Interproximal reduction: a controlled step in orthodontic treatment
Interproximal reduction — IPR, also called enamel reduction, slenderizing or, informally, "stripping" — is a common step in modern orthodontics, especially with clear aligners. At the clinic, IPR is carried out only when the treatment plan calls for it, and the amount is tailored to each patient.
IPR is a delicate procedure that requires skill and should only be done after a full assessment of the teeth and mouth. At Dr Haim Aseriel's dental clinic in Jerusalem, the consultation includes a thorough examination, X-rays when needed, and a clear explanation — in English — of the process and the expected result.
Please note: IPR has nothing to do with teeth grinding. Grinding or clenching your teeth is a condition called bruxism; IPR is a planned procedure performed by the dentist.
What is IPR on teeth, when is it done, and who is it for?
The American Association of Orthodontists (AAO) defines interproximal reduction as the removal of a small amount of enamel from between the teeth to reduce their width. The aim is to create a small space between the teeth, which makes straightening more efficient, reduces crowding or improves the proportions of the smile. In many cases, IPR can create room for alignment without extracting teeth.
When is IPR done?
IPR is used during orthodontic treatment to make room for tooth movement, to improve the bite, or to correct teeth of mismatched size or shape.
Is IPR right for everyone?
No. People with significant tooth sensitivity — see sensitive teeth — or with particularly thin enamel are not ideal candidates. And when crowding is severe, only more extensive orthodontic treatment, sometimes with extractions, will create enough space. Only an examination can tell whether IPR suits you.
Why IPR is used, and how it differs from dental contouring
Each case is assessed individually. The most common reason for interproximal reduction is orthodontic treatment, particularly with clear aligners. When teeth are crowded, removing a minimal amount of enamel provides the space the teeth need to move into position, without extractions.
IPR is also used to correct a tooth-size discrepancy between the upper and lower teeth (known as a Bolton discrepancy), and after straightening it can improve the contact between front teeth, for example to reduce a small triangular gap ("black triangle") near the gums.
IPR vs. dental contouring: in the US, "dental contouring" (enamel shaping, or odontoplasty) usually means cosmetic reshaping of the visible edges and surfaces of a tooth — smoothing a small chip or evening out length — whereas IPR works on the contact surfaces between teeth to make room for orthodontic movement.
IPR is also different from natural tooth wear. Wear builds up over years from clenching, chewing or bruxism, and is not controlled like a clinical procedure; dental erosion, in turn, is caused by repeated exposure to acids such as soft drinks or reflux. A professional examination tells these situations apart and determines what kind of treatment, if any, is needed.
How interproximal reduction is performed
1. Clinical assessment and digital planning
The process starts with a careful clinical assessment. The amount of enamel to be removed from each tooth is set in advance according to the straightening plan, often with a digital scan and dedicated software, without exceeding biological limits. Usually only tenths of a millimeter are removed, and never more than about half of the enamel thickness at the contact area.
2. The procedure itself
The gums are checked first, and tartar is removed if needed. Enamel is then reduced with very thin abrasive strips, fine discs or oscillating instruments. These tools allow gentle, precise reshaping without overheating the tooth. Finally, the treated surfaces are smoothed and polished.
3. Fluoride protection
After the procedure, fluoride or another enamel-strengthening agent is applied to protect the teeth and limit sensitivity. Most patients feel little discomfort during or after IPR, although some notice mild sensitivity to hot and cold in the first days, which usually goes away on its own.
4. Follow-up
Follow-up matters as much as the procedure itself. A check-up is usually recommended about two weeks later to see how the teeth and gums have responded. When IPR is part of orthodontic treatment, follow-up visits continue on the schedule of the overall treatment.
Examination, treatment plan and price quote
detailed and personalized
During the consultation, Dr Haim Aseriel examines your teeth, explains all the options and gives you a transparent price quote, with no obligation. The clinic is at 12 HaTnufa Street, Jerusalem.
Before IPR: preparing for treatment
Before any interproximal reduction, the dentist assesses the teeth and the patient's goals. This first examination is used to plan exactly how much reduction is needed for a good functional and aesthetic result. X-rays may be taken to check the internal structure of the teeth and make sure the enamel is thick enough.
The first appointment is also the time to discuss alternatives. For minor cosmetic concerns, for example, veneers or bonding may be more appropriate than extensive reshaping. Every step, its duration and the expected result are explained beforehand; patients who feel nervous about dental work can read about care for anxious patients.
Aftercare: what to expect after IPR
Some temporary sensitivity in the treated teeth is possible after interproximal reduction.
Temporary sensitivity
This is considered normal, results from removing part of the outer enamel layer, and in most cases fades within a short time. If sensitivity lasts or worsens, contact the clinic so the cause can be checked.
Food and drinks
Avoiding very hot or very cold food and drinks in the first days is recommended. If you wear aligners, follow the usual rule: take them out to eat and drink anything other than water, and brush before putting them back in.
Oral hygiene
Keep brushing and cleaning between the teeth carefully. The small spaces created by IPR close as the teeth move during orthodontic treatment, according to the plan.
How much does IPR cost?
The cost of interproximal reduction depends on the complexity of the case, the number of teeth treated and the overall orthodontic plan.
IPR is usually part of a wider straightening treatment, so it is generally quoted within the overall plan rather than on its own. The clinic does not publish a price list: after an examination, you receive a detailed written quote. For English-speaking and American patients, the clinic provides itemized receipts that you can submit to your insurer; whether the treatment is reimbursed depends on your policy, so check with your insurer beforehand.
The clinic is at 12 HaTnufa Street in Talpiot, south Jerusalem, open Sun 8:00–19:00 · Mon 9:00–19:00 · Tue–Wed 9:00–21:00 · Thu 8:30–21:00 · Fri 8:00–14:00. During the consultation, the options, their pros and cons and the costs involved are explained, so you can make an informed decision.
Interproximal reduction: frequently asked questions
When it is done properly and within limits, up to about half of the enamel thickness at the contact area, interproximal reduction does not harm the teeth or gums. According to a literature review, follow-up studies of more than five years found low rates of new decay between the teeth, and no difference in gum health up to nine years after treatment. A rough surface can collect plaque, so the area is polished at the end and cleaning between the teeth every day matters.
During interproximal reduction, usually only tenths of a millimeter of enamel are removed from the sides of the teeth. The amount is planned separately for each tooth and does not exceed about half of the enamel thickness at the contact area.
Not exactly. In the US, dental contouring (enamel shaping) usually means cosmetic reshaping of the visible edges or surfaces of a tooth, for example to smooth a small chip or even out tooth length. Interproximal reduction removes enamel from the contact surfaces between teeth to create space for orthodontic movement, usually as part of treatment with clear aligners or braces.
Interproximal reduction is not suitable for everyone. People with significant tooth sensitivity or particularly thin enamel are not ideal candidates, and severe crowding usually needs more extensive orthodontic treatment, sometimes with extractions. Only an examination can show whether IPR is appropriate for a given patient.
Some temporary sensitivity in the treated teeth can occur after interproximal reduction. It is considered normal and usually fades within a short time. Sensitivity that lasts or gets worse should be checked by the dentist.
Sources
- Livas C et al., Enamel reduction techniques in orthodontics: a literature review, The Open Dentistry Journal, 2013 – View source
- González-García E et al., Assessing Enamel Thickness to Estimate Interproximal Reduction: A CBCT-Based Study, 2025 – View source
- American Association of Orthodontists, Glossary of Orthodontic Terms (interproximal reduction) – View source
- American Association of Orthodontists, Clear Aligners – View source
