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21st. Century Orthodontics

21st. Century Orthodontics

Crowded Teeth , Aligners . A case report 

By Dr. Kamsiah BDS, MDSc 

Patient didn’t have enough room in her upper jaw for her teeth to fit normally, her teeth bunched up, overlapped  and twisted and  getting pushed to the front . 

Crowded teeth can make it hard to brush and floss well. Then it’s easier for plaque, tartar, and harmful bacterial to build up — and down the line, this can lead to tooth decay and gum disease.Your crowded teeth can also get worse over time.

Yes, we did invisible braces to fix her problem. This is a five year follow-up case. 


Why Fix Teeth Crowding?

Teeth crowding is not only a cosmetic problem. Crowded teeth, if left untreated, can result in many serious short-term and long-term dental health issues. Here are just a few reasons to consider treating crowded teeth before they lead to more serious problems:

  • Fixing teeth alignment sooner rather than later will significantly lower the chances of needing major treatment later on.
  • Aligning your teeth and supporting bones into the correct positions will increase the durability and strength of your teeth for years to come.
  • Correcting crowded teeth will aid in the alignment of your jaws, making chewing more effective and reducing the likelihood of headaches and poor digestion. Tooth occlusion and jaw alignment will be more coordinated.
  • Repairing crowded teeth will make dental hygiene much easier and more effective, lessening the occurrence of tooth and gum decay and cavities.
  • Teeth crowding, if left untreated, can lead to an increased chance of gum disease. Crowded teeth can also cause premature wear and tooth loss from teeth rubbing against one another, and long term jaw joint damage.
  • Last but not least, properly aligned teeth will give you more confidence to show off your smile!

Crowded Teeth Treatment

So, what can be done to fix teeth crowding? Treatments range from minor intervention with a removable appliance, to possibly needing months or years of treatment, or in extreme cases, removal of one or more teeth. The best treatment needed to fix your teeth crowding problem depends on how severe your crowding is and your age when starting treatment. Possible courses of treatment include:

  • Braces: Braces are always an effective way to move teeth into proper alignment. Sometimes this may be combined with removing one or more teeth in order to make room for your other teeth to align. This will correct your crowding issue and give you a straight, confident smile!
  • Invisalign: A popular choice when it is an option, invisalign brace systems adjust your crowded or crooked teeth to get you the smile you want, while making it less obvious that you’re wearing them. Many times, no one will be able to tell that you’re wearing braces at all. This is a great choice for adults who would prefer to avoid traditional metal braces.
  • Retainers: This is another popular treatment for teeth crowding. Retainers are custom-made devices, made from molds specifically to fit your mouth and its needs. They are made from wires or clear plastic, designed to hold your teeth and jaws in place to realign teeth. Retainers may be adjusted regularly by you or your orthodontic provider to adjust with your changing smile and continue the straightening process.
  • Veneers : Porcelain veneers are some times used to correct crowded and crooked teeth. This is a more invasive procedure than cosmetic recontouring. It is often the fastest way to achieve a new smile and eliminate the cosmetic concerns of patients who have minor crowding and miss shape teeth.
  • Tooth removal : In more severe cases, tooth removal may be the only way to address crowded teeth. Those who simply have too many teeth for the size of jaw can have their symptoms relieved fairly quickly by an extraction. The other teeth then have the space to realign, or be guided into place with an aligner.
    Those are the five top treatments for crowded teeth and will usually be tackled in that order. Aligners are the least intrusive and have a very high success rate. Braces are also very effective, as is cosmetic recontouring. Only when we have tried those procedures or where they would be unsuitable would we consider surgery. It’s something we would discuss with you at the time.
    For fast, effective relief from crowded teeth, contact us @drkamsiah, today. We’re here to help!

Bracket repositioning using photography

We reposition brackets based on root position as viewed on on the Radiograph as well as marginal ridge heights as viewed in the mouth. On top of that we @drkamsiah also use photos of patients to help us position the brackets.

Continue reading “Bracket repositioning using photography”

Fluorosis, Orthodontics, Veneers using the Digital Smile Design treatment concept

Multidisciplinary dentistry in management of untreated Fluorosis in an adult using ceramic veneers. Malocclusion treated with Orthodontics and Bone Screws . Continue reading “Fluorosis, Orthodontics, Veneers using the Digital Smile Design treatment concept”

MAJALAHWM.COM : Datin Dr. Kamsiah G. Haider Pakar Pergigian Kosmetik & Digital Smile Design

I was created to create a beautiful smile.”

Saya menemui seorang doktor pergigian kosmetik yang tidak boleh duduk diam, beliau tidak berhenti belajar dan mempelajari teknik-teknik terbaru Continue reading “MAJALAHWM.COM : Datin Dr. Kamsiah G. Haider Pakar Pergigian Kosmetik & Digital Smile Design”

Orthodontics or Prosthodontics? Facial keys using the Digital Smile Design to help in diagnosis and treatment planning.

Adult deep bite can be difficult to successfully treat, treatment should only begins with a proper diagnosis. Continue reading “Orthodontics or Prosthodontics? Facial keys using the Digital Smile Design to help in diagnosis and treatment planning.”

DSD Official Course in Malaysia 2018. 

Dr. Kamsiah is one of the official DSD Instructors and Masters who teach the Digital Smile Design courses.

DSD Malaysia official

I would like to share my experience with Malaysian dental surgeons. In my years in practising clinical dentistry I’ve come across so many instances of patients wanting to rush the end product without a reasonable idea of what it will be. I do my best with every case and try to envision what will please dentist and patient.

From simple to complex cases — DSD is the answer

Guessing is a recipe for failure.There’s an old adage I’ve often referred to: ‘there never seems to be time to do things right, but there’s always time to re-do it’.

Now, by incorporating the digital smile design in my clinal routine,. I am able to eliminate guesswork. I can’t emphasis enough about the importance of having a ‘blueprint’ to achieve the desired result of cosmetic treatment.With digital smile design it makes so much sense .

Since attending several lectures , courses and applying the technique in all my aesthetic cases  , I finally became the first to obtain Master in DSD in Malaysia and the  first DSD Instructor in South East Asia .

Recognise the complex case, how to apply in your daily dentistry .

Precision is the hallmark of every professional dentist. The objective must be to achieve a high degree of certainty. This will also enable both the patient and the dentist to know in advance what the final outcome in advance.

When things go awry from lack of planning and from the failure to work out details before starting an actual restoration, it may shake a patient’s faith in their dentist. To some, digital smile design seems time consuming and meticulous especially in treatment planning . However this was my missing link all these years . It is the secret to having a happy patient.

The Digital Smile Design Concept (DSD) seeks to present to the world a new face of Dentistry, more human, emotional and artistic, but also more efficient and precise through digital technology, further enhancing our noble profession in society, because after all there are not many things in this life that are more important than a healthy, natural, confident and beautiful SMILE.

Overview of the course:

Complex cases are not limited to the number of units in the case. They range from single unit cases to full mouth reconstruction cases. Even straight forward cases could be complex cases. To avoid unforeseen patient and dental problems, sound treatment knowledge and treatment planning skills are essential for managing these cases. Recognizing problems beyond the dental scope and expanding your view to the entire patient is especially important for a successful treatment outcome. Participants will have the opportunity to learn how the Digital Smile Design concept helps in their daily dentistry.

Course Objectives:

At the end of the Stage I course (Introduction level), you will be better able to:

  • Learn data collection and recognize the entire view of the patient from the DSD perspective
  • Know what the data , photos , videos collections are necessary to make sound sequential treatment plan
  • Recognize the complex case
  • Recognize your own limitation and determine whether to treat or refer the patient
  • Learn how to manage complex cases


This course will be followed by two other sessions . Each session will give participants the opportunity to discuss their own complex case treatment plan with the instructor and other participants.

At the end of the Stage II course (Intermediate level), you will be better able to:

  • Recognize wise use of mock provisionals
  • Learn advanced data collection and sequential treatment planning
  • Learn how to manage complex cases
  • Lean how to work with (other) specialists

At the end of the Stage III course (Advanced level), you will be better able to:

  • Understand the role of digital technology for treatment planning
  • Assess the risk of treating advanced complex cases
  • Learn how to manage complex cases
  • Lean how to work with (other) specialists

Teaching Method: Lecture, hands-on  and case discussion

Recommended for: General dentists and specialists


Diagnosis and Treatment planning in a oligodontia case using the Digital Smile Design Concept.

A keynote presentation and animation in Diagnosis and Treatment planning in a oligodontia case using the Digital Smile Design Concept.

Continue reading “Diagnosis and Treatment planning in a oligodontia case using the Digital Smile Design Concept.”