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.

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.

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.

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.

Dental development involves the replacement of the baby teeth (from the age of 6) by the fuller set of adult teeth.

Adult teeth are greater in number and are greater in size.

The canines are usually in there correct position by 12 years of age, but not in all patients.

Sometimes the canines (fangs) do not develop at the correct position, or are delayed in coming down, or their space is closed by an early extraction of a baby tooth.

In any case the crowded canines look odd, although some societies actually want that teenage look way in to their mid 30’s.

In this case, we were seeing a 28 year old female who wanted her smile improved.

The canines were so way out that the RHS canine actually had no space whatsoever.

We offered 3 options with Invisalign:

1 remove the canines and no Invisalign treatment

2 remove the 1st premolars with a shorter Invisalign treatment

3 remove the 2nd premolars with much longer Invisalign treatment, as these 2 teeth are further away from the canine problem.

The patient chose the last option because the 2nd premolar on the RHS was root filled and may fail one day.

So we agreed and took impressions/scans.

The Invisalign Clincheck came back with a favourable treatment plan and time line, 18 months.

We agreed and removed the upper 5/5 and fitted the aligners.

The patient came to see us every 8 weeks for a review and after 18 months we did some refinement aligners.

The change was dramatic and the patient was extremely happy with our planning and execution.

Invisalign is a brand and product, but we would always recommend a dentist with many years of experience.

#invisalign#clear braces# aligners# crooked teeth

O post When you think your smile is hopeless 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.

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.

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.