Good question!
In 1939, the Winston-Salem Journal described Old Town as one of the best three (3) courses in the Southeast. Perry Maxwell went a step further saying that it will soon be "regarded as one of the nation's seven (7) best". That's quite a remark considering that Maxwell had already worked at many classics himself, including Augusta and Pine Valley, and helped a number of Northeastern gems recover from hurricane damage, including Maidstone, and he had visited many others during his travels to metro-Philly. (Don't forget Crystal Downs, Southern Hills and Prairie Dunes )
By the 1950's, Old Town hosted The Atlantic Coast Conference Championships (the old Southern Conference). Arnold Palmer won one a Conference championship at Old Town in 1954. The W-S paper further reveals that many professionals, like Nelson, Snead, Gudahl, would practice at Old Town before the GGO and The Big Sky Classic in Asheville. Then, in 1956, Old Town officially became the home of Wake Forest golf.
So throughout the first couple of decades, Old Town was highly regarded.
So what happened, you ask? It appears that Old Town kept much to themselves in the 70's and 80's. Very private and sleepy, perhaps? Even Tom Doak was reportedly turned away when he inquired about walking the property. Like all other courses, the architecture evolved. Trees were planted everywhere. Fairways, bunkers, and greens gradually shrunk and deteriorated.
By the mid-1990's, club officials started paying more attention to our golf course.....the way it looked, the way it played. A few of us started asking good questions. What was intended originally? In short, there was a greater sense of pride and appreciation for our architectural heritage, our roots, and Perry Maxwell. Today, a 1940 aerial and black-and-white photos serve as our templates. Then, panelists from the leading magazines, architects, and others in the golf industry have been allowed to see what we have. Plus, classic architecture is more revered nowadays than ever. So the interest in restoring the classics is at an all-time high!
"Undulation" throughout the property -- on both the fairways and the greens -- is the linchpin of Maxwell's design. Old Town is a place that should celebrate short grass, space, and width - not the opposite. Because these are the elements that accentuate "undulation". Golfer just don't see anything like it around here in the Carolinas. I think its an attraction and speaks for itself.
Maybe Brad Klein, Ron Whitten, or Tom Doak can answer your question more precisely. There are many others courses in the Top-100's today that have been re-discovered. Perhaps they just received some tender loving care also.