Understanding Interproximal Reduction (IPR) in Orthodontics:
Insights from Dr. Sum at Aidencare
At Aidencare Dental Clinic, we frequently utilize orthodontic aligners to help our patients achieve a straighter, healthier smile. One technique often associated with aligner therapy is Interproximal Reduction (IPR), a precise method used to create small amounts of space between teeth. I've observed numerous cases from other practitioners where excess IPR has led to undesirable gaps post-treatment. Here, I aim to shed light on the correct application of IPR and how we approach it at our clinic to ensure optimal results for each patient.
What is Interproximal Reduction (IPR)?
Interproximal Reduction refers to the careful removal of tiny amounts of enamel from between the teeth. This procedure is commonly performed in orthodontic treatments involving aligners to correct crowding without the need for extractions, or to achieve better proximal contact and tooth alignment.
The Risks of Overdoing IPR
From my professional observations, a common pitfall in aligner treatments is the excessive application of IPR. Some aligner companies may propose more aggressive IPR than necessary, which can lead to gaps between teeth at the end of treatment. These gaps are not only aesthetically displeasing but can also pose challenges to the patient’s bite and oral health.
Another significant concern with excessive IPR is prolonged tooth sensitivity. When too much enamel is removed, it can lead to increased sensitivity during and after treatment, making it uncomfortable for patients to consume hot, cold, or sweet foods and beverages. This sensitivity can detract from the overall success and comfort of the orthodontic experience.
The use of IPR with an IPR machine (Photo from dentistry.co.uk)
Our Approach at Aidencare Dental Clinic
In our practice, we take a conservative and tailored approach to IPR. Early in the treatment process, I assess whether there is sufficient room for tooth movement and determine the precise amount of IPR required. Typically, this might involve an initial minimal reduction, such as 0.05mm or 0.1mm, rather than a more aggressive approach.
Technique Preference: I favour using manual interproximal strips for performing IPR over automated IPR machines. The manual method allows for greater control and precision, reducing the risk of removing too much enamel and causing undue sensitivity. This hands-on approach helps ensure that each adjustment is as minimal and accurate as possible.
The above photo showing manual IPR is taken from Dentistry.co.uk
Steps in our IPR approach include:
Detailed Assessment: Before starting treatment, a thorough examination and imaging are done to understand the specific needs of each patient.
Conservative Implementation: If IPR is necessary, we begin with the minimal amount possible to achieve the desired movement, closely monitoring the progress.
Manual Technique: Using manual interproximal strips, we carefully sculpt the space needed between the teeth. This method provides a gentler and more controlled reduction.
Regular Monitoring: Throughout the treatment, regular check-ins allow us to adjust our approach based on how the teeth are responding, ensuring that we do not remove more enamel than absolutely necessary.
Customization for Each Case: Recognizing that each orthodontic case is unique, we tailor our IPR techniques to the individual needs of each patient. There are indeed cases where more significant IPR is needed, and in these instances, we ensure it is done judiciously and thoughtfully.
My personal thoughts
At Aidencare, our priority is to provide orthodontic treatment that respects the natural structure of your teeth while achieving optimal alignment and function. By adopting a cautious approach to IPR, we minimize potential risks such as unwanted gaps and prolonged sensitivity, ensuring that each patient receives care customized to their specific dental circumstances.
If you are considering aligner therapy and have concerns about IPR or any other aspect of the treatment, I encourage you to discuss these openly with us. Together, we can plan a treatment that aligns with your dental health goals and leaves you smiling confidently.
Remember, in orthodontics as in all aspects of healthcare, less is often more. At Aidencare, we are committed to ensuring that every treatment step, including IPR, is performed with the utmost precision and care for the best possible outcome.