Interproximal Reduction (IPR)

Alignment of teeth and bite correction can be corrected in several ways. In cases where the bite is slighlty off or there is minimal overlap between teeth, Dr. Virdee may suggest a procedure called Interproximal Reduction (IPR). At first thought, the name can make the procedure sound way more complicated than it truly is. IPR involves removing a very tiny amount of enamel on the side or the length of the tooth surface. It is important to note that IPR is only performed by an orthodontist.

What is Interpoximal Reduction?

IPR is performed by removing a small amount of enamel using either a thin disk or a thin abbrasive metal strip between the teeth. In effect, this reduces the size of teeth. The amount of reduction is so minor that you many are not able to appreciably see any changes in tooth size. This is a common procedure, especially in patients using clear aligners. It is a conservative alternative to extractions and is done in controlled amounts. The amount of enamel that is removed is less than the thickness of a sheet of paper! It is done chairside and only takes a few minutes.

Why would a clinician choose IPR?

IPR helps orthodontists to create an esthetic and functionally healthy smile by helping with the following conditions:

1. Reducing crowding

IPR is used when a patient has mild crowding that does not warrant the need to extract permanent teeth. This technique allows the clinician to align the teeth withough affecting the bite.

2. Reducing the appearance of black triangles

Black triangles occur when the contact between the teeth is not optimal either due to tooth anatomy or recession of the bone and gingiva around teeth. Most patients will say there is a "gap" betweent their teeth that is bothering them esthetically or causes a food trap. This is not truly a a gap as the teeth do contact each other. Modifying the shape of the teeth with IPR from triangular to rectangular teeth reduces these gaps.

3. Correction of the bite (e.g., open bite)

In patients with mild open bites (gap between the upper and lower incisors), IPR may be used to help bring the teeth together in the front. This is commonly done for patients in clear aligner treatment.

4. Reducing proclination of the front teeth

IPR is often used to create minor space between teeth which helps to retract or move the incisors back. This is a great alternative to extraction of teeth when the upper and lower front teeth are slightly forward or patients complain that thier teeth "stick out". This technique also helps to bring the teeth back closer to the centre of the bone, reducing the risk of gingival recession around teeth.

Is IPR safe? Are there any long term effects

This is a very common question that Dr. Virdee receives when her patients first hear about IPR. Dr. Virdee usually takes some time to align the teeth first before she makes any decisions about IPR. This allows for the least amount of filing between the teeth. The amount of enamel reduction on either side of the tooth is very minimal, usually less than 0.25 millimeters per side of the tooth. Since the thickness of tooth enamel usually ranges between 1.5-2mm millimeters, a reduction of 0.25 millimeters is safe. However, as with any medical procedure, there are risks involved with IPR. Reducing enamel with IPR can increase the risk of tooth sensitivity and cavities if a patient does not have good oral hygiene. Dr. Virdee will always discuss the risk and benefits for each patient case prior to performing this procedure.

Am I a candidate for IPR?

There are many indications for IPR. Dr. Virdee will personally assess each pateint to confirm they are a candidate for this procudre. Please contact us for a consultation with Dr. Virdee by scheduling a consultation with Dr. Virdee!