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.

Smile Awards 2012

The Smile Awards were held last week and for the third year in a row I'm delighted to have brought home a Highly Commended certificate, this time for 'Best Aesthetic Practice'.

Like many other industries and professions the dental industry has several awards ceremonies throughout the year, and dentists and practices are using these as a method of both team building within the practice and a way of promoting themselves to their clients. The other awards focus on things like marketing, teamwork or practice appearance, but the Smile Awards are the only ones to focus on clinical excellence. The categories cover the many ways of improving a patient's smile, whether this is through the use of white fillings, tooth whitening, crowns and implants or orthodontic treatment. Dentists submit photographs and a writeup of the case, which are judges anonymously by a panel of dentists and specialists.

The 'Best Aesthetic Practice' is a new category, to recognise a practice which provides aesthetic dentistry (which can encompass any type of dentistry which improves the appearance of someone's smile). I submitted a portfolio all about the practice, including photographs, testimonials, financial details, our branding and our staff.

The awards were held at the Landmark Hotel in Marylebone, London. I travelled down with Carly-Ann and Angela, its great to be able to dress up and enjoy a night out, we're more used to spending working time together. Here we are at the drinks reception.

The Landmark is a beautiful five-star hotel, with a large central atrium decorated with palm trees. It reminds me of a rhiad in Marrakesh, but on a much larger scale. The dinner was held in the grand ballroom and was delicious! Its always great to meet friends and colleagues and I'd arranged to sit with my friend and colleague John Scholey and his team, it was great to catch up and have a bit of banter!

After dinner the awards were announced, with the judges stressing the high standard of entries and how both the number and quality of entries had increased over the last few years. Sadly neither my fixed braces case nor my removable braces case picked up a prize in their categories. However John won the fixed braces and another orthodontist who qualified the same time as me, Darsh Patel, won the removable category. Although they showed before and after pictures on a large screen for all the shortlisted entries it wasn't possible to really tell why certain cases had won, but there were certainly some impressive smile transformations.

The last award to be announced was for Best Aesthetic Practice. Originally this was to be a regional award, but all nine practices were judged together. Having checked out the opposition beforehand (of course!) I really didn't think we had a chance in this, so it was a fantastic surprise to be announced as joint runner up and to be awarded Highly Commended along with a Harley Street practice, which shows a Yorkshire practice can really cut it with the big London practices!

Of course we had to have a little celebration...

The night didn't end there, Carly-Ann and Angela strutted their stuff on the dance floor and I enjoyed chatting with colleagues, some I'd met before and some I hadn't. It was great to finally meet some faces who I've been in touch with via Twitter, I'm pleased to say we got on just as well in real life as we do online! it was clear that everyone had real enthusiasm for their own branch of dentistry. We even got filmed for a promotional video, though I'll need to review it carefully before I post the link!

Back in Yorkshire I've had time to reflect and for this to really sink in. I've worked really hard over the last six years to make this practice a success. Many said it couldn't be done without an NHS contract. It has been tough at times, particularly when the recession hit as orthodontics is a 'luxury' item, but many dentists have found that cosmetic treatment is still a growing area, we all need to feel good after all.

I couldn't have done this alone, and I really have to say a big big 'Thank You' to my husband Jack Cooke and his business partner Richard Moon. Jack and I started on the road to our own practices when we bought the property in 2005, and I still share facilites and staff with their practice Ashby Dental. Their rebrand and redecoration last year prompted my own rebrand and together we've both introduced treatment coordinators (Carly-Ann and Angela) who've really helped to grow our businesses. At the risk of this becoming an Oscar acceptance speech I should also thank Chris Barrow for his business coaching excellence since 2005, all the dentists who refer patients to me, and my patients, especially those who recommend us to their friends. And of course my family, not just Jack but my children and my parents-in-law who often help out with childcare.

This isn't the end though, I plan to keep improving Wetherby Orthodontics and making many more patients happy with their new smiles. Its not all about awards, in fact my patients are far more important. I am confident of giving my patients great service and great treatment, awards are just an extra way of recognising this.

"Why is your Invisalign more expensive?"

That's a question I often get asked, and it's usually specifically about Invisalign rather than other type of orthodontic treatment I provide.

Do a quick internet search and you will see lots of offers for Invisalign treatment, some significantly cheaper than others. Have a look at your local orthodontic specialist and they will probably charge more than the general dentist down the road. In areas of high competition like London the price differences are even bigger and there may well be aggressive marketing on the internet or in magazines.

So why has this happened and why is a specialist more expensive than a general dentist? Have a read of this article by American orthodontist Ted Rothstein to see a bit of the background.

To summarise, Invisalign is one of a few orthodontic treatments that are easy for any dentist to start using, requiring a one day course to become certified and able to provide treatment (though there are now other similar treatments like ClearStep and Inman Aligner with similar issues to Invisalign). If you were a dentist who could now offer the treatment direct to your patients then why not, rather than referring to a specialist who will take the fees that could otherwise come to you? Why subject your patients to treatment with fixed braces when they can wear invisible removable braces instead? If you are the consumer why should you pay more to see a specialist when the same treatment can be bought for less?

Here's a quote from the article; "Dr. Rothstein reports that he is seeing in recent years a growing number of patients on consultation in treatment with Invisalign by the generalist who simply lacked an understanding of the limitations of the Invisalign appliance. General dentists are not fully trained to recognize the many nuances associated with effective treatment, or even foresee the potential problems lying in wait as they proceed. Training and experience really do make a difference.
There are also cases in mid-course where the general dentist had no idea how to handle the problem that the patient was encountering and cases where the end result of the Invisalign treatment were so lacking that the only recourse was to finish the case with fixed braces."

I'm sure there are some general dentists who get comparable results to a specialist, but only with the right experience and attention to detail, and how do you know who these are? Be sure to ask questions about your potential treatment and also about what is included. Does that cheap fee include hidden extras like refinements and retainers and how often will you be reviewed? What sort of customer service do you get and do you enjoy your visits?

It's a bit like getting your hair cut. Do you prefer to go to the small salon that has out of date magazines and faded decor, see the junior stylist at a medium salon or pay the extra to see the senior stylist at the best known salon in town? The end result is important but so is the experience you receive.

You should know that Invisalign offers significant discounts to providers who commit to providing a large number of treatments per year, they have to get the numbers in or risk paying large penalties. Even with these discounts some offers I've seen are so low it must be costing the practice money instead of making it. As a small practice and a specialist offering many types of treatment my numbers are relatively low so I can't always take advantage of this, or do "extras" like tooth whitening, hygiene or veneers to gain extra revenue.

I'll finish with a final quote from the article which puts it better than I can; "...isn't the consumer better served by the orthodontic specialist even though having to pay a higher fee? Indeed when the consumer pays more to engage the services of the specialist isn't he receiving more in the way of experience and wisdom that far outweighs the additional fees the consumer may have to pay"

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.

Success at the Smile Awards 2011

The 2011 Smile Awards were held on Friday and I travelled down to London with dental nurses Carly-Ann and Lisa. We got glammed up for the ceremony at the posh Royal Garden Hotel (I met Carol Vorderman while checking in!), have a look at the pictures on Facebook to see our frocks.

Although there are several dental industry awards over the course of the year these are the only ones to judge treated cases, they do this anonymously and reward true clinical excellence. Just making the shortlist is an achievement in itself, I was shortlisted for two categories, Orthodontic Smile Fixed Appliances and Orthodontic Smile Removable Appliances, along with some well known orthodontists and dentists.

Although I didn't get an award for the Fixed Braces category I was awarded Highly Commended for my Removable Appliance entry. In a later blog I'll share the pictures of Katherine who I treated using Invisalign. I always do my best to get not just a good-looking result but a technically great orthodontic result as well, so I am delighted to have this recognised in such prestigious awards.

There really was an amazing array of smile transformations on display, from orthodontics to veneers and implants to a full facial reconstruction following severe trauma. There are some talented dentists, surgeons and and technicians out there and I was delighted to see some fellow northern dentists getting awards, congratulations to all my shortlisted and winning colleagues.

After two years of Highly Commended I will be back next year hoping to go one better and get a trophy!

Brides and Braces

If you are getting married you are probably thinking about your appearance on the day, especially as it will be immortalised forever in the photos. Hair and makeup are just as important as the dress, but have you thought about your smile?

A wedding is often the factor that prompts brides into getting dental attention, whitening is probably the most frequently requested treatment but you may also be thinking about the position of your teeth. I have treated several brides-to-be (and mothers of the bride) to give them a better smile before their wedding. The limiting factor is often time, most orthodontic treatments need at least a year and the more time you have the better.

However, if you have less time don't panic, we can get a significant improvement in most people's teeth in about 6 months. We can fit the braces, progress the treatment as far as possible in the time available, then remove the braces in time for your big day. Afterwards we can reassess whether to re-fit braces to complete treatment.

Alternatively, you could pick invisible braces like lingual Incognito braces or removable Invisalign, which means your treatment can be continued without interruption, these are especially good options if time is a bit short or you don't want the additional cost and time of removing/refitting braces.

Recently one patient got married wearing her ceramic fixed braces as she was keen not to interrupt treatment. Ceramic braces are like traditional fixed braces but made of clear porcelain rather than metal so they blend with the teeth. I changed the wire for a tooth-coloured version before the wedding and she smiled with confidence all day. You can see the braces in the pictures (see above) but they are barely noticable. I know Faye herself was delighted that her teeth looked straighter and knows she made the right decision about keeping the braces on. I'd like to congratulate Faye and her husband on their wedding and wish them the best for the future.

If you would like to get your teeth straightened before your wedding please call us to arrange an appointment to discuss the options, it may be easier than you think!

Invisible braces for Chris Evans

Regular visitors to Wetherby Orthodontics will know that we usually have Radio 2 playing in the background and if they're lucky Carly and I will even sing along!

I did miss Chris Evans on this morning's breakfast show talking about his new invisible braces, but it didn't take long for a patient to tell me they'd heard it. Chris is such a smiley person and I've always noticed that his teeth aren't perfectly straight, particularly the lower ones. As more and more people get straighter teeth I guess he has now decided to get something done. I'm sure it will make a big difference to his smile and I wish him well with his treatment.

From the description we think he's wearing Invisalign, clear removable braces that fit tightly against the teeth. They really are almost invisible and are very easy to get used to, they certainly won't give him any problems with his radio and TV work. Of course, if you don't want to tell people about it you don't have to. Other types of invisible braces are available too, like lingual Incognito braces, sported by Myleene Klass (see earlier blog), so there really is something for everyone, they don't have to look like Ugly Betty's braces!

If you'd like to find out more about invisible braces there's more information on our website or on the Invisalign website (linked off the title of this blog). Please get in touch if you'd like an appointment for an assessment for your own teeth.

Smile Awards 2011 Shortlisting

We are delighted to announce that Megan Hatfield has been shortlisted for two categories in the 2011 Smile Awards.

The Smile Awards are the ONLY dental awards in the UK to reward clinical excellence in dental and facial aesthetics. Megan Hatfield has been shortlisted in the Orthodontic Smile-fixed appliances category for her treatment of a teenager with crooked teeth, and the Orthodontic Smile-removable appliances category for her treatment of a young adult using Invisalign clear braces (photo above). Just making the shortlisting is a massive achievement and we are delighted that Megan's hard work is getting recognition.

The awards ceremony is in London on Friday 25th March. Megan will be hoping to improve on the 2010 awards where she was shortlisted for two categories and won Highly Commended in one of them.

How do you make braces disappear?

Easy, you put them on the back of the teeth!

You may not have heard of lingual braces (lingual = tongue, so they are on the tongue side of the teeth), by their very nature they are invisible so you can't see them, which makes it difficult as orthodontists to promote them!

On Saturday I attended the British Lingual Orthodontic Society (BLOS) annual meeting. As you might expect for something so specialist it is a pretty small group, but the doubling of membership over the last 12 months shows how this type of treatment is growing in popularity. Did you know that 18% of adults believe they'd benefit from straightening their teeth, but 72% are unaware of lingual braces (BLOS Ipsos Mori Survey)?

I was particularly pleased to hear of how many people are now using Incognito lingual braces, as I have recently started using this system, having used two other lingual systems before. It is completely customised for each patient making it easier for us orthodontists to use, more comfortable for you to wear, and giving really great results, as good as I would expect with conventional braces. Having fitted Incognito on a few patients now I am delighted with it and so are my patients who are already getting the benefit of having straighter teeth.

I was also honoured to give a "Clinical Pearl", sharing a tip with my colleagues that can make treatment easier. Lingual braces are certainly challenging to use and the learning curve is steep, for that reason I'd recommend you only see a specialist orthodontist if you are considering lingual treatment.

I came away from the meeting inspired and I'm keen to bring this type of treatment to more people.

If you'd like to find out more visit the websites in the links above, visit our website or call us to book an appointment for an assessment.

Hide your braces, not your smile!