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.

A sense of loss

Being a registered patient means that you have no access problems when you have a dental problem; you are recognised by the receptionist and the dentist and nurse know you very well.
The dentist has maintained your oral health, patched up or maintained your lifelong teeth.
Even when a new dentist arrives, you are comfortable in the knowledge that the dental record will tell all.
Much like your prized car, your dental health was looked after with great care.

It is rare for a clinic to close down, and when it does you feel abandoned.
Please do speak with anyone if you feel alone and lost, even a family member may have wise and comforting words for you.
You can contact us by email if you need advice.

You and 2000+ other patients may need to register with another dentist. Some patients may just abandon dental care completely.
Many clinics are already fully booked and it may take you a while for you to register with another dentist.

Trying to carry on

You may have paid in full or by instalments and are in the middle of treatment. Where can you go to get the remainder fo your treatment done?
It can be difficult for a dentist to pick up treatment midway, they may have another opinion or a different dental treatment plan in mind.
Usually the dentist is compassionate and understands your situation. He/she may just want to charge for what treatment was left to do.
Sometimes you have paid for crowns or veneers to be fitted and are in temporaries. It can be difficult for you because you cannot just turn up at Accident and Emergency.
Many patients would have already paid for these once and do not want to pay again.
The problem is that temporaries are a short term solution and you must get permanents fitted soon.
Dental implants once placed can be left indefinitely until a crown is placed.
Many patients may have already paid in full however for the implant and crown.

Financial loss

If you have paid by a credit card then the bank may be able to get your money back.
If you have taken finance, contact the finance company for advice. They may advise stopping the payments for now.
The finance company will be able to trigger their insurance policy for monetary loss and help reimburse you.
Under the consumer credit act if a service is not provided then the finance company may have to investigate but ultimately reimburse you.
Trying to get a refund from a closed down clinic may be difficult because the clinic probably closed down because of financial problems.

In current treatment 

If you are in pain, have had recent surgery or need stitches out then please contact another dental surgery and let them help. Sitting on a dental problem will only make it worse.
It may be difficult to get crowns fitted without having new impressions taken. Maintain a good diet, be careful with temporaries and have a soft diet.

Invisalign patients

Invisalign patients should try to stay on the current aligner if they needed teeth spacings or attachments bonded. If they are just changing aligners then please change to the next one if the old aligner was a good fit. If the delay is long then contact Invisalign and see about transferring the treatment to another Invisalign provider.
If you feel that the aligner is getting tired then just wear it at night as a retainer until you can resume treatment. You may change to the next one if the old one is beyond tired.
You should not progress through the aligners as you may have required spaces to be made.
We will be happy to help patients in the middle of Invisalign treatment and we can liase with Invisalign on your behalf.

Dental Implants

Patients in the middle of treatment or require implants etc. but are not in any pain should maintain good oral hygiene. Implants do not need immediate attention as there is a waiting time for the bone and soft tissues to mature. You may be desperate to get the crown fitted but hopefully you are wearing a temporary denture or crown. An antiseptic mouthwash helps keep the mouth clean.
Do seek immediate help if you are worried, have a swelling or are in pain. Sometimes all you need is a reassuring word.
If the finance company allows it then you may be able to transfer to Forma as an ongoing treatment case.

Further advice

All is not lost. If you have lost a lot of money try to see if your household insurance has a legal department who can try to get your money back, either from the clinic or the finance company.
Citizens Advice I feel are limited in knowledge in these situations, but they are worth a phone call.

If we have not covered your situation and need help, please do email us directly.

O post Finest Dental: What to do when a clinic closes 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.