Interproximal Reduction (IPR), often referred to as slenderizing or stripping, is a standard orthodontic procedure that involves mechanically removing a minimal amount of the outer tooth surface. This technique is frequently used in conjunction with aligner therapy or traditional braces. While the process of reducing tooth enamel may sound intimidating, the direct answer to whether it hurts hinges on the fundamental biology of your tooth structure. This article will explore the specifics of the IPR process to clarify the sensations felt during and after the procedure.
Understanding Interproximal Reduction
Interproximal reduction is the precise removal of a very small fraction of enamel from the sides of teeth where they touch their neighbors. The primary objective of this technique is to generate minute amounts of space within the dental arch to aid in tooth alignment. This space is often needed to resolve mild to moderate dental crowding or to correct tooth size discrepancies. The process is considered a conservative alternative to tooth extractions, which were previously the common method for gaining space. It also serves an aesthetic purpose, particularly when closing “black triangles” near the gumline. The amount of enamel removed is carefully controlled by the orthodontist, typically no more than half a millimeter (0.5 mm) from any single tooth surface. This measured approach ensures the structural integrity of the tooth is maintained.
The Sensation During the Procedure
The question of pain during interproximal reduction is largely answered by the biological composition of the tooth’s outer layer. Enamel, the hard, protective layer being reduced, is an inert tissue that does not contain any nerves. Consequently, the sensation of sharp pain is generally not associated with the procedure itself. Patients most commonly describe feeling distinct pressure, vibration, or a scraping sensation as the instruments work between the teeth. This feeling is a result of the mechanical action of the reduction, not nerve stimulation within the tooth.
Because the procedure is limited to the non-innervated enamel, local anesthetic injections are seldom required. Some individuals may experience a momentary, transient tightness as the tool passes through a crowded contact point between teeth. Any minor discomfort experienced is typically related to the pressure applied by the clinician or the vibration transmitted through the tooth structure. The entire process is usually completed in a matter of minutes for each contact point being treated.
Techniques and Tools Used
The mechanical process of IPR involves several different specialized tools, which account for the various sensations felt by the patient. For very minor adjustments or in difficult-to-reach areas, orthodontists often use fine, hand-held abrasive strips. These thin strips are coated with diamond particles and are manually worked back and forth, offering the clinician excellent tactile control and a gentle filing motion.
For creating larger amounts of space more efficiently, rotary instruments are employed. These include specialized, diamond-coated discs or reciprocating burs attached to a dental handpiece. The rotating discs move quickly and precisely, generating the noticeable vibration and light noise that patients feel and hear. The use of these power-driven tools allows for controlled and uniform reduction across the contact surface. The goal is to safely remove the precise, predetermined amount of enamel while leaving the surface smooth and contoured.
Post-Procedure Sensitivity and Care
Following interproximal reduction, it is common to experience a temporary increase in tooth sensitivity. This sensation can manifest as a heightened response to cold air, hot liquids, or sweet foods. The sensitivity occurs because the enamel, which insulates the underlying dentin, is slightly thinner in the treated areas. This temporary sensitivity is usually mild and typically resolves within one or two days as the teeth adjust to the minor surface change.
To minimize any discomfort, a clinician may immediately apply a fluoride varnish to the treated surfaces, which aids in remineralization and sealing the enamel. Patients are generally advised to use a desensitizing toothpaste for a short period and to temporarily avoid foods and drinks with extreme temperatures. Maintaining excellent oral hygiene is important after IPR to ensure the health of the reduced surfaces. Brushing gently and using dental floss or interdental brushes helps keep the newly created space clean. If sensitivity persists beyond a few days or becomes severe, contacting the orthodontist is recommended.