My Interproximal Reduction (Shaving Tooth Enamel)

How Your Dentist Determines You Need Interproximal Reduction

The process of shaving tooth enamel is called interproximal reduction. In this post I describe the process and the details of my experience. If your teeth are crowded like mine, you may need interproximal reduction as part of your Invisalign treatment. It's not always an option though. Some dentists choose to remove teeth to make room - which is far more painful and requires recovery time. If your dentist wants you to remove teeth to make room, you may want get a second opinion.

In my case, the dentist told me he'd rather avoid removing teeth and instead choose to shave the enamel of teeth on the top and bottom. Talk about dodging a bullet! My treatment currently calls for 7 reductions of .5 millimeters on the top and 7 reductions of .2 millimeters on the bottom.

What happens when you get Interproximal Reduction

I wasn't able to get pictures when I had my reductions done, but I compiled some pictures I found online to give you an idea of what happens. Different dentists will use different tools, but the process is generally the same. My dentist used diamond strips, which are ultra thin and slide between the teeth. Once the diamond strip is between your teeth, the dentist will slide it back and forth to shave the tooth. It kind of works likes a cheese grater, which sounds gross, but it's not painful at all.

Diamond strips

I highly recommend asking your dentist for a local numbing agent on your gums. Depending on how steady of a hand your dentist has (and probably how crazy the angle is they have to work at) the only thing that will hurt is getting your gums slices by the diamond strip. It kind of feels like a paper cut anywhere the strip slides over on your gums/flesh. I had minimal issues when I had the bottom done.

To ensure the correct amount has been taken off of your teeth, your dentist will slide a gauge key into the space between the teeth. The space you need created totally depends on your plan. An example is shown below, note again these are not my teeth.

Gauge set

My Interproximal Reduction

Below are the pictures showing where I've had reduction on my bottom teeth. It's not a huge difference, but you can definitely tell when you look at my before and after pictures from my progress page.

Interproximal Reduction on bottom

I can see that some of the attachment glue got shaved off on a couple of the teeth in the close up above, but it's not noticable in person. Let me know if you have questions.

Progress Weeks 17-18

Images After: Tray 9

Remaining Trays: 15

Lockjaw: Consistent. No pain
Headaches: None
Pain: Only sore first day of new tray

Wear: 16-20 hours a day
Brushing: Not as much as I should during the day at work
Flossing: Every night

Front View

Top View

Bottom View

Right View 

Left View

Progress Weeks 15-16

Below are pictures after tray 8, I'm currently on tray 10 so I'll also be posting pictures after tray 9 soon.
No changes to my tray-wearing experience. It's actually become pretty predictable, so I figured it would be good to just have a standard checklist that gets posted with each picture set to make posts easier and more consistent for me.

Images After: Tray 8
Remaining Trays: 16

Lockjaw: Consistent. No pain
Headaches: None
Pain: Only sore first day of new tray

Wear: 18-20 hours a day
Brushing: Not as much as I should during the day at work
Flossing: Every night

Front View

Top View

Bottom View

Left View

Right View

Progress Weeks 13-14

Tray seven is done, 17 to go! Below are pictures after tray 7. I was in a rush had just eaten. I didn't have time to brush so some of the pictures show just how super stained your teeth are after food and drink. Insane right? I've decided to try to add side shots to the set because this seems to be where things are doing the most movement right now.

The lockjaw and craziness of not really having a matched bite has become more "normal" for me. I think my teeth have gotten used to moving around all loosey goosey so I don't really have as much pain after a new trays. It's kinda of sore after I take of the trays for sure, but no major headaches or tension like I had when I first started Invisalign. Kind of hard to believe that I'll been wearing my trays for almost 4 months now. I'll be moving into tray 9 in just a few days. Kind of exciting to be coming up on the halfway mark (tray 12) before I know it! :)

Front View

Top View

Bottom View

Right View

Left View

Doing pretty good. I haven't been wearing my trays as much as I should - more like 18-20 hours rather than 20-22 but it hasn't been an issue. Things are moving around well, pain isn't constant in any way. I floss every night and have a brushing routine that isn't psycho. Things are good and it's more "routine" now. Not gonna lie though, I'm ready to have these things off. June 2013 can't come soon enough!

Progress Weeks 11-12

Here are my pictures after tray six, with 18 remaining trays.All attachments are still on, though I did get worried one day when I popped my tray on and something came loose. It was food. HA! Where did that come from? : O

Maybe I'm crazy but I feel like my teeth are looking MORE crooked on the bottom than before. I keep inspecting the trays, to make sure things are matching up and they are but who knows LOL. The lockjaw and popping is constant now, can be painful. When I was on tray 6 it was definitely the worst it'd been. I started taking the soma (muscle relaxer) which helped more than I thought it would. I'm behind on these post so I'm trying to get caught up.

Front View

Top View

Bottom View

Slacked on wearing my trays enough during tray 6. Hadn't been wearing my trays as much as I should - more like 16-20 hours instead of 20-22. OUCH. I still floss every night and the next tray went on without issue due to me being good about wearing it the few days before the switch! I blame snacking and delicious non-clear liquids. :)

Progress Weeks 9-10

Tray five is done, 19 to go! All attachments are still on and holding strong after my second tray with them on.

Below are pictures after tray 5. The headaches have been reduced a little, in favor of more teeth pain than anything. I do have jaw tension and my lockjaw has become pretty much constant. I filled the prescription for muscle relaxers when I started tray 7. I'm kind of behind on posting so I'll get these posted ASAP since it's almost time for post-tray 6 pictures!

Front View

Top View

Bottom View

Starting to slack. Haven't been wearing my trays as much as I should - more like 18-20 hours rather than 20-22. I'm still flossing every night though! Not wearing the trays as much as I should, I'm sure it having a direct affect on me having more constant lock jaw. I think its that combined with the fact that the movement is more aggressive now that the attachments are on. :(

Progress Weeks 7-8

Tray four is done. It was the first tray with attachments and I can say with pride that none of them have come off yet. Hopefully the glue holds for the rest of the treatment. :) Only 20 trays to go! Apparently people still can't see my trays. I like it.

Below are pictures after tray 4. No new developments; the headaches and tension are around consistently  for the first 4 days of the tray. The lockjaw chooses to be better/worse at random, but sticks around day in and day out. It's not affecting my health or life so I let it be. I did get a prescription for muscle relaxers just in case, but I haven't needed to fill it yet. We'll see.

Front View

Top View

Bottom View

Still on a roll. Consistent wear (hitting my 20-22 hours every day) and flossing every night. Routine is good - time consuming but definitely worth it.

Progress Weeks 3-4

Tray two is done and I'm halfway though tray 3! Two down, 22 to go. Below are the pictures after tray two, posting them a little late, but equal intervals from the last progress post. I'm starting to see like one or two teeth moving, but other than that not any major differences. I can definitely feel a difference.

Tray two has been somewhat annoying with headaches and lockjaw. Based on my progress so far into tray 3, I'm expecting things to get more annoying/painful. It's not killer - maybe an average 4 on a pain scale of 1 to 10 when it hurts - but the headaches are inconvenient. Sometimes they try to rage on me when I'm tired or trying to work.

Front View

Top View

Bottom View

No painkillers for you! The dentist is being totally lame about giving me the pain medication I need. Taking 4 advil at a time (800 mg) does very little and any less does nothing. Not really keen on taking that much advil all the time. It's bad for your workout progress and for your tummy.

My previous dentist gave me vicodin and muscle relaxers for some jaw pain which helped tremendously. They want me to come in to talk to the dentist, because if I look him in the eyes and say the same thing, that will be more effective. I'm going in next week for my attachments so I figured I could suffer until then rather then go to the dentist 20 times each month. My dentist's office and I talk almost every week. They're always messing something administrative up, but damnit I like the dentists.

I've been a pretty good girl.
I've worn my trays for between 20-22 hours every day and have flossed almost every night. :) I've been a little more lax about drinking non-water things with the trays in. I keep my trays clean though so it hasn't been an issue. Yay progress.

Progress Weeks 1-2

Tray one is done! 1 down, 23 to go. Below are the pictures after tray one, I don't see much of a difference. Tray one gave me little to no pain. No one has noticed my trays so far. Very cool.

Front View

Top View

Bottom View 

Tray 2 is in! On Monday evening I put in tray two. It's been pretty painful for the last few days. I've had a headache going since Tuesday. Poppin' lots of advil which is helping some, not a ton. The top tray is giving me the most pain, but surprisingly comes off pretty easily. The bottom tray is less painful, but is nearly impossible to get off. Makes no sense!

Today is day 3 of my second tray set and it feels like my teeth are all over the place every time I put the trays back in. It seems to take at least 20-45 mins before I feel like my teeth are lined up inside the trays again. Definitely encourages me to keep them on for longer.

I've been a good girl!
I've worn my trays for between 20-22 hours every day. I've also been flossing almost every night. :)

Progress - Before Invisalign

These are my before invisalign pictures. I take pictures after I've completed a tray - about every 2 weeks. Click here for a full list of my progress posts so far. My teeth tend to look more crooked in photos, so the images show an extreme version of any imperfections. My teeth aren't horribly mangled, but they're crooked in lots of little ways.  I can say with confidence that there's room for improvement. 

Notice twisting and crowding in front 6 teeth on top and bottom.

Crowding on top

Crowding on bottom

Right view

If you read my "About Me" you know that I'm looking to correct the crowding in my front upper and lower teeth. The crowding hasn't caused any major issues like pain or cavities yet. I do have minor plaque buildup on the bottom teeth when I go in for cleanings. Based on past dentists visits, the crowding is expected to increase over time, so I consider this both a preventative and cosmetic treatment. Can't wait to start seeing some progress!  :)

Is Invisalign Right for You?

Will it suit your life style?

Depending on current condition of your teeth, you might be worried that you aren't a candidate for invisalign, but what you should consider first is: Will it fit your lifestyle?

Did you know...

• You'll be wearing the trays around 22 hours a day.
• You can only drink water while the trays are in.
• You should brush your teeth every time you eat/drink non-water liquids before putting your trays back in. Technically you're also supposed to floss.
• You won't be inclined to pull the trays on and off a lot. It can be kind of a pain.
• You will be going in to the dentist every 6-8 weeks just like with other treatments.
• If your dentist doesn't see that you are making the progress you should be, they won't give you multiple trays at a time and you may have to go in more frequently.

If you're like most people, you don't floss every day and you don't tote around a toothbrush and toothpaste with you either. If you aren't someone who can commit to drinking water most of the time or can't commit to brushing pretty regularly, invisalign isn't for you. If you have to eat constantly or think you'd lose your trays as much as you lose your car keys, you're not a candidate. The trays are $50 a piece to replace and can take weeks to re-fabricate, making you treatment even longer.

Reality Check: No one is perfect.
The recommended rules can't be followed 100% of the time. If you can't get to the sink or forget your toothbrush, you can manage until you are reunited with your bristly buddy. But let's be honest. If you aren't willing to commit to the rules 95% of the time, you aren't going to get the results.

Don't waste your time and money if you don't think you can live up to the treatment expectations. Invisalign is a good option - don't get me wrong - but it requires you to be more diligent than braces, which are permanently attached.

If you're responsible, committed, and ready to start a 1-3 year journey then buckle up. For your hard work you'll be rewarded with the benefit of few of people noticing your corrective trays. :)

Will it suit your teeth?

It's the next logical question.You'll be surprised how many cases are treatable by invisalign. It can actually correct most types alignment issues. I've seen corrections on overbites, underbites, gaps, crowding, crossbites, and even some pretty serious cases of malocclusion (think of teeth that look like a mountain ridge.) For more info on malloclusiion check out the wikipedia page. Ultimately, your provider will decide if you are eligible. No two dentists are the same, so don't be scared to seek a second opinion if one dentist doesn't think you are a candidate.

For more details go to invisalign's official site a list of treatable cases, including images and additional details.