Dr Asif Chatoo

Interview with Lingual Orthodontist

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Dr Asif Chatoo qualified as a dentist from King’s College, London and gained his Masters Degree in Orthodontics from GKT Dental Institute, London. He has received specialist training in Lingual Orthodontics and has a keen interest in the multidisciplinary treatment of adult patients. Among UK-trained orthodontists, Asif is the only one to be accredited by both the European Society of Lingual Orthodontics and the World Society of Lingual Orthodontics. Asif is a Lecturer in Lingual Orthodontics, a Course Administrator at Warwick University and lectures around the world. He is the author of a chapter on ‘Interdisciplinary Treatment with Lingual Orthodontics’ in the book Esthetics in Lingual Orthodontics (Quintessence Publishing).  Asif is the founder of London based clinic The London Lingual Orthodontic Clinic which was the first clinic in the UK to specialise in lingual orthodontics.

Please tell us a little about yourself and why you trained to be a dentist and in particular why you specialised as a lingual orthodontist?

I cannot remember any specific reasons why I wanted to become a dentist but what I do remember is that orthodontics fascinated me.

This is because it is a true blend of art and science. In addition to the more obvious scientific learning’s about teeth, you had to understand about the growth and development of the human face, the effects of age and about the changes which occur as a child. The art was creating a beautiful smile.

Whilst completing my specialist training in orthodontics I attended a lecture about lingual orthodontics. I was amazed at the ability of moving teeth with appliances that could not be seen. I felt that I could benefit from wearing braces but did not have the courage to wear normal braces. The fact that there was a solution for me was wonderful. The fact that I too could use this technique was unbelievable.  I was inspired to learn.

What is the difference between lingual orthodontics and regular orthodontics?

Pioneering orthodontic techniques have led to the development of ‘invisible’ braces which fit behind the teeth instead of at the front. These are known as lingual braces. Like traditional ‘train-track’ braces, they are made up of a series of metal clips or brackets which are bonded to the teeth and threaded together with flexible wire, gently nudging the teeth in the right direction.

Unlike conventional braces, lingual braces are completely hidden from view meaning teeth can be straightened without it affecting appearance or confidence, making the process more appealing.

Lingual braces are customised to the individual’s teeth with the aid of digital computer imaging, which helps make them efficient, effective and less intrusive.

Do you think that general trends as to surgery are changing with people being more conscientious about preserving what they have than opting for more drastic changes such as implants and veneers?

When it comes to smile aspirations, it’s not the overly whitened, ultra-perfect teeth that patients want. The most sought-after look is a youthful, bright, natural smile which isn’t completely perfect, like that of Kate Middleton. Teeth that don’t look like your own are actually ageing.

I strongly believe it’s important to maintain the health of your own natural teeth. Implants and veneers should be considered a last resort rather than one of the initial options when it comes to correcting your smile as some of your healthy teeth have to be removed.

Your smile is one of the first things people notice about you, so it’s worth investing in. Using orthodontics to correct the positioning of your natural teeth provides a solution that lasts a lifetime (so long as you use your retainers correctly after treatment).

Veneers don’t last forever and may need replacing after 10-20 years. A replacement set of veneers will not cost less than the first set. It is also an invasive procedure as some of the tooth’s structure is trimmed away.

Is there an optimum age to start this treatment?

It is never too late to correct problems such as crooked teeth, gaps between the teeth or those that protrude.

The lingual brace approach is discreet and appeals to teenagers and adults alike. Our patients range in age from 13 – 73 years old, with the majority in their 30’s

Increasingly people prefer to have their problems treated discreetly which is why lingual braces offer the ideal solution, especially for adults.

Does the length of the orthodontic treatment vary?

The length of orthodontic treatment varies from patient to patient and depends on the final aims. Treatment time varies from 6 – 24 months with the majority of patients needing 12-15 month’s of orthodontic treatment.

How long does the effect of the treatment last, is it permanent or does it require maintenance in order to keep that perfect smile?

At the end of treatment some form of long term retention is necessary to prevent the teeth moving back to their original position. This is to also protect the patient’s investment in their smile. At the London Lingual Orthodontic Clinic we ensure that we teach our patients good oral hygiene skills and hope that this is something they will carry on with throughout their life.

What do you find is the most common option as to orthodontics and do people’s perceptions change after a consultation?

When I meet a patient for an initial consultation, I find that many don’t realise that we can achieve the same treatment results with lingual braces as with traditional ‘train-track’ braces, but without anyone knowing that they are undergoing orthodontic treatment. Many like the idea that this ‘invisible’ brace techniques allows them to revel in the secret transformation of their smile and notice how their teeth are changing when they look in the mirror.

At you clinic you offer teeth whitening when you have teeth straightening treatment. Do you find people are wary of teeth whitening? How effective is the treatment and is there anyone that should not have there teeth whitened?

Once teeth have been straightened and beautifully cleaned, many patients choose to complete their treatment with whitening – this is paid for by the patient.

The new legislation that came into force on the 31 October 2012 relating to teeth whitening should go some way to negate worries that patients may have when it comes to teeth whitening. The new parameters are in place to protect patients and ensure that teeth whitening procedures are carried out in a safe and controlled way.

The new law draws a clear line between the products that can legally be used for tooth whitening by dentists, or under their direct supervision, and the products that can be purchased by non-dental professionals. Under the Regulations only dental practitioners can purchase tooth whitening products containing or releasing up to 6% hydrogen peroxide.

It is also outlined that the dentist is to carry out an examination before embarking on a course of tooth whitening, to determine whether tooth whitening is a suitable treatment option for the patient.

With more and more celebrities and people in the public eye having a whiter straight smile have you seen an increase in popularity of the services your clinic offer?

In the UK we are gradually getting better at taking care of our smiles. The rise of the ‘celebrity smile’ is making us even more conscious of our less than perfect teeth.

Celebrity culture helps drive trends and this includes smile aspirations. A straight bright smile can make a real difference to a celebrity’s overall appearance and people want to emulate this.

At the London Lingual Orthodontic Clinic, we have treated many actresses, models, TV presenters and city executives as well as high-profile people in the public eye and you’d be none the wiser that they were undergoing treatment.

So finally, as an expert in your field, what do you see as the next innovations for orthodontics?

The end of impression moulds – With new 3D processes, orthodontics will be taken to a whole new level. The advent of 3D scanning will mean that orthodontists can digitally scan their patient’s mouth while they sit in the chair. This could mean the end of impression moulds which would be a welcomed advancement for many patients!

AcceleDent – ‘A Power Plate for teeth’ – At The London Lingual Orthodontic Clinic we piloted, and now regularly use a device called the AcceleDent, also known as ‘a power plate for teeth’. It works by using gentle vibrations to speed up the rate at which the teeth move into the desired position. These vibrations accelerate the turnover of new bone in the gums and can shorten the treatment time considerably. (AcceleDent is a hands-free gadget which can be used for 20 minutes a day while you are on the computer, watching TV or listening to music.)

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