Reducing Tooth Widths forForm, Function and Stability

InterproximalReduction

Founded in 1900, the American

Association of Orthodontists (AAO)

has more than 15,500 members. Active

AAO members limit their practices to the

dental specialty of Orthodontics and

Dentofacial Orthopedics. Orthodontists

are dental specialists with at least

two years of advanced orthodontic

education after dental school.

The purposes of the American

Association of Orthodontists and

its member orthodontists are:

to advance the art and science

of orthodontics;

to encourage and sponsor research;

to strive for and maintain the highest

standards of excellence in orthodontic

education and practice;

and to make significant contributions

to the health of the public.

You Are On Your Way To A Healthy,New Smile.

To help you achieve it, your orthodontist feels thatinterproximal reduction, making some of your teethslightly narrower, will contribute to the successfuloutcome of your orthodontic treatment. It may alsocontribute to long-term stability of your results afteryour braces are removed. Interproximal reduction isthe removal of some of the outertooth surface, called enamel,usually between teeth that touch;it has been used in orthodonticssince the 1940s. It is also knownas slenderizing, stripping, enamelreduction, reproximation andselective reduction.

Whatever the name, the intentions are the same—to acquire more space for your teeth, to bring yourteeth into alignment, to improve your bite (the wayyour teeth come together) or to make the teeth moreattractive. Sometimes interproximal reduction is donealone, but it is usually done in combination withorthodontic appliance treatment. Sometimes it iseven done in conjunction with tooth extractions.Sometimes it is done following orthodontic treatmentto establish stability. Many times front teeth arecontoured during or after orthodontic treatment tocreate a balanced and harmonious appearance ofteeth. Your orthodontist will recommend enamelreduction if it is a solution to your individual need.

2 mm deficient (Illustration not to scale)

Interproximal reduction (also known as slenderizing, stripping,enamel reduction, reproximation and selective reduction) isa means by which additional space is acquired for your teeth.This illustration shows how 2mm of space can be gained throughthe process of interproximal reduction.

About the AAO:

Will InterproximalReduction DamageMy Teeth Or Gums?

The health of your teeth andgums is of utmost concernto your orthodontist. Studiesamong patients who have hadinterproximal reduction showthat the procedure does notmake teeth more susceptibleto tooth decay. Nor does theprocedure predispose gumsto gum disease. Occasionally,some patients may experiencesome sensitivity to hot orcold. Overall, the results aregenerally positive.

The primary reason orthodontists choose to perform interproximalreduction on some patients is to reduce the size of the teeth so thatthey can be aligned properly. Studies among patients who have hadinterproximal reduction show that the procedure does not maketeeth more susceptible to tooth decay nor does it predispose gumsto gum disease.

Before

After

How Does Interproximal ReductionWork?

1. Your doctor will identify which teeth are to beslenderized.

2. Enamel is removed from the sides of each tooth,where the tooth comes in contact with neighbor-ing teeth. The enamel may be removed manuallyor with the aid of a specially-designed dentalhandpiece.

3. Your orthodontist carefully removes the desiredamount of enamel, leaving each tooth withsufficient enamel to remain healthy and sound.

4. In performing enamel reduction, the doctor care-fully creates needed space that will allow teethto be placed so that the bite is improved andthe teeth take on a pleasing appearance.

5. Desired positioning can be achieved after teethare slenderized.

Extra space is created when tooth width is reduced. These beforeand after photos demonstrate how slenderized teeth can be posi-tioned during orthodontic treatment. The orthodontist can alsoshape teeth to create a more attractive appearance.

Front teeth form the framework upon which lips rest. Evaluatingfacial characteristics through photographs and x-rays is an essen-tial step in orthodontic treatment. Your orthodontist will examineyour facial appearance and decide whether or not interproximalreduction is suitable or beneficial.

How Will This Procedure Help MyTreatment?

Interproximal reduction will help your orthodontistposition your teeth for good function and good looks.In some cases, enough space can be created so thatteeth do not need to be removed. After your bracesare removed, your more slender teeth are more likelyto stay where your orthodontist has moved them.

HowWill My Orthodontist DecideWhetherOr Not I Need Interproximal Reduction?

When deciding if reshaping of teeth is to yourbenefit, your orthodontist will consider such factorsas the size and shape of your teeth, their positionsand alignment, and your facial features. Front teethform the framework upon which lips rest, and theirpositions play an important role in facial appearance.Sometimes the orthodontist may suggest the removalof teeth to enhance the facial appearance. Educationand experience in evaluating facial characteristicsallow the orthodontist to develop a treatment goalthat produces a healthy bite, which can contributeto nice-looking teeth and facial attractiveness.

The removal of the enamel generally causes nodiscomfort for most patients because there areno nerve endings in the outer layer of the tooth.

After the teeth have been slenderized, they are smoothedand polished. Your doctor may recommend a topicalfluoride treatment, as well as daily use of a fluoride rinseto help the teeth maintain their resistance to decay.

Prior to interproximal reduction, teeth slightly overlap.

After wires are removed, the orthodontist gains some space bygently contouring the sides of the overlapping teeth.

Following interproximal reduction, teeth have sufficient room toalign, the patient has a more aesthetically-pleasing smile and animproved bite.

This patient had interproximal reduction performed as part of hercomprehensive orthodontic treatment. Small amounts of space werecreated to allow teeth to be positioned for optimal function. Thepatient’s front teeth were shaped to provide a more atractive appearance.

Before After

What Is Orthodontics?

Orthodontics is the branchof dentistry that is officiallyknown as Orthodontics andDentofacial Orthopedics. Thepurpose of orthodontics is totreat any type of malocclusion,which is simply another wayof saying “bad bite.”

When you have a malocclusion, that means yourteeth, lips and/or jaws don’t line up the way theyshould. As a result, your teeth may be crooked, yourbite may not work correctly and your jaws may lookunbalanced.

To fix bad bites, orthodontists—dentists who arespecially trained—use braces and other correctiveprocedures, including materials often called“appliances,” to achieve tooth and jaw alignment.This correction of the teeth and their supportivestructures makes for a healthy, attractive smile.

It’s Important To Choose An Orthodontist.

An orthodontist is a specialist in the diagnosis,prevention and treatment of dental and facialirregularities. All orthodontists are dentists, butonly about six percent of dentists are orthodontists.Admission to orthodontic programs is extremelycompetitive and selective.

It takes many years to become an orthodontist,and the educational requirements are demanding.

An orthodontist must complete college requirementsbefore starting a three-to-five-year graduate programat a dental school accredited by the American DentalAssociation (ADA). After dental school, at least twoor three academic years of advanced specialty educa-tion at an ADA-accredited orthodontic program arerequired to be an orthodontist. The demandingprogram includes advanced education in biomedical,behavioral and basic sciences. The orthodonticstudent learns the complex skills required to managetooth movement (orthodontics) and guide facialdevelopment (dentofacial orthopedics).

Only dentists who have successfully completedthese advanced specialty education programs maycall themselves orthodontists.

For a Smile that’sGood for Life:

• Follow the American Dental Association’s recom-mendation and start dental visits by your child’sfirst birthday.

• Make regular visits to your dentist at least everysix months.

• Take your child for an orthodontic check-up nolater than age 7. If a problem is detected, yourorthodontist can determine the best time to starttreatment.

• Get your child an orthodontic check-up even ifhe or she is past age 7. Although an early check-upcan be extremely beneficial, the fact is that mostorthodontic patients begin active treatmentbetween ages 9 and 14.

• Keep in mind that orthodontic treatment canalso benefit adults. Less visible, more comfortablebraces make treatment more appealing than ever,and healthy teeth, bones and gums of almost anyage respond well to treatment.

• Choose an orthodontist – the dental specialist whois uniquely qualified to treat orthodontic problems.

• Take advantage of the affordability of orthodontictreatment today. Most orthodontists have a varietyof convenient payment plans.

• Remember that successful orthodontic treatmentis the result of a partnership. The orthodontist,family dentist and, especially, a cooperative patientall work together to create a healthy, beautifulsmile that’s good for life.

The members of the American Associationof Orthodontists wish you and your family

good dental health.

For information on orthodontics, visit theAmerican Association of Orthodontists’ Web siteat www.braces.org or call 1-800-STRAIGHT.

Please note: The 1-800-STRAIGHT toll-free numberworks for calls from the United States AND Canada.

Achieving healthy, beautiful smiles is a team effortthat involves the orthodontist, the family dentist,the patient (and the parents, if the patient is young)and, as needed, other dental specialists. The ortho-dontist provides the expertise, the treatment planand the techniques to straighten teeth and align thejaws. The family dentist helps make sure that teethand gums stay clean and healthy. The patient mustcooperate by following the dentist’s and orthodontist’sinstructions carefully so that the teeth and jaws movein the way desired and on the prescribed schedule.

Because dental hygiene is so important, regular visitsto the family dentist must continue every six monthsduring orthodontic treatment (or more often, ifrecommended). It is essential that the patient avoidfood which may damage orthodontic appliances. Thepatient must also maintain a healthy, nutritional dietto achieve the best possible results from treatment.A good diet provides essential nutrients to bones andtissues undergoing change during orthodontic treatment.

Partnership: You, Your Orthodontistand Your Dentist.

401 North Lindbergh BoulevardSaint Louis, Missouri 63141-7816

314.993.17001-800-STRAIGHT (consumer information line)

www.braces.orgEmail: info@aaortho.org

© 2009 American Association of Orthodontists