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Charles H. Tweed, 1895-1970 James L. Vaden Cookeville, Tenn I n introductory remarks at an orthodontic lecture delivered March 1, 1965, in Virginia, Charles H. Tweed 1 (Fig 1) claimed that the most fundamental paragraph ever written in any orthodontic text could be found in the seventh edition of Angles Treatment of Malocclusions of the Teeth. 1 The study of orthodontia is indissolubly connected with that of art as related to the human face. The mouth is a most potent factor in making or marring the beauty and character of the face, and the form and beauty of the mouth largely depend on the occlusal relations of the teeth. Our duties, as orthodontists, force upon us great responsibilities, and there is nothing in which the student of orthodontia should be more keenly interested than in art generally, and especially in its relation to the human face, for each of his efforts, whether he realizes or not, makes for beauty or ugliness, for harmony or disharmony, or for perfection or deformity of the face. Hence, it should be one of his life studies. 2 Tweed went on to say that for more than 6 years he practiced and advocated that philosophy of orthodontic treatment, which demanded a full complement of teeth. Then, late in 1934, frustrated by his ability to create facial balance in only a few of his patients, he began to analyze his practice results. For the next 4 years, he spent half of his time analyzing the dental casts, photographs, and x-rays of the patients he had treated up to that time. He classied the patient photos into 2 groups: those with balance and harmony of facial proportions, and those that lacked these qualities. In virtually every instance,he said, those patients possessing balance and harmony of facial proportions had mandibular incisors that were upright over basal bone. The faces that lacked these attributes of facial pro- portion had teeth that were too prominent and the mandibular incisors were not upright and over basal bone. It must be noted that the lack of harmony in facial contour is in direct proportion to the extent to which the denture has been displaced mesially into protrusion.He observed that he had successfully obtained all 4 orthodontic objectives in only 20% of his patients and lamented that These harsh facts all but made me give up the practice of orthodontics.Tweeds contributions to the specialty of orthodontics are legendary. He made a lasting and undeniable impact on the specialty. His letters, lectures, articles, 3-12 and 2-volume textbook 13 established a foundation in ortho- dontic thought and treatment that continues to be used today. Essentially, Tweed brought the specialty from the period of simply straighteningteeth to a concern for the best balance and harmony of facial lines, the stability of the dentition after treatment, a healthy periodontium, and an efcient chewing mechanism. He emphasized these 4 objectives of orthodontic treatment in all that he did. He made the extraction of teeth for correction of a malocclusion acceptable. He started orthodontics on a path of correcting bialveolar protrusionsnot creating them. He enhanced the clinical applications of cephalo- metrics as he developed the diagnostic facial triangle. Tweed's diagnostic triangle, which denes the anterior limit of the denture, is, in Tweed's words, my greatest contribution to orthodontics.11,13,14 Tweed's other great contribution was the concept of anchorage preparation. 13 At the end of his years, he developed a sound and consistent preorthodontic guidance program that used serial extractions of deciduous and permanent teeth to achieve the desired end results. One can ask how did one man do all these things? How did all of it happen? Therein lies an interesting story. Valuable sources of information are Tweeds many letters that are housed at the Charles Tweed International Foundation in Tucson, Arizona. On the pages that follow, I hope the reader will obtain some insight into Charles Tweed and understand the rest of his story.THE EDGEWISE APPLIANCEBEGINNINGS The edgewise appliance was the last in a long line of inventions by Edward H. Angle. 15 Angle decided that since a tooth could only be moved in 3 planes of space, all the necessary forces could be incorporated into the archwire. With that thought in his mind, he designed the edgewise appliance and decided that an article describing the appliance must be published. He chose the journal Dental Cosmos. Because Tweed had just Am J Orthod Dentofacial Orthop 2015;147:S171-9 0889-5406/$36.00 Copyright Ó 2015 by the American Association of Orthodontists. http://dx.doi.org/10.1016/j.ajodo.2015.02.004 S171 PILLARS IN ORTHODONTICS

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  • Charles H. Tweed, 1895-1

    hepra tictrea th.The atefac anto a hespe ts,pho edup 2

    denture has been displaced mesially into protrusion. Heobserved that he had successfully obtained all 4

    THE EDGEWISE APPLIANCEBEGINNINGS

    since a tooth could only be moved in 3 planes of space,

    describing the appliance must be published. He chose0889-5406/$36.00Copyright 2015 by the American Association of Orthodontists.

    PILLARS IN ORTHODONTICSall the necessary forces could be incorporated into thearchwire. With that thought in his mind, he designedthe edgewise appliance and decided that an articleAm J Orthod Dentofacial Orthop 2015;147:S171-9bone. It must be noted that the lack of harmony in facialcontour is in direct proportion to the extent to which the

    The edgewise appliance was the last in a long line ofinventions by Edward H. Angle.15 Angle decided thatgroups: those with balance and harmony of facialproportions, and those that lacked these qualities.

    In virtually every instance, he said, those patientspossessing balance and harmony of facial proportionshad mandibular incisors that were upright over basalbone. The faces that lacked these attributes of facial pro-portion had teeth that were too prominent and themandibular incisors were not upright and over basalhttp:human face, for each of his efforts, whether he realizesor not, makes for beauty or ugliness, for harmony ordisharmony, or for perfection or deformity of theface. Hence, it should be one of his life studies.2

    Tweed went on to say that for more than 6 yearscticed and advocated that philosophy of orthodontment, which demanded a full complement of teen, late in 1934, frustrated by his ability to creial balance in only a few of his patients, he begnalyze his practice results. For the next 4 years,nt half of his time analyzing the dental castographs, and x-rays of the patients he had treatto that time. He classied the patient photos intoJames L. VadenCookeville, Tenn

    In introductory remarks at an orthodontic lecturedelivered March 1, 1965, in Virginia, Charles H.Tweed1 (Fig 1) claimed that the most fundamentalparagraph ever written in any orthodontic text couldbe found in the seventh edition of Angles Treatmentof Malocclusions of the Teeth.1

    The study of orthodontia is indissolubly connectedwith that of art as related to the human face. Themouth is a most potent factor in making or marringthe beauty and character of the face, and the formand beauty of the mouth largely depend onthe occlusal relations of the teeth. Our duties, asorthodontists, force upon us great responsibilities,and there is nothing in which the student oforthodontia should be more keenly interested thanin art generally, and especially in its relation to the//dx.doi.org/10.1016/j.ajodo.2015.02.004orthodontic objectives in only 20% of his patients andlamented that These harsh facts all but made me giveup the practice of orthodontics.

    Tweeds contributions to the specialty of orthodonticsare legendary. He made a lasting and undeniable impacton the specialty. His letters, lectures, articles,3-12 and2-volume textbook13 established a foundation in ortho-dontic thought and treatment that continues to be usedtoday. Essentially, Tweed brought the specialty from theperiod of simply straightening teeth to a concern forthe best balance and harmony of facial lines, the stabilityof the dentition after treatment, a healthy periodontium,and an efcient chewing mechanism. He emphasizedthese 4 objectives of orthodontic treatment in all thathe did. He made the extraction of teeth for correction ofa malocclusion acceptable. He started orthodontics on apath of correcting bialveolar protrusionsnot creatingthem. He enhanced the clinical applications of cephalo-metrics as he developed the diagnostic facial triangle.Tweed's diagnostic triangle, which denes the anteriorlimit of the denture, is, in Tweed's words, my greatestcontribution to orthodontics.11,13,14 Tweed's othergreat contribution was the concept of anchoragepreparation.13 At the end of his years, he developed asound and consistent preorthodontic guidance programthat used serial extractions of deciduous and permanentteeth to achieve the desired end results.

    One can ask how did one man do all these things?Howdid all of it happen? Therein lies an interesting story.Valuable sources of information are Tweeds many lettersthat are housed at the Charles Tweed InternationalFoundation in Tucson, Arizona. On the pages that follow,I hope the reader will obtain some insight into CharlesTweed and understand the rest of his story.970the journal Dental Cosmos. Because Tweed had just

    S171

  • S172 Pillars in orthodonticsnished the Angle course and because Angle admiredand respected Tweeds abilities, Angle asked Tweedand Glen Terwilliger to help with the article. For 7 weeks,they worked together and, in the process, became closefriends. It was during this time that Angle advised Tweedthat he (Tweed) could never master the edgewiseappliance unless he limited his practice solely to itsuse. After completing the article for Dental Cosmos,

    Fig 1. Charles H. Tweed. Courtesy of the Charles TweedInternational Foundation, Tucson, Arizona, and used withpermission.Charles Tweed returned to Arizona and established inPhoenix what might have been the rst edgewisespecialty practice in the United States.

    For the next 2 years, the 2 men worked togetherclosely. Tweed made progress records of his patientsevery 4 months and took the records by train to Pasa-dena, California, where Angle studied them and outlineda treatment plan for the next 4 months. Angle waspleased with Tweeds results, and he was instrumentalin getting Tweed invited to lecture at several orthodonticmeetings. During these 2 years, in more than 100 lettersnow housed in the Tweed Memorial Center library, Angleurged his young disciple to carry out 2 vital requests:(1) make every effort to establish orthodontics as aspecialty within the dental profession, and (2) dedicatehis life to the development of the edgewise appliance.

    THE ARIZONA SPECIALTY LAW

    Tweeds work toward the accomplishment of Anglesrst request is outlined in excerpts taken from a letterthat he wrote in 1948 to Dr Whitmarsh, in response toWhitmarshs request for information about the Arizonaspecialty law.16

    May 2015 Vol 147 Issue 5 Supplement 2 American Jowould endeavor to develop a course which wouldfulll the legal requirements necessary to complywith our proposed new law here in Arizona; and Iwas designated to crack the ice and have the rstlaw passed. At a later date the University of California,under Guy S. Milberry, Dean of the Dental School,instituted training in that institution whereby dentistswho wished to practice orthodontia would take theirminimum requirements in prosthetics and utilize thegreatest part of their time in clinical orthodontics.This was an effort on the part of Dr. Milberry to fulllthe requirements made necessary by laws such as werepassed by Arizona in 1929.

    Oh yes! The aftermath of this legislative attempt inbehalf of orthodontia was the cold treatment appliedto the energetic crusader' by the dental professionpractice both dentistry and orthodontia would berequired to pass the examinations of both the Dentaland Orthodontic Boards.

    In a class previous to the last class that Dr. Angle gavewas enrolled Dr. Steven (Allen G.) Brodie, now Dean ofthe University of Illinois Dental School. There was anunderstanding between the three of us that Dr. BrodieHouse and Senate of the State Legislature; and nallysucceeded in having the rst specialty law of its kindpassed in these United States for my state of Arizona.

    Upon the passage of the law, any man taking thedental examination in Arizona after 1929 would belicensed as a dentist and could not practice ortho-dontia. Any orthodontist passing the orthodontic ex-amination would be licensed as an orthodontist andcould not practice dentistry. Those who wished tofor this belief were that the University of California,from which I graduated in 1919, devoted 11 hoursto orthodontics, and any clinical experience wasoptional. I found the same situation prevalent in virtu-ally all the dental colleges in the U.S. The average timedevoted to orthodontics, if my memory serves mecorrectly, varied from no hours to approximately235 hours. And yet our dental laws allowed us totake a dental examination and with little or no ortho-dontic training we were allowed to designate ourselvesas specialists in orthodontia. This, of course, is mostunfair, and I made an endeavor in 1929 to correctthis condition in my state.

    I visited 95% of all of the dentists in the state of Ari-zona, traveling 5,000 miles, to interview them person-ally, with a copy of the bill that was proposed. I actedas a lobbyist; addressed various PTAs; interviewed theIn 1929, after surveying the curricula of all the schoolsof the United States, I was convinced that orthodontiawas being held in bondage by dentistry. The reasonsof Phoenix. So effective was the treatment that yourstruly had to leave the community of his birth and open

    urnal of Orthodontics and Dentofacial Orthopedics

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    Pillars in orthodontics S173

    Amhis practice here in Tucson. However, great fun washad by all of us in this joust.Having been responsiblefor the passage of this much needed legislationand observing the great pleasure of my benefactor,Dr. Angle, on its passage, was certainly sufcientreward for the efforts put forth for its enactment.My kindest regards to you.Fig 2. The 100-case report display in Chicago,Foundation, Tucson, Arizona, and used with perAs a reward for Tweeds efforts to get a specialtypassed in Arizona, Angle gave him a diploma fromAngle School. Tweed had no Angle School diplomaause he and his 4 classmates had attended anrovised Angle school course given by George Hahnother Angle School graduates. Angle had accepted

    eeds class, but subsequently closed his school andeled to Hawaii. He returned while the class was insion and gave several lectures. Tweeds class waslast of the Angle School.

    EEDS PROFESSIONAL JOURNEYA ROCKYRT

    In 1932, Tweed had his rst article published in thegle Orthodontist. It was entitled Reports of Cases.17

    eed held to Angles rm conviction that onest never extract teeth. This conviction lasted forears.In 1936, Tweed delivered a lecture on the extrac-of teeth to the membership of the Angle Society.

    other Angle (Angles wife, Anna Hopkins Angle),editor of the Angle Orthodontist and a memberthe Angle Society, refused to attend the lecture.

    erican Journal of Orthodontics and Dentofacial OrthopedGeorge Hahn, the man who went out of his way tocreate the opportunity for Tweed to take the Anglecourse, criticized him severely. Angles disciplesconsidered Charles Tweed to be a traitor to thegreatest man orthodontics had ever known. Tweedwas crushed by the response, but he returned homedetermined to continue his research.18

    0. Courtesy of the Charles Tweed Internationalion.proconwithof 4prowherepo

    oneeve

    icsHe worked even harder than before. By 1940, he hadduced case reports, with 4 sets of records, of 100secutively treated patients who were rst treatedthe nonextraction method and later with extractionrst premolars. He managed to get himself on the

    gram of the 1940 Angle Society meeting in Chicago,re he would present a paper and display his caserts (Fig 2).Dr Robert Strang, the master of the ribbon-arch andof Angles most respected students, described the

    nt this way.

    I noted that Dr. Charles Tweed was scheduled to be onthe program of the meeting in Chicago. I planned tobe there with the objective of lacing into himfor violating Dr. Angles sacred principle of non-extraction in treatment.

    Previous to reading his paper, Dr. Tweed had placed ontables before and after casts and photographs of onehundred consecutively treated patients. The resultsin all of these one hundred patients were magnicentand beyond criticism. I also met Dr. Tweed and notedthat he was a most modest, unassuming and friendlychap.

    May 2015 Vol 147 Issue 5 Supplement 2

  • S174 Pillars in orthodonticsMaDr. Tweed read his well-written and illustratedpaper. He explained his objective of keeping theteeth over basal bone, which made it necessary toextract teeth in many patients; however, it did pro-duce stable results. Then he sat down. There was noapplause. The room lled with shouted demandsfrom the oor. For at least an hour, Charlie gotthe worst tongue-lashing that you can possiblyimagine and not one word of praise for the beautifulresults of treatment. Here was a student ofDr. Angles violating the most xed and rigid rulein his instructionnever extract teeth.

    During all this vicious attack, my mind took a com-plete turnover. I could visualize nothing but thatmarvelous exhibit of treated cases. Not one individ-ual in the room had complimented the essayist.They were all ripping him to pieces for extractingteeth. Finally, I obtained the oor and compli-mented and defended him to the best of my ability.When I sat down, I, too, took a tongue-lashing thatcompared very favorably with the one Charlie hadjust received. Subsequently, I took his course, andpracticed, taught and published his techniques inmy textbook.

    Fig 3. First Tweed study course. Courtesy of the ChArizona, and used with permission.

    y 2015 Vol 147 Issue 5 Supplement 2 Americanwasat aTheHerwasonnotworresuhisin 1

    andwouwoube gwaswor

    arle

    JoDr. Tweeds work was so outstanding as to elevatehim, in my mind, to the position of the best clinicalorthodontist in the world.19

    The rst Tweed study club began in 1941 (Fig 3). Itcalled the Tweed Seminar, and its participants metmachine shop in Tucson, with 36 men present.

    y included Robert Strang, Cecil Steiner, Bill Downs,b Margolis, Paul Lewis, and Hays Nance. Tweeddeveloping quite a reputation. He was appearingprograms at local and national levels. All theoriety led to congestion in his ofce. On a normalking day, he might have from 3 to 5 visitors. As alt, his practice suffered, and he was forced to curtailresearch. The situation culminated in a heart attack945. Charlie Tweed was 50 years old.20

    After Tweeds recovery, his study club had a meetingsuggested that a better way of handling the visitorsld be to invite everyone at the same time. A few daysld be devoted to the new men, and a few days wouldiven to the study club. Hence, the Tweed Study Courseborn. It continues toourish to this day because of thek and effort of the late Levern Merrield, who

    s Tweed International Foundation, Tucson,

    urnal of Orthodontics and Dentofacial Orthopedics

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    ticpro rs.He teorth heDep inMis ofits n,a fu g.

    Pillars in orthodontics S175succeeded Tweed as course director, serving from 1970 to1983. Herbert Klontz has served as course director since1983. The study course Tweed started is now internationalandwelcomes over 300 students per year to Tweeds ofceand teaching facility in Tucson.

    During the 1950s and 1960s, Tweeds study courseourished. It was attended by all who wanted to learnhow to use the edgewise appliance and to obtainbalanced faces to their patients. Tweed worked at hispractice, gave many lectures, and authored benchmarkarticles. His 2-volume text set a standard for orthodontictextbooks and is a treasured collectors item today.13

    THE TWEED-ANGLE RELATIONSHIP

    Contrary to what is sometimes inferred by those whoare not aware of the facts, Tweed always respected andappreciated Edward Hartley Angle. Yes, he departedfrom Angles teaching. As a result, many staunch Angledisciples became furious with Tweed, hence the storiesabout bad blood. But Tweed always treasured hismentor and his wife, Anna Hopkins Angle.

    Walter Sandusky related the following story. Charlietold me that he would give $5,000 per child for each ofhis ten grandchildren if they could each spend just oneafternoon alone with Dr. Angle. Of course, I questioned,why? He retorted, because Dr. Angle was the greatestmotivator of men I have ever known, even in such a shorttime as one afternoon he could plant the seed of ambi-tious achievement in a young persons heart that hewould never lose.21

    According to Francee Chenowth (personal communi-cation; April, 1989), Tweeds devoted employee forapproximately 25 years and an employee of the TweedFoundation for the next 25 years, Dr Tweed sent MotherAngle a dozen roses on her birthday every year for aslong as she lived.

    A story related by the late Bob Felix (personalcommunication; April, 2013) is equally interesting.When Dr Felix took the course, Tweed informed all thestudents that Mother Angle was going to come by fora visit. Tweed told the students: I expect all of you tobe on your best behavior. You are to look sharp, andwhen Anna walks into this laboratory, I would appreciateit if everyone would stand and acknowledge her pres-ence. She is a grand lady.

    The rst page of Tweeds magnicent and nalwork,13 the 2-volume textbook on which he laboredfor several years, has the following dedication: To Dr.Edward Hartley Angle, a dynamic psychologist with thepower to mold the character of men; to his devoted

    wife, Anna Hopkins (Mother) Angle, who guided hiscareer and bathed the wounds of those undergoing his

    American Journal of Orthodontics and Dentofacial Orthopedteachings that we wanted to continue to improveour program and, at the same time, do what we couldto be of some assistance to Dr. Tweed and his founda-tion. He mentioned to me that it was imperative for hisadvanced course to have a good, solid, basic, courseavailable for the men to attend before they could beaccepted at Tucson. For several years this had beenprovided by the courses of both Dr. Strang andDr. Lewis, then by Dr. Lewis at the University of De-troit. Dr. Lewis and his faculty were having difcultiesarranging for adequate facilities; they soon moved toan art center in Kalamazoo, Michigan. These problemsconcerned Dr. Tweed and he suggested that I contactDr. Lewis regarding the possibility of moving his basicedgewise course to St. Louis University. Dr. CopeSheldon who was on our faculty, as well as the facultyof Lewis course, assisted me in persuading Sam LewisicsOur faculty was so enthused over the treatment andteaching results we were enjoying with Dr. Tweedsand Dr. Tweed was in 1955 when Dr. Peter Sotiropou-los and I attended the advanced course in EdgewiseTechnique at Tucson. [Peter and his wife Betty wereon their honeymoon when he attended Tweedscourse!] We had previously attended the basic coursedirected by Dr. Samuel Lewis in Detroit. At that time,it was a requirement that you rst attend either Dr.Lewis or Dr. Strangs basic course. We were veryenthused over Dr. Tweeds approach to diagnosisand his utilization of the edgewise appliance. I hadalready started a conversion of our graduate depart-ment clinical teaching to this appliance. The menwho taught this technic for us were Dr. Cope Sheldonof Kansas City, Dr. Howard Strang of Chicago, and Dr.Harold Kesling of LaPorte.Historically, the rst contact between our departmentlding procedures; to Dr. George W. Hahn of Berkelfornia, who directed the Angle School duriAngles absence in Hawaii and who more thone else developed in me whatever digital skill aof profession I possess.

    EEDTHE UNIVERSITY PROPONENT

    Tweed loved and respected university orthodongrams and university graduate program teachegave of his time and talent to many graduaodontic departments. One of his favorites was tartment of Orthodontics at St Louis Universitysouri (Fig 4). A letter that Ken Marshall,22 chairgraduate program, wrote in1980 to John Rushtoture president of the Tweed Foundation, is revealin

    Dear John,to join forces with us in St. Louis, starting with thecourse presented in the summer of 1957.

    May 2015 Vol 147 Issue 5 Supplement 2

  • Universiiyama. Cpermission.

    S176 Pillars in orthodontics

    MaThe acquisition of the Lewis Course for our depart-

    Fig 4. Tweed examines a patient at St LouisMasterokis; also pictured is George UchFoundation, Tucson, Arizona, and used withment, as well as the ensuing close relation whichdeveloped with Dr. Tweed and the Tweed Foundation,was undoubtedly the most important single event inthe development of the St. Louis University GraduateOrthodontic Department to its international positionof dominance. It was in this same year, 1957, thatthe founding of the St. Louis Orthodontic Educationand Research Foundation was established throughthe active and generous assistance of Dr. Tweed. Heattended each annual meeting of this Foundationuntil the time of his death. Each year he would goover the student cases presented at the meeting andthen discuss them before the entire membership.This past meeting of the Orthodontic Education andResearch Foundation was the twenty-fth.

    In addition to attending the St. Louis Universitymeeting each year, Dr. Tweed also presented anannual paper, led the clinical discussion, and at theconclusion of the program, would contribute his hon-orarium, and travel expenses to the department. Hisgenerous enthusiasm for our program attractedmany of his friends and followers who, likewise,became annual contributors to the department. Mostnotable among this group was Dr. Cecil Steiner whovolunteered his service, teaching several continuingeducation courses and presenting papers to thefoundation meeting. At the same time that the SteinerRadiology Section was being established, a portion of

    TW

    wer

    y 2015 Vol 147 Issue 5 Supplement 2 American Jothe endowment which had been given to the

    tesy of the Charles Tweed International

    ty with Peter Sotiropoulos, John Barton, and Leoourdepartment by Dr. Tweed personally and also by theTweed Foundation was being used to create theCharles H. Tweed Technic Laboratory.

    The nal project in which St. Louis University and Dr.Tweed were closely linked was in his publication of thetwo volumes on his technique and the edgewiseappliance. For several years, I had tried to persuadehim to put all of his material together in a book. Afterhe nally made the decision to undertake the project,we assisted him in working out an agreement with theC.V. Mosby Publishing Co. of St. Louis, to do the pub-lishing. The art work was done by Dr. Bill Brims ofthe University department of medical illustrations.Dr. Uchiyama of our faculty, along with several grad-uate students, assisted Dr. Tweed and Dr. Merrield inbringing it to a successful conclusion. This was aherculean effort by Dr. Tweed, however, the result isand will continue to be the true classic techniquepublication in the history of our specialty.

    Sincerely,

    Kenneth C. Marshall, D.D.S., M.S.

    EED FOLKLORE

    Coupled with Tweeds burning desire for excellencee humility, kindness, and a sense of humor. He

    urnal of Orthodontics and Dentofacial Orthopedics

  • obse, Ari

    Pillars in orthodontics S177loved to deliver spontaneous lectures to study coursestudents as they worked on their typodonts. Therewere always certain things that he wished to indeliblyimpress on each class. When a thought would cometo mind, he would stroll up and down the aisles and,as the students looked up from their typodonts,

    Fig 5. Tweed, pedaling backwards on a bicycle,Charles Tweed International Foundation, Tucsonproceed in an emphatic manner to deliver his message.On one such occasion, he was discussing most emphat-ically the impossibility of doing excellent orthodonticsin an overcrowded practice. He said, Hell is going tobe full of orthodontists who are carrying ve to sixhundred active patients in their practice. Joe Jarabak,a student in that course, quickly asked, Charlie,will they offer the Tweed course in Hell? The classbroke up in laughter. In characteristic manner, hebeat the palm of his hand to his forehead and stalkeddisgustedly from the room, taking the squelchgood-naturedly (personal communication from WalterC. Sandusky, Jr; July, 2013).

    Among the well-known stories of Dr Tweedsempathy is the kindness shown to the late Dr BobTelford, who became ill with a recurring lung diseasewhile in the graduate program at the University ofWashington. He was forced to drop out of schooland move to Tucson for his health. Al Moore, the chairat the University of Washington, wrote to Dr Tweedand asked him whether he could be of some helpto Bob. When Bob had recovered sufciently, hewas brought into Dr Tweeds ofce to complete histraining under a preceptorship program. Dr Tweed

    American Journal of Orthodontics and Dentofacial Orthopedthen converted the front part of the teaching spaceacross the patio from his own ofce into a niceorthodontic ofce for Bob, and there he practicedhappily for the rest of his life (personal communicationfrom Walter C. Sandusky, Jr; July, 2013).

    The late Charles Burstone (personal communication;

    rved by young William Gaylord. Courtesy of thezona, and used with permission.February, 1999) related the story of an insightfulmoment that he witnessed when he took the TweedCourse in the 1950s. At that time, every participanthad to prepare his or her typodont and have it readyfor the course. The rst day was check-in day.Dr Tweed checked all the typodonts. Dr Burstone re-ported that Tweed would tell each American studentto do this or that to make the typodont better. Hewanted them correct. There was a man from anothercountry at the course who did not have the resourcesto make a good typodont; his typodont was reallybad. The Americans were just waiting for this man toget up to Dr Tweeds desk. They were stunned whenDr Tweed looked at the typodont, quietly put his armaround the man, and stated, Come and sit downwith me. Let me help you with this. Dr Burstonerelated that Dr Tweed worked with the man forapproximately an hour and a half to prepare histypodont. He surmised that Tweed did this becausehe knew that the man did not have the resourcesthat others had, and he had empathy for his situation.

    Tweed was a fun-loving person who liked to do allsorts of interesting and unique things. One of hisfavorite tricks, because he had strong legs that were

    ics May 2015 Vol 147 Issue 5 Supplement 2

  • the C

    S178 Pillars in orthodonticsdeveloped during his young manhood when he rantrack in high school, was to ride a bicycle while sittingbackward. He loved to demonstrate to all the children

    Fig 6. Tweed hard at work in 1950s. Courtesy ofArizona, and used with permission.in his life who would watch him do it because nobodycould even come close to doing what the great masterbicycle rider could do, much less with an ever-presentcigarette in his mouth (Fig 5). A young boy watchinghim happened to be a future president of the AmericanAssociation of Orthodontists, Dr William Gaylord(personal communication; September, 2013) ofFlagstaff, Arizona, who sent the photograph to theTweed Foundation along with a set of bands thatDr Tweed had meticulously fabricated in the 1940s.Yes, Bill Gaylord and his brother were the beneciariesof Tweeds interest and generosity while they weregrowing up in Tucson. In fact, Dr Tweed wasinstrumental in Dr Gaylords attending Saint LouisUniversity to study orthodontics. He probably knew,somehow, that Bill Gaylord would grow up to be thepresident of the American Association of Orthodontistsand receive the Merit Award from the OrthodonticEducation and Research Foundation in St Louis.

    His many hours, day and night, devoted todeveloping the edgewise technique and the diagnostictriangle, his continuing research, and the constantrequests for lectures caused him to be away from hisfamily much of the time (Fig 6). This he always seemedto regret. Many who took Tweeds course and interactedwith him told stories of his advice that family must

    May 2015 Vol 147 Issue 5 Supplement 2 Americanalways come before practice. The late Dale Wade(personal communication; February, 1992) related oneof these stories about Tweed coaching him to spend

    harles Tweed International Foundation, Tucson,more time with his family. Dr Wade said that his timewith Tweed was special. He appreciated his sage adviceduring his formative years in orthodontics. This storyfrom Dr Wade can be repeated by many other peoplewho went to Tucson to be with Charles Tweed.

    In addition to his many clinical contributions to thespecialty, Tweed gave guidance, inspiration, and leader-ship to more orthodontists in the world than anyone elseof his time. Because of Charles Tweed, the edgewiseappliance became universally popular. His diagnosticfacial triangle and his anchorage preparation conceptsgave generations of patients orthodontic treatmentthat was designed for facial balance and stability ofthe nal tooth positions. Charles H. Tweed personieda conscientious desire to develop the best possibleorthodontic treatments for his patients and to teachyounger men his methods. He was truly an orthodonticicon for the ages.

    REFERENCES

    1. Angle EH. Treatment of malocclusion of the teeth: Angles system.7th ed. Philadelphia: S. S. White; 1907.

    2. Lecture notes, March 1, 1965. Tucson, Ariz: Tweed MemorialCenter Archives.

    3. Tweed CH. The application of the principles of the edge-wise archin the treatment of malocclusions: II. Angle Orthod 1941;11:5-11.

    Journal of Orthodontics and Dentofacial Orthopedics

  • 4. Tweed CH. Soldering technic for steel arch wire. Angle Orthod1941;11:68-9.

    5. Tweed CH. Indications for the extraction of teeth in orthodonticprocedure. Am J Orthod Oral Surg 1944;30:405-28.

    6. Tweed CH. A philosophy of orthodontic treatment. Am J OrthodOral Surg 1945;31:74-103.

    7. Tweed CH. The Frankfort-mandibular plane angle in orthodonticdiagnosis, classication, treatment planning, and prognosis. AmJ Orthod Oral Surg 1946;32:175-230.

    8. Tweed CH. Why I extract teeth in the treatment of certain types ofmalocclusions. Alpha Omegan 1952;46:93-104.

    9. Tweed CH. Evolutionary trends in orthodontics, past, present, andfuture. Am J Orthod 1953;39:81-108.

    10. Tweed CH. The Frankfort-mandibular incisor angle (FMIA) inorthodontic diagnosis, treatment planning and prognosis. AngleOrthod 1954;24:121-69.

    11. Tweed CH. Was the development of the diagnostic facial triangleas an accurate analysis based on fact or fancy? Am J Orthod1962;48:823-40.

    12. Tweed CH. Treatment planning and therapy in the mixeddentition. Am J Orthod 1963;49:881-906.

    13. Tweed CH. Clinical orthodontics. Volumes I and II. St Louis: C. V.Mosby; 1966.

    14. Tweed CH. The diagnostic facial triangle in the control oftreatment objectives. Am J Orthod 1969;55:651-67.

    15. Angle EH. The latest and best in orthodontic mechanism. DentCosmos 1928;70:1143-58.

    16. Tweed CH. Letter to DeForest Whitmarsh. Tucson, Ariz: TweedMemorial Center Archives.

    17. Tweed CH. Reports of cases. Angle Orthod 1932;2:235-43.18. Cross JJ. The Tweed philosophy: the Tweed years. Semin Orthod

    1996;2:231-6.19. Strang RH. Highlights of sixty-four years in orthodontics. Angle

    Orthod 1974;44:101-12.20. Cross JJ. The Tweed Foundation: A History. In: Dale J, Rushton J,

    editors. A half century of carea future of caring. Tucson, Ariz:Shandling Lithographing; 1982, p. 72-9.

    21. Sandusky WC Jr. Dr. Tweedthe man. In: Dale J, Rushton J,editors. A half century of carea future of caring. Tucson,Ariz: Shandling Lithographing; 1982, p. 25-35.

    22. Marshall K. Letter to John Rushton. Tucson, Ariz: Tweed MemorialCenter Archives.

    Nostalgia Advertisement from a 1925 issue of the Journal

    Pillars in orthodontics S179American Journal of Orthodontics and Dentofacial Orthopedics May 2015 Vol 147 Issue 5 Supplement 2

    Charles H. Tweed, 1895-1970The edgewise appliancebeginningsThe Arizona specialty lawTweeds professional journeya rocky startThe Tweed-Angle relationshipTweedthe university proponentTweed folkloreReferences