Incognito Expert Forum, Nice

At the weekend I visited Nice, France for an expert forum on Incognito lingual braces. I've been using braces hidden behind the teeth for 9 years, and now use the Incognito brand almost exclusively for this type of treatment. Incognito braces are completely custom made to the specialist's prescription, leading to fantastic results and a great 'wearing experience' for the patient. This was a new meeting by invitation only, so I was delighted to be one of only 20 UK orthodontic specialists to attend, and the only one from Yorkshire. The meeting was held at the Hotel Negresco, a spectacular if rather unusually decorated hotel on the main Promenade des Anglais. Fortunately we had lovely weather, a complete contrast to Storm Abigail in the UK!

There were about 150 specialists, mainly from Europe, plus technicians from the German laboratory where they custom make each appliance. (Sadly some people hadn't made it due to the terror attacks in Paris affecting travel, more on that later.) The technology is incredible, Incognito started with 3D printing technology in 2001 when it was very new, and have continually developed the process and made it almost fully digital now. Many orthodontists are buying oral scanners which remove the need for taking impressions and sending by post. There were audible gasps of 'wow' in the audience as Incognito revealed the new digital light printer that can do the work of 40 of their previous printers. It's really useful to know what happens in the lab in between taking impressions and fitting the braces as it helps me to plan the treatment and understand what can and can't be achieved. I'm sure it's also useful for the technicians to see the clinical side and get to know the doctors.

Saturday afternoon was taken up with lectures by specialists from France, Japan, Italy, Scotland, Germany and the USA. The lectures including a lot of clinical tips, really helpful for not only planning treatment but also getting the best out of the braces to achieve the best results for my patients. There were some challenging cases treated to a very high standard. It was also great to chat to colleagues about lingual braces, and also about many other orthodontic topics, as well as having a social catchup with some friends I've met before.

Sunday was split into smaller groups leading to interesting and stimulating discussion. I gave a short presentation on providing temporary 'false' teeth to disguise gaps during treatment, and picked up some very useful tips and tricks from other specialists. It was inspiring to listen to others who use the appliance in many different situations, often in preference to other types of orthodontic brace. I can certainly recommend Incognito braces in confidencewith the knowledge it will deliver results as good as, or even better than traditional fixed braces on the front of the teeth.

Sunday afternoon was free so I walked along the prom to the old town. I had a good impression of Nice and would like to return and explore it more fully. It was really encouraging to see residents and tourists behaving normally after Friday's terrorist attacks in Paris, with many people and families out for a walk. In fact, the organisers and locals had been keen to stress that we were safe and still very welcome, and getting home via Nice airport presented no problems. Obviously our thoughts were very much with the French people and the Parisiens in particular.

I'd like to thank 3M Oral Care and Incognito for the invitation, and look forward to another meeting next year.

Which brace is better?

On Saturday I attended the British Lingual Orthodontic Society (BLOS) spring meeting. (For those who don't know lingual orthodontics is the treatment of misplaced teeth using braces that are attached to the back of the teeth, rather than the front.) I am a committee member for BLOS and having helped with organising the meeting I'm pleased to say it was a really great day.

The meeting was fully subscribed showing a growing interest in lingual orthodontics in the UK (plus there were some European delegates). The venue was the Four Seasons Hotel at Canary Wharf, who were incredibly helpful and provided some amazing food during the breaks, especially the chocolate themed afternoon coffee break (yes dentists eat just as much chocolate as anyone else!).

This meeting brought together some of the best lingual orthodontists in the world, with practices in Paris, Berlin, Italy and Tel Aviv. Many of these ONLY use lingual braces! Each spoke about the lingual system of their choice with reasons why they preferred it over another. There were lots of clinical cases showing some fantastic treatment results and many happy patients. Each system has its own advantages and disadvantages, but there were a few things that really came over as a whole.

• Lingual orthodontics is in demand. The number of people wanting treatment that is rising and as orthodontists we need to be able to select braces that will get the result the patient wants as aesthetically as possible.
• If we, as orthodontists, do not get interested in lingual treatment we risk getting left behind. The UK may be behind other countries but we do follow the same trends eventually.
• Technology is becoming increasingly important. Most of the systems demonstrated used advanced Cad-Cam technology to plan and manufacture the braces. This makes it easier for the orthodontist to plan treatment, the patient to see the potential result, and gives greater accuracy of the braces and the final result.

But the thing that really came over, and was stressed by Dr Silvia Geron, is something that probably applies to all orthodontic treatment. It is not the 'system' that gives a really good result. It doesn't matter whether you choose Harmony, Incognito, eBrace or any of the other lingual systems, as the final result is in the hands of the orthodontist. It's down to how we assess, plan and use the braces that is important, rather than a specific brand. The skill and experience of the person doing the treatment is what really makes the difference between a good result and a fantastic result.

The Duchess and the French orthodontist

On Saturday the Daily Telegraph carried this article about the Duchess of Cambridge and how 'pioneering' French orthodontist Didier Fillion has used 'micro-rotations' of the teeth to produce 'harmonious asymmetry' and give her a natural look, according to Dr Fillion's friend Bernard Touati.

I do think the Duchess has a lovely smile, I'm so pleased she hasn't gone down the route of porcelain veneers and instead chose orthodontics to help her, but I do have a few problems with the way this article portrays what she has had done. Let's leave aside for now the breach of patient confidentiality (it's NOT ok to tell your friends about your clients) and read between the lines of the article.

Harmonious asymmetry
I don't see much that's asymmetric about Kate's teeth. I'm sure if you used an accurate measuring device you'd be able to pick up small differences, but it's what the eye sees that counts. I'm not sure why an orthodontist would deliberately aim to leave asymmetry but there will always be some imperfections when the natural teeth are kept. The only way to get that perfectly even, perfectly white 'American' smile is with porcelain veneers, and even with that type of treatment a natural look can still be achieved if wished.

Micro-rotations
If something is 'micro' then are we able to detect it? I would never claim to be able to align teeth perfectly, I can get close to perfect, but perfect does not exist. There will always be 'micro-rotations' (see above!)

Lingual braces
There is little information to tell us what Kate actually had done to her teeth. This is not the first article to suggest she has had treatment by Dr Fillion, who could be called a dental pioneer in lingual braces. Lingual braces are like traditional fixed braces but attached to the back of the teeth (tongue side=lingual). Put them on the back and nobody can see them. Dr Fillion runs a respected course in lingual orthodontics in Paris and has developed his own system called Orapix. However, there are orthodontists all over the UK using lingual braces and it is growing in popularity amongst orthodontists and clients who'd like straighter teeth but prefer discreet braces.
I've been using the technique for five years and about 20% of my adult clients now choose lingual braces. As an orthodontist it is a challenging technique but I now feel comfortable using it and look forward to seeing my lingual clients. Almost anyone who is suitable for standard fixed braces is suitable for lingual braces, though they require a bit more time to get used to and cost more.
Take a look at the British Lingual Orthodontic Society website (you'll see Didier Fillion is the president) for more information and to find an orthodontist near you, or have a look at my own website. You don't need to be a princess or travel to London or Paris to get a smile like Kate's.

We may never know exactly what the Duchess has had done with her teeth but they do look lovely, straight yet natural. You can certainly be sure we will be seeing a lot more of her smile!

Treatment fit for a Queen?

Did Kate have braces to improve her smile before her wedding day?

There is a lot of speculation that the Duchess of Cambridge had treatment with lingual braces before her wedding day including reports that she visited a specialist on Harley Street and an article in Hello magazine this week. Her smile is certainly fantastic, I'm sure any bride wants to look their best on their wedding day but when you will be seen by millions around the world and the images will form part of history it's even more important!

You might know that Prince William had braces when he was a teenager, as did brother Harry and cousins Eugenie and Beatrice. This is nothing unusual, it's estimated that up to a third of children have a need for braces and there will be more that have them for cosmetic reasons.

So how did Kate manage to keep braces a secret? It's likely she wore lingual braces, braces that are fixed to the back of the teeth to keep them hidden, rather than being invisible. It's not a new treatment but this type of treatment is growing in popularity and celebrities like Myleene Klass have chosen them. I think it's highly likely Kate also had some tooth whitening as well.

The good news is you don't have to be a future queen or go to Harley Street to have this type of treatment. I have been treating patients with lingual braces for several years, from self-conscious teenagers to middle-aged business men. The thing they have in common is wanting a better smile without wearing "Ugly Betty" braces, and they are suitable for most orthodontic problems. I use a system called Incognito which is highly customised to make the braces more comfortable and more accurate. Not only do you keep your braces hidden but you get the benefits of straighter-looking teeth whilst still wearing them!

If you are interested in having treatment fit for a queen then please give us a call and book an appointment for an assessment, and soon you can be smiling like Kate and William on their wedding day.

Beat the VAT rise!

Here at Wetherby Orthodontics we will help you beat the VAT rise!

How?

There is NO VAT on dental and orthodontic treatment, so our fees remain unaffected by the VAT rise. If you've made one of those "New Year, New You" resolutions why not come along and see us to find out how we can help you achieve a beautiful smile. You can even continue smiling during your treatment with Invisalign or Incognito braces.

However, some things we need to run the practice are affected by VAT and many of our supply companies are putting prices up, so our fees will be changing on 1st February. If you attend for an initial assessment in January you will get our 2010 fees guaranteed for three months (this extends to our young patients too)!

So don't put it off any longer, give us a call and come in for a chat to find out how we can help.

Beautiful Braces

These are Incognito lingual braces, made of beautiful gold alloy. They are highly customised to make them fit near the teeth for comfort and certainly the patients I have fitted them on so far have found them fairly comfortable. The customisation also means the results should be excellent.

Patients love them because you can't see them as they are hidden on the back of the teeth, unless you do a Myleen Klass pose (see previous blog post)!

I think they are beautiful (but then I'm an orthodontist and we're all a bit odd like that!), its such a shame they are hidden on the back of the teeth.