Interproximal reduction (IPR), often called slenderizing or stripping, is a common procedure in modern orthodontics. It involves the controlled removal of a very small amount of enamel from the sides of the teeth. This technique is frequently used to help with tooth movement and alignment, particularly with clear aligner therapy. When performed by a qualified professional, IPR is a predictable and well-established method.
What Interproximal Reduction Involves
Interproximal reduction is a minimally invasive technique used to create small amounts of space between adjacent teeth. The primary purpose is to resolve minor to moderate dental crowding and correct discrepancies in tooth size. By slightly reducing the width of specific teeth, the orthodontist gains the necessary room to move the teeth into ideal positions without the need for tooth extractions.
The amount of enamel removed is highly conservative, typically ranging between 0.2 and 0.5 millimeters per contact point, creating up to 1.0 millimeter of space between two teeth. This small reduction is precisely calculated to ensure the structural integrity of the tooth remains sound. Since the procedure targets the enamel, it does not involve the sensitive inner parts of the tooth.
The procedure is commonly used to address mild crowding, adjust tooth proportions for better aesthetics, or help close “black triangles”—small gaps near the gum line. Enamel is reduced using specialized, fine-grit abrasive tools, such as thin diamond strips or rotary discs. This method has been used in orthodontics for decades and is considered a safe alternative to extraction in many cases of space deficiency.
Potential Risks and How They Are Managed
While interproximal reduction is a routine procedure, it carries potential risks that must be carefully managed. The most common concern is a temporary increase in tooth sensitivity to hot or cold stimuli after enamel reduction. This sensitivity is usually mild and resolves on its own within a few days or weeks.
A more serious risk involves removing too much enamel, which could weaken the tooth structure or increase the long-term risk of decay. Professionals mitigate this risk through patient selection, recommending the procedure only for those with sufficient enamel thickness, which is assessed before treatment begins.
During the procedure, the amount of enamel removed is meticulously controlled using precise measurement tools, such as fine metal gauges, to ensure strict adherence to established safety limits. The goal is to remove only the minimum necessary amount, often no more than one-third to one-half of the total available enamel thickness. By employing conservative protocols and precise instrumentation, the risk of structural compromise is kept extremely low. Proper technique also includes protecting the soft tissues, such as the gums, from irritation by the abrasive tools.
Post-Procedure Care and Long-Term Considerations
The steps taken immediately following IPR are important for ensuring long-term safety and health. The newly reduced enamel surfaces must be polished thoroughly to restore smoothness and prevent the collection of plaque and bacteria. If the surface remains rough, plaque can accumulate, potentially increasing the risk of dental decay.
After polishing, a topical fluoride treatment is commonly applied to the reduced surfaces. This application promotes the remineralization of the newly exposed enamel, strengthening the tooth and reducing temporary post-procedure sensitivity. Patients may also be advised to use a fluoride mouth rinse at home to maintain this protective effect.
Long-term studies show that when IPR is performed conservatively and correctly, it does not negatively impact the long-term health of the teeth. Teeth that have undergone IPR within safe limits have decay rates no higher than those of unreduced teeth. The durability of the treated teeth is dependent on a patient maintaining excellent oral hygiene.