “A journal for the promotion of orthodontia as a science and a specialty.” He tried to avoid articles on treatment appliances and methods. But after a year of operation, problems surfaced. It became more difficult to get high-quality submissions, and the costs of publishing a pure specialty journal with a small circulation and no advertising revenue were mounting to nearly $1000 per year, a substantial sum in those days. Dewey soon soured on his thankless task and resigned as editor, after completing the fourth issue of volume 1 of the American Orthodontist in August 1908. Angle was not happy with this turn of events. In a letter written to Dewey on January 26, 1909, Angle said that he was “disappointed and greatly grieved over [Dewey’s] resigning from the Journal.” He continued, “I cannot but feel that it is a serious mistake. I wanted the Journal to be yours, you to develop that field, make it a grand and useful organ, and I thought you could and would work it out.” However, Dewey did not recant.

The idea of a journal fully devoted to orthodontics lost tempo with Dewey’s resignation, but the concept did not die. In 1910, Milo Hellman, another distinguished Angle School graduate with broad scientific interests, took on the editorship of the American Orthodontist under the condition that he would be able to effect a definite plan for the journal to satisfy all of its constituencies, the biologists and the mechanics, the speakers and the researchers. He proposed creating 3 equal journalistic departments: the first for proceedings and news from the Angle School Alumni Society, the second containing continuing education in orthodontics for specialists and generalists, and the third devoted to “the latest and best information on mechanics as employed in Orthodontia.” Even with this expanded base of content, the American Orthodontist continued to struggle for money, readership, and authorship. Hellman edited 8 interesting issues before reluctantly shutting down the magazine with its October 1912 issue (volume 3, number 4), after the Alumni Society of the Angle School voted to separate itself from the journal’s operation.

Many still thought that a journal devoted exclusively to orthodontics was an exceptionally good idea. Dr C. V. Mosby, an enterprising young physician who started a medical book publishing house in 1906 in St Louis, must have been interested in this idea by 1914. Mosby had not previously published a periodical. Details were worked out between Dewey, the appointed editor, and Mosby, the well-connected publisher. They seemed to agree that the new journal should not be limited by region or sponsoring organization. An “international” journal would be appropriate. In his first editorial in January 1915 for the new International Journal of Orthodontia , the predecessor of the AJO-DO , Martin Dewey stated that the success of the periodical would depend “upon the ability of the publishers to produce a high-class journal and give it wide circulation, and upon the editor and his staff to secure for publication each month meritorious contributions on timely subjects of interest to those engaged in the practice of orthodontia, dentistry and its allied specialties.” All that indeed happened, and the rest is memorable history ( Fig ).

Apr 6, 2017 | Posted by in Orthodontics | Comments Off on Setting the stage for the AJO-DO: The haphazard times before orthodontic specialty journals
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