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

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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

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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

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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

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.

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“From the start Dr Kumar and the FormaSmile team have been absolutely brilliant – always quick to answer any questions and really made me feel comfortable. You really get the feeling that Dr. Kumar actually cares about getting you the best results, not just going through the motions! The treatment has been great, and my teeth look fantastic”

Anna

“Very very happy with my Invisalign treatment & FormaSmile. My teeth are now lovely and straight. Dr Kumar was very professional and made sure I got the best results. I would definitely recommend. Every penny well spent!”

Dave

“I cannot recommend Dr Kumar and his team highly enough. As someone who was not comfortable at the dentists, he completely put my mind at ease and was very patient and professional in explaining all the possible treatment options. After an 18 month plan the results are more than what I was hoping for and I believe most of that was down to Dr Kumar himself. I would completely recommend FormaSmile to anyone looking to correct their smile.”

Ellie

“Amazing results from Dr Kumar & FormaSmille. I had lost my confidence to smile, I was self-conscious of my teeth. But with Invisalign & Raj’s careful attention to detail, I can now smile with pride”

Melanie

“Dr Kumar is a fantastic dentist – I met him many years ago & still go to him for my dental care. I had Invisalign which gave me the confidence to smile again. Thank you so very much”

Simon

“A flawless experience with FormaSmile. I paid one price up front and that was all (even when I required further adjustments to get my stubborn teeth in line). Dr Raj was always available (at short notice) and flexible and I’m really happy with the final results. I’m so glad I got my Invisalign done here”

Helen

“Great service! I started my Invisalign 18 months ago, the result is outstanding”

Keith

“Dr Kumar and his team have been perfect throughout my Invisalign journey and I couldn’t be happier with the results. If you’re seeking a honest, reliable and professional dentist then I highly recommend Forma Smile & Beauty- an investment that’ll keep you smiling!”

Priya

“At FormaSmile I had Invisalign treatment as well as a tooth removed and dental implant put in. As a result of the professionalism, high quality work, and good humour of Dr Kumar and his colleagues, I will be using FormaSmile for all my dental work going forward. I would also recommend to anyone that is in need of dental work”

Louisa

“Outstanding professionalism and incredibly pleasant atmosphere. I highly recommend Dr Kumar  and FormaSmile to anyone thinking of undergoing any dental treatment”

Sara

“I’ve just finished my Invisalign treatment and I’m very pleased with the results. I always got quick responses to any queries and it was easy to arrange visits. I would highly recommend”

Paul

“I completed my Invisalign treatment, 1 filling and a root canal treatment at FormaSmile. Dr Kumar is professional, explains the treatments clearly and is accommodating. I’m very happy with my Invisalign results, I now have a lovely smile and healthy teeth. I would recommend FormaSmile”

Gemma

To read more reviews from happy patients please see our website or search FormaSmile google reviews.

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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.