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What is interproximal reduction (IPR) and why is it used?

28 September · 4 minutes

Interproximal reduction has become a common procedure can be carried out either shortly before or during a patient’s orthodontic treatment. If you want to know more about IPR, what it is used for and more, keep reading.

What does IPR mean, exactly?

Dental IPR is an orthodontic procedure that consists of reducing the size of the tooth to gain a minimum amount of space during orthodontic treatment. Tooth stripping is a very common technique that is also known as interproximal reduction (IPR), although this method is not used in all cases of orthodontic treatments.

Patients who require dental IPR orthodontics treatment are those who suffer a moderate degree of dental crowding. This procedure reduces the width of the teeth between 0.2 and 0.5 millimeters. The area that is reduced is the sides, adjusting them to find the necessary space to position the teeth aesthetically. When it comes to more severe dental crowding, the option to consider is the extraction of a tooth.

What is interproximal reduction used for?

Although it has different functions within orthodontics, its main objective is to reduce the width of the teeth to gain space, avoiding any extractions, to align them within the natural structure of the patient's mouth.

Arch enlargement

The main function of interdental stripping is to gain space within the dental arches, specifically during orthodontic treatments. In cases where minimal gaps are required to correctly position a tooth that is outside the dental line, this is when the procedure is used. For patients suffering from medium dental crowding, it is a good option without having to make any extractions.

However, it is also used to reduce the black spaces that usually arise after orthodontic treatment. By eliminating the triangle formed by two teeth, in reducing the width by the necessary measurements, it allows the gums to have enough space to recover and grow, covering the black spot that forms.

Orthodontist holding model of the mouth explaining how IPR treatment is conducted

Incisor protrusion

Dental IPR procedures are also used to reduce incisor protrusion, which is when the upper incisors fit in front of the lower incisors when the jaw is closed. The most recommended option is to reduce the size of the upper lateral incisors when there is a disproportion with the lower lateral incisors using the stripping technique. This condition is also known as the problem in the Bolton Analysis.

Interproximal reduction vs tooth extraction

Finally, the difference between interproximal reduction vs tooth extraction is a common topic. IPR is used to avoid the extraction and loss of teeth, with the orthodontist reducing the size by at least 0.25 millimeters. This allows them to gain the space that’s needed for the tooth to move back into its correct position within the arch . Extraction is used in more complex orthodontic cases with quite severe crowding.

When is interdental stripping done?

Interdental stripping is performed on certain teeth with the aim of having a harmonious aesthetic result, in addition to being a less invasive method for the patient, although this will depend on the condition or characteristics of the patient's teeth. In addition to facilitating the work of the orthodontist, it is a simple and practical way to solve the problem of space in orthodontic treatment.

IPR is performed when Bolton discrepancy occurs, which is when the upper incisor is positioned outside the lower incisor, when you want to simulate the physiological wear of the teeth, any skeletal deformity or, the most common, to obtain gaps when positioning within the aesthetic dental line.

For whom is it advisable to do this treatment?

The use of IPR is only recommended and applied for patients who need to gain a minimum amount of space in the mouth structure. Patients with moderate crowding can solve the gap problem using this method.

Tooth stripping is a very common procedure in adult patients who have orthodontics, regardless of the type, with a medium dental crowding and where the movements required are limited to making room to continue with orthodontic treatment and achieve a perfect smile.

A lady in the middle of having treatment

Pros and cons of interproximal reduction

In general terms, there are very few cons to interproximal reduction, as long as the treatment is performed by a qualified professional with all the skills necessary for dental IPR. The process is usually very efficient in solving the space problems that patients with common dental crowding have.

However, if you go to a dentist or orthodontist who does not have the necessary knowledge and removes the enamel excessively, the patient may have future problems. These can be avoided by seeing a specialist with experience in stripping.

Consequences: Side effects of teeth stripping

There can be some side effects to teeth stripping, it can cause increased sensitivity in the teeth exposed to the reduction treatment, as well as the loss of healthy layers or parts of dental structure that are eliminated. This means that interdental stripping can slightly hurt, normally only in the short term.

Moreover, it is a treatment that is only performed on patients with perfect oral hygiene, in order for it to be effective. In addition, it is necessary to consider and measure how much enamel should and can be removed so as not to affect the stripping process.

IPR in orthodontics: Before and after

Before IPR is carried out in an orthodontics treatment, it is necessary for the specialist to carry out a series of evaluations to find out more about the condition of each particular tooth. Since each does not have the same amount of enamel, it is important to reduce the enamel layer by an approximate 0.25 millimetres.

After IPR orthodontics treatment, the specialist must polish the rough areas to avoid cavities. It should be taken into account that after IPR treatment, the teeth may increase their sensitivity to changes in temperature. That is why dentists recommend special toothpastes and to not consume cold drinks to avoid discomfort.

Graphic of teeth before and after IPR treatment

Do I need interproximal reduction?

At Impress, we take the health of our patients very seriously. That is why we offer an X-ray of your smile during your first visit for free and without commitment. In this consultation, we will tell you what your smile needs, as well if you need to have stripping performed.

We encourage you to come visit us so that we can check that you are perfectly fit to start an invisible orthodontic treatment. Call us or get in touch via WhatsApp on +44 20 3808 1072, email uk@smile2impress.com, or make an appointment online.

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Frequently Asked Questions about IPR

Does interproximal reduction hurt?

Do IPR proceedings hurt?‚ÄĚ is a common question. The procedure, when performed by a professional with the necessary skills and knowledge of the techniques does not generate pain for the patient, nor consequences after the treatment. So in brief, interproximal reduction doesn't hurt. The expert must know the amount of enamel that can be reduced according to the physiology of each tooth and the oral structure of the patient. The enamel layer that covers and protects the tooth does not contain nerve endings, so it does not generate any type of pain. However, the patient may feel some kind of discomfort due to the force applied during the reduction and, therefore, local anesthesia is not used before starting the procedure.

How safe is IPR?

IPR is safe if the proceedings are conducted by a qualified and experienced professional. 

Are there other techniques?

Yes, there are other techniques to obtain space within the dental structure to correctly position the teeth. One of them is the expansion of the arch, which consists of modifying the arch by extending its length. There is also the protrusion of the incisors that, through fixed orthodontics, move the incisor teeth slightly forward to gain the necessary space. And finally, one of the techniques that is often avoided is complete extraction of a tooth.

Can IPR be detrimental to oral health?

No, interproximal reduction must be performed by trained professionals, otherwise it may create future problems due to excessive removal of enamel. If done properly, it is a very conservative procedure that can help us resolve major problems during orthodontic treatment. The process to reduce the enamel in order to obtain space when reorganising the dental structure does not cause any problems for oral health. However, when this treatment is done incorrectly by invading the entire layer of enamel that protects the tooth, it can cause future problems, such as cavities and excessive sensitivity in the teeth.

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