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.

Why do you get an overjet?

Sometimes teeth can move forward from thumb sucking or pen chewing and even from teeth grinding at night.

Teeth grinding or clenching is caused by the cheek muscles that press onto the teeth, pushing the side teeth in and causing the front teeth to move forward.

If left untreated, the upper teeth can continue to push forward and upwards causing the front teeth gum to shrink/recede.

Also as the upper teeth move forward, they lose contact with the lower teeth and the lower teeth may drift upwards.

Do I need teeth out?

In most cases where the overjet is 7mm or more we recommend 2 upper teeth are removed. This happens quite frequently in children and so young or old adults should not be surprised that they too may need teeth removed.

Will extractions affect my face?

Patients with a large overjet sometimes have a long narrow face and or protruding upper or both upper and lower lips.

Extraction teeth and moving the teeth back will allow the lips to be a resting angle, and also to be flatter.

If you have very thin lips then extractions may not be advised, but with full lips, extractions will help improve the facial proportions.

Will extractions affect me later in life?

Remember most teenagers have 4 premolar teeth extracted for fixed braces, and they do not have any problems later in life.

Adult extractions are quite common with orthodontics, and much safer than interdental stripping (IPR).

The lower teeth therefore prevent the upper teeth from being moved orthodontically back.

This lady had a narrow arch and the upper teeth were sticking out. She had fixed braces as a teenager, did not wear the retainers and the teeth moved forward.

The patient was not happy with her profile but did not want a quick solution, she wanted the best solution that fitted around her teeth. She felt that her upper lip stood out and her lower lip was trapped under the upper teeth.

Her lower teeth were slightly angled forwards and the lower jaw was set back. The overjet was 12mm.
This is common in patients who have a shorter lower jaw or a longer upper jaw.

The upper teeth could have been tipped back but there would only be a slight change in the profile and overjet.
We recommended Invisalign with 2 upper premolar extractions, and the patient agreed.

2 teeth were removed at the clinic and plastic fake teeth were placed inside the aligners.

The patient collected 6 aligner packets at a time and came in every 60 days for a check up.

The aligners were changed every 10 days and taken out only for eating, brushing teeth and the odd social event.

Invisalign was used as the orthodontic treatment of choice and it took 15 months to finish the treatment.

The upper teeth were reshaped at the end although the UL1 could have been reduced more.

The patient received straightened teeth and a more relaxed profile. The lower lip no longer rested underneath the front teeth, and her lips became more relaxed and in a natural position.

Jaw surgery was not needed.

In summary what looked like a surgical case ended up as an Invisalign extraction case.

#invisalign #clear braces # clear aligners # straight teeth #braces

O post Using Invisalign to reduce the facial profile 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.

Not all patients have had the benefit of orthodontic treatment, and as they get older the problem gets worse.

Sometimes teeth have been orthodontically treated but without adequate retention, orthodontic relapse occurs.

The protrusion of upper teeth can be from tongue, thumb or even lower lip forces and this can create an unfavourable profile.

In this young lady we have a normal nasolabial angle but an increased upper E-line measurement, meaning that the upper lip protrudes out. protrusion. This can be from a longer upper jaw or a shorter lower jaw (asymmetric growth) but it can also be from upper teeth protruding outwards.

Sometimes the lower lip gets caught behind the upper front teeth and can cause protrusion.

This case study shows a young lady who did not have orthodontic treatment and she was not happy with dental appearance or the lip profile.

The only way to reduce the overjet was to remove upper premolar teeth. Nothing else would give a better result without also lower jaw surgery, which we normally do not recommend.

We agreed to do Invisalign with 2 upper teeth extractions.

We had 39 upper and 22 lower aligners, and the patient changed her aligners every 10 days.

After about 1 year we carried out a refinement scan for some new aligners; 11 in total.

The large overjet was greatly reduced to within 2mm and the patient was very happy.

We discussed using Invisalign retainers, that are rotated every 4 months, to stop them from stretching.

The upper lip profile has been relaxed and the patient can comfortably close her lips together. A great result with such a simple technique.

O post The only way is Out 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

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Spaces between teeth can occur in many ways. A patient may have genetically spaced teeth, genetically missing teeth, or teeth extracted. 

Spaces between teeth can also occur from habits such as tongue thrust, pencil chewing and thumb sucking etc.

Teeth can also drift in patients who have suffered periodontal disease/ gum disease. 

The most common space between teeth is the midline upper diastema such as in the artist Madonna. 

Some ethnic minorities will have a higher percentage of teeth spaces.

Most patience have an acceptable smile with space between their teeth, but some patients may want the spaces closed. 

Some dentists will add fillings between the teeth to close the spaces, but we do not agree with that as the fillings can add unnecessary widths to the teeth, can stain chip or even fall off. Fillings added to teeth can also cause gum disease. 

Our advice to close spaces is to use Invisalign aligners. 

The most convenient orthodontic system is Invisalign, in that it is removable clear and really easy to clean. With no pain or food trapping, then why would anyone want fixed braces?

This young male patient had already had braces as a child but over time and without his retainer his teeth stared to drift forwards. There may have been a history of tongue thrust as well. 

From the picture you can see some tartar has built up between the teeth which is quite common when there are spaces present. The patient was a trainee lawyer and did not want to wear fixed braces so we agreed on Invisalign orthodontic treatment.

The Invisalign treatment consisted of 25 pairs of aligners each pair being changed every two weeks and the patient being reviewed at the clinic every 6-8 weeks.

We added attachments to some of the teeth to aid in retention of the aligners. 

The patient was however, not very good at attending and so we probably saw him every three months. 

As you can see from the photographs the patient was nearly finished and his attachments are still on. We achieved space closure, the attachments  were removed and the patient was given three pairs of Invisalign retainers. 

Treatment time was extended due to the patient’s poor attendance. 

As you can see a dramatic difference has been achieved with removable Invisalign aligners and very few appointments with the patient. 

Invisalign allows us to plan treatment around a patient who cannot attend very regularly and in a few cases we have seen patients only once in a year treatment, but with a successful result. 

O post Tooth drift and how to treat it 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.

Julia Roberts is known worldwide as a beautiful woman, a great actress and having a great wide smile.

The smile is wide because she has a wide mouth, but also because her teeth are aligned and the arch is widened to show more teeth in her smile; you can actually see back to her molars.

Now we all cannot be born to look like JR but there is 1 thing we can do.

Have a great smile.

The way to do this is to straighten the teeth, push out the molars and premolars so that they show in the smile.

When you smile you can actually count more teeth being visible.

Invisalign can help achieve that perfect smile without taking over your life.

Invisalign aligners were used in the following case:

Lady patient aged 26 had 2 upper front teeth sticking out and she wanted the teeth straighten into alignment.

We noticed that she had unusual bumps on the backs of the teeth, that hit the lower teeth on biting and actually caused the overcrowding.

So we advised that the lower teeth need to be moved back, the back teeth out to allow space for the upper front teeth to be aligned.

In all it took about 12 months treatment, but the worth was worth it.

Here are a couple of videos of a similar case whereby the arch is widened to create a great smile.

O post How to get a smile like Julia Roberts 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 a removable orthodontic system made up of a series of clear aligners that you normally change every 2 weeks.

Unlike normal orthodontics which have fixed brackets and wires, Invisalign allows you to remove the aligner to clean your teeth.

Because there are no brackets fixed to your teeth or archwires, Invisalign allows you to floss your teeth as well.

Flossing is very difficult with fixed orthodontics because the wire gets in the way. So normally you have to use interdental brushes under the wire and around the brackets.

One downside is that some patients tend to drink fizzy, sugary drinks constantly with the aligners in; this can cause a build-up of sugars inside the aligner and can cause tooth decay. We recommend avoiding fizzy drinks for all orthodontic systems.

We recommend a fluoride mouth rinse used once a day before going to bed.

With all orthodontic systems, sometimes we need to make spaces with interproximal stripping. This is where a disc or small bur is used to open a space between 2 teeth contacts. The contact between the 2 teeth is opened up.

The space is normally 0.3 to 0 .4 millimetres wide and will normally close with the aligner system.

Sometimes however the space is created too early, i.e when the teeth are heavily crowded or rotated then that can cause uneven spacing between teeth; these spaces do not close very well.

In reality this happens very rarely but can ruin patient’s expectations.

We advise interproximal stripping is done on teeth that are relatively straight or later in the treatment when they are not as crowded.

We also advise stripping should be done with a thin narrow disc and not with a drill or dental bur.

The last problem with orthodontics is poor oral hygiene as this can cause a problem with any orthodontic system especially fixed but less so with Invisalign.

In conclusion, Invisalign being a removable orthodontic system rarely can ruin teeth.

O post Can Invisalign ruin your 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.

Question is how much do you value your smile?

What you really want to do is to invest in the correct treatment that is cost effective but gives you the smile that you desire.

There are many ways to straighten your teeth and many dentists who can do it.

How do you know what is the best treatment for your dental crowding more spacing?

Ideally you would put your trust into the dentist with whom you have consulted with, but sometimes the dentist may have a preference in treating you, with which you may not agree.

Orthodontic treatment can only be cheap if you want limited results, that is either you want quick treatment or only a few teeth moved.

Dental crowding may look like just one or two teeth, but it may actually involve more teeth at the back of the mouth.

Ideally you want to move the back teeth first to creates pace for the front teeth.

So orthodontic treatment should treat the upper and lower arches.

So how expensive is Invisalign?

The normal range for Invisalign treatment of both arch’s and moving front teeth and back teeth can range from £3000 to £5000.

The average fee is around £4000 for which you will get dual arch treatment involving most of the teeth in the arch.

Full arch treatment is what you really need, which minimises stripping of the enamel to create space and allows you to create a wider smile.

Limited arch treatment maybe cheaper and quicker but it will involve less teeth and more enamel stripping.

To find a good dentist go for a face to face consultation, get an Itero scan done to see how your smile can be improved and see their before and after cases. Only then will you be comfortable that you have found a competent dentist.

Most dental practises will offer a payment plan to help you spread the costs.

Remember you only want to do Invisalign once.

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Extreme lower crowding can mean a tooth needs removal in order to achieve the best result and or minimise the treatment time.

This lady had been a thumb sucker as a child. As her teeth and jaw were developing the forces of the thumb sucking caused the upper teeth and jaw to protrude and the lower teeth and jaw to be compressed inwards.

She wanted orthodontic treatment without fixed braces.

We advised that the lower incisor was extremely crowded with very little bone in front of it.

To keep this tooth would mean extracting a side premolar and the great movement may cause the tooth to loosen and fall out. Also, she would have had a large triangular space between the incisors. We recommended that the tooth should be removed instead.

Her upper teeth stuck out more than 10mm and this would mean her upper treatment would take a long time. She had fractured the incisors because they stuck out, which is common in this type of bite.

Luckily we avoided taking any upper teeth out to improve her appearance.

We agreed Invisalign with 1 lower incisor removed and the patient agreed.

When the aligners arrived, we removed the incisor and the aligners were fitted.

Patient attended every 6-8 weeks.

She needed 42 upper aligners, changed every 10 days and lower 21 aligners.

Patient was very happy and went to see her own dentist to have the upper incisor edges rebuilt.

O post When extracting a front tooth makes sense 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 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.