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 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.

My Treatment Overview

Since I started Invisalign I've had three sets of trays created. Below are the details of each, including alterations to the teeth completed to assist the treatment. In summary, my first treatment had almost a year of trays, attachments and teeth shaving. As I went through the plan the dentist changed the amount of teeth shaving based on my comments and the actual results. After my first treatment, I got my attachments removed. My second treatment was cut short because the trays were starting to fit sideways on top. I'm currently working through my third set of trays.

Treatment 1 - Start July 2012

Treatment length: 24 trays (48 weeks)
Attachments: Added to 11 specific front teeth after 6 weeks (or first 3 trays)
Teeth Alterations: Interproximal reduction (shaving of the tooth enamel to create space between the teeth)

• Teeth Shaving at 13-18 weeks of treatment (or after 7ish trays)
• 7 reductions on the top teeth of .5 millimeters
• 7 reductions on the bottom teeth of .2 millimeters

The video below shows the expected transition start-to finish and attachment locations (in red). The arrows point to where the teeth shaving (interproximal reduction) will occur.

Treatment 2 - Start July 2013

Treatment length: 15 trays (30 weeks)
Attachments: Removed! I wanted them off after my first treatment. My dentist worked the removal into my treatment plan for round 2. Basically it just takes longer
Teeth Alterations: None. The teeth shaving expected on the top teeth in Treatment 1 was changed after it seemed that the amount completed on the bottom was too much.

Terminated after 10 trays: My trays were starting to fit sideways. I thought it was just because I was slacking on wearing them, turns out the trays were fabricated in a wacky way due to the mold of my teeth.

Treatment 3 - Start August 2014

Treatment length: 17 trays (32 weeks)
Attachments: Nope
Teeth Alterations: None. 

These fit great.