At Forma Smile, we specialize in solving complex orthodontic challenges that many practices overlook—like lateral incisor crossbites.

This case demonstrates the power of strategic tooth movement with Invisalign. The key to success? Careful sequencing. First, we moved the obstructing teeth out of the way to create space, then progressively pushed the UR2 and UL2 forward into their correct positions, correcting the crossbite and establishing proper occlusion.

The Treatment Journey:

✓ Phase 1: Strategic repositioning of blocking teeth

✓ Phase 2: Forward movement of lateral incisors (UR2 & UL2)

✓ Phase 3: Refinement and occlusal settling

✓ Duration: 12-15 months

✓ Result: Corrected crossbite, improved bite, enhanced smile aesthetics

Why Invisalign for Complex Cases?

Invisalign’s precision allows us to execute complex tooth movements in a controlled, predictable sequence. The aligners apply gentle, consistent pressure, making it ideal for intricate cases like lateral incisor crossbites that require careful planning and execution.

This patient now enjoys a corrected bite, improved facial balance, and the confidence that comes with a properly aligned smile—all achieved discreetly with clear aligners.

Ready to transform your smile? Book a consultation with Dr. Raj Kumar to explore how Invisalign can solve your orthodontic challenges.

O post Treating an anterior crossbite of the laterals apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

In cases like these, the patients are looking for a dramatic improvement of both the teeth and face.

Take this teenager, her upper and lower lips are protruding. The nasolabial angle is an acceptable 90 degrees, but this is because the nose is upturned and the upper lip sticks out.

She had mildly proclined upper and lower teeth and her lip seal was strained due to hyperactivity of the Mentalis chin muscle.

We agreed to remove the UR4, UL4, LR4 and LL4. This would allow retraction of the front upper and lower 6 teeth and allow the lips to become more relaxed.

The teenager was at boarding school and so the teeth were extracted over 2 visits during the school holidays. Attachments were bonded and she went off to her studies.

She was told to wear the aligners 20 hrs a day and to change them every 10 days. No elastics, TADS or aligner cut out were required.

We did a single review at half term.

Approximately 11 months she returned for a review at the end of the aligners.

There were some minor refinements to do to the occlusion. So we carried out a new Itero scan and took photographs.

Refinement aligners were ordered and fitted 2 weeks later.

Treatment time would be 1.25 years in total with only 2-3 review appointments in-between.

The facial changes were dramatic however.

The face is slimmer, the lips are more relaxed, with the lower lip more so. She will complete the refinements and we will then provide her with 3 upper and 3 lower retainers to retain the occlusion. #invisalign #clear braces

O post Face changes with Invisalign extractions apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

The 1st premolars 4/4 are usually removed, but sometimes the 5/5 may be heavily filled and are better candidates for removal.

The problem however is that the 5/5 are further away from the anterior crowding and so it takes much longer to carry out treatment.

The patient had severe upper crowding. With a deep bite. We agreed to remove the 5/5 and provide Invisalign to close the gaps and correct the crowding. The aligners were changed every 2 weeks.

The patient wore the aligners mostly 20 hrs a day.

Treatment time was 18 months in total and patient was travelling across Asia, so he attended every 3 months.

The back teeth were moved forward whilst the from teeth were moved backwards.

The patient could not travel back, so he had the attachments removed, 3D scans taken and sent to us. We ordered 6 retainers and posted them to Hong Kong. Job well done.

O post Severe crowding calls for tooth removal, but which ones? apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

Having braces as a teenager is no guarantee that the smile will be acceptable in your early adulthood. Retainers given after orthodontic treatment are not designed to last too more than 1-2 years, and as a teenager you may still be growing.

This patient was 22 years old with moderate upper and lower crowding, centre line shift, premolar rotation and some tooth wear of the incisors.

The 2 lower incisors were forward, which was causing the upper 2 front incisors to drift forward. The 2 upper lateral or side incisors then started to fall behind the front incisors.

All in all, an unstable situation.

We agreed Invisalign aligner treatment. It took 13 months with no teeth extractions. The patient attended every 6-8 weeks for review appointments.

The patient received 6 retainers that will last 5-10 years. #invisalign #clear braces # braces # crooked teeth

O post Moderate crowding treated without metal braces apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

Teeth can develop in many ways and sometimes an abnormal formation can cause occlusal/visual problems.

Dens in dente is an extra cusp formation usually on the incisors, which can interfere with the bite or cause tooth drift. The Dens in dente or talon cusp can be made of enamel, dentine and even nerve tissue.

It looks like a bump and sometimes you can feel it with your tongue. Most people grow up with them and think of them as normal.

They rarely are a massive dental problem.

Dental anomalies are rare and usually of a genetic nature or a disruption during tooth development, such as chicken pox or measles.

The case above shows the forward drift of the UL1 as the lower teeth bite onto the talon cusp, this can also be called an increased overjet.

The patient had a close/deep bite with a narrow arch and prominent UR1 and UL1.

Sometimes the teeth drift due to clenching, which can cause muscle forces to compress the back teeth, moving the front teeth forward, this is called arch collapse.

We advised Invisalign aligners with some minor recontouring of the UL1 incisor.

The lady wore Invisalign trays for about 9 months to expand the dental arch and bring in the upper incisors. The aligners were changed every 2 weeks. The lower teeth were also moved downwards to create space (deep bite reduction).

Patient was happy with straightened front teeth and widened arch.

Tooth whitening was done and the patient received 6 Vivera retainers that so far have lasted 10 years.

O post Upper tooth drift related to a palatal tooth bump-Dens in Dente apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

Then one day, finally the braces were off and they can rejoin the rest of the school as a normal looking teenager.

The kind dentist gave them a set of plastic retainers, that were either worn, lost, could no longer fit onto the teeth, or were still being worn (after 10-15 years).

Fortunately most retainers will not look like this, however no plastic retainer worn regularly will last more than 2-3 years.

Plastic materials will warp or distort under bite pressures and the moist oral cavity.

Teeth are known to move with or without orthodontic treatment (Proffitt) and also teeth are known to move post orthodontically when retention is not adequate (Proffitt).

We see many young adults that have orthodontic relapse because the retention was inadequate.

This lady had been a thumbsucker as a youngster and had had orthodontic treatment.

Sadly the retention device was inadequate and the patient had a relapse, with dental crowding and an increased overjet.

She did not want to wear fixed braces and did not want cosmetic veneers.

We offered her Invisalign treatment to move back the molars and the front teeth.

She agreed and we provided Invisalign treatment for 15 months. The patient attended every 6-8 weeks.

She had no pain, could take them out for eating and could drink with them in.

Nobody at work knew she had Invisalign.

The patient could slowly see the improvement with the aligners and was very happy at the end.

We provided 3 pairs for Vivera retainers, that are worn x2 a week and rotated every 4 months. On average our patients email us for a replacement set every 5-8 years.

invisalign # vivera # clear aligners

O post Orthodontic relapse overjet treated with Invisalign apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

Many patients have narrow dental arches from thumb sucking or clenching their teeth. The facial muscles create forces that will compress the teeth, narrowing the dental arch and cause dental crowding.

The teeth may begin to overlap, rotate or even protrude.

Teeth out o their natural positions are more prone to damage from trauma or tooth wear.

Sometimes you may notice one front tooth is shorter than the other.

Simply by moving the teeth back to their original positions will recreate the space and solve the crowding issue.

This Invisalign case was a 28 year old student who had severe upper and lower crowding and a missing tooth.

We used Invisalign to expand the dental arch and move the teeth back to their original positions, using the missing tooth space.

It took 15 months of treatment and the patient attended every 8 weeks.

At the end we provided 6 Invisalign retainers and tooth whitening as well.

The 3 pairs of retainers are rotated every 4 months which keeps the teeth locked in their final positions.

#invisalign#aligners#braces#crooked teeth

O post Arch expansion apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

Invisalign is the world’s most advanced clear aligner system.

Only Invisalign clear aligners use SmartTrack material to shape your smile with precision,

comfort and predictability.

Here at FormaSmile we have been using Invisalign to create beautiful smiles since 2000 and have

created over 1100 new smiles.

Paula’s Patient Journey

Paula came to Forma because she was unhappy with her smile and very conscious of her teeth. For years she had been considering teeth straightening but as a young working professional didn’t want metal braces. After the initial consultation and given all the possible treatment options, she decided to go with Dr Kumar’s advice and proceed with Invisalign.

Paula presented with an overjet of 10mm, where her upper teeth stuck out over her bottom teeth. Her treatment consisted of the removal of 2 upper premolars and then using Invisalign to widen her arch and move the upper teeth back.

So that she did not have gaps in her smile during treatment, the aligners were fitted with 2 fake resin teeth, so that no one could tell she’d had extractions.

Reviews were every 2 months and she changed aligners every 10 days. Her total treatment plan was 15 months.

Aimee’s Patient Journey

After having visited several other dentists and being a nervous patient, Aimee came to Forma on a friends recommendation. Here at FormaSmile Aimee was given all the treatment options, costs and time for her to go away and make an informed decision. The Forma team were always at hand for any further questions or advice needed. Aimee started her Invisalign journey with us 2 weeks later.

Aimee presented with upper and lower crowding, a deep bite and deformed lower jaw. As a result of this Aimee was biting the sides of her lower teeth.

Invisalign was given to widen the lower arch, correct the over crowding and the deep bite. The jaw deformity could not be corrected but as a result of Invisalign Aimee no longer bites the sides of her mouth.

Reviews were every 2 months, aligners were changed every 2 weeks. Her total treatment plan was 12 months and to finish her treatment, Aimee received free tooth whitening.

For more patient journeys please see our website.

O post Start your Smile with Invisalign at Forma apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

The E line

The E line is an imaginary line drawn from the nose tip to the chin. In the ideal face the upper and lower lips sit just behind the E Line, with the lower lip being fuller being closer.

Changes in the positions can be seen in patients who have :

1 Upper jaw being forward or backward

2 Lower jaw being forward or backward

3 Small or big nose

4 Full or flat lips

5 Teeth protrusion

All except teeth protrusion would involve a surgical intervention to correct or early fixed orthodontics with headgear etc. However teeth problems appear quite late into adulthood and many long or old adults would not wear fixed braces with head gear.

Bimaxillay protrusion

Bimaxillary proclination is a dental term used when both upper and lower teeth are angled forwards causing the lips to procline forward.

It is most common amongst African and Asian populations.

It is usually due to the increased length of the bone that holds the teeth, the dentoalveolar process, but can be sometimes due to tongue thrust as well.

It can also be seen where the lips are full but loose/incompetent which can allow the forward tilting of the teeth.

The lip profile can be seen to have a reduced angle between the base of the nose and the upper lip. The lips can be seen to be actively trying to close the mouth.

Sometimes a patient may have difficulty in having a relaxed pose with the lips together due to the proclination.

In a study carried out in 2007, Chinese participants preferred a flatter smile than a bimaxillary protruded smile.

In another study larger than average teeth that do not fit in the dental arch, can lead to proclination and also crowding.

Patients can inadvertantly ask for smile makeovers or veneer treatment hoping that the protrusion can be reduced, but without gross tooth destruction it is ill advised.

Most adult patients would like this type of malocclusion corrected orthodontically, but would not want fixed braces if at all possible.

Invisalign orthodontics solution

Invisalign clear aligners can be of great help in reducing this dental problem.

Space needs to be created to allow retraction of the teeth.

This can be done either by:

Pulling back all the teeth is possible if the wisdom teeth have been removed.

The amount of space at the back may be limited by the lower jaw.

Stripping the enamel between teeth contacts; this can only give 4-5 mm backward placement. But some patients prefer this option.

The best option is the removal of 2 upper and 2 lower premolars. This can give a total of 5-10m of space allowing the front teeth to be angled backwards to near vertical.

The spaces are closed during the process with the Invisalign aligners. At each aligner stage the space is reduced and the teeth crowding also less.

Extractions allow you to have maximum profile reduction and change in crowding without damaging the enamel of the teeth.

With the extraction of 4 premolars we were able to reduce the crowding and the profile. Notice the reduction of the lip profile and the nasolabial angle.

O post Proclined teeth and the Eline apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.

Many patients are too embarrassed to have braces as adults. They put up with their smile (not) because the thought of fixed braces and the pain just puts them off.

They missed the opportunity as teenagers at school, because either nobody bothered to offer any help, or their smile got worse as they reached adulthood, and nobody wants fixed braces at university.

So mid 20s they wander what they can now do now that they are working and trying to move up the job ladder or getting married perhaps.

Invisalign aligner treatment was invented about 20 years ago and arrived in the UK about 18 years ago. It is a series of removable aligners, that move teeth sequentially. You can drink with them in and there is no pain.

In this case study a young woman presented with protruding teeth and multiple spaces. The protrusion is usually due to thane or thumb forces and can push out the teeth and the anterior part of the maxilla as well.

In extreme case surgery is needed to reduce the bone position/ protrusion.

After a careful assessment of the patients needs and dental occlusion, we agreed to use Invisalign aligners.

Impressions and photos were taken and aligners ordered. She came back to have the aligners fitted and the whole sequence was given to the patient. Treatment time was about 15 months, which can be reduced to 12 months now.

She was supposed to come back after 3 months for a review, but did not come back for 2 years!

Inbetween her treatment she had had 2 children and Invisalign was the perfect partner on her journey of self-discovery. She just changed aligners every 2-3 weeks and got on with her life.

We were both very happy with the results and she could not thank us enough.

I hate to say it but the improvement was amazing and she had turned into a swan.

O post Invisalign can easily fix spaced out teeth apareceu primeiro em Forma Smile | Dentist in London - Dental Clinic London - Invisalign Clinic in London - Invisalign Specialist - Dental Implants in London - Dental Care - Dental Boutique based in Central London EC2.