When teeth need a little more room
Overlapping teeth need room to move into alignment. Interproximal reduction creates space by reducing a small amount of enamel—the hard outer layer—from contacting sides. The British Orthodontic Society (BOS) explains that it can also be used to adjust tooth shape.[1]
It can be used with fixed braces or clear aligners, but is not a routine requirement for everyone wearing either. The decision depends on tooth size, shape, and the space needed. Whether extractions can be avoided must also be judged within the overall treatment plan.[4]
The sites and amount matter more than the word “little”
Enamel thickness, tooth shape, and previous restorations vary, so the same amount is not removed from every tooth. A literature review emphasizes planning around these differences and checking the amount removed.[4]
The BOS warns that excessive removal can harm teeth. Ask which teeth will be treated, how much will be removed, and why. Do not follow a plan based solely on photographs without an in-person assessment, and never try to file your teeth yourself.[1]
Does it make cavities more likely?
This is an understandable concern. A 2022 systematic review of eight clinical studies found no increase in decay, adverse periodontal changes, or sensitivity after interproximal reduction in the included studies. However, evidence quality ranged from low to very low.[3]
Findings from appropriately performed procedures do not mean that any amount of filing is safe. Better studies with longer follow-up are needed, and individual decay risk and aftercare still matter. Careful control of removal and finishing remains important.[2][3]
Smoothing the surface is part of the procedure
Creating space is not the final step. The treated surfaces need finishing and polishing. The BOS patient leaflet explains that insufficiently smoothed surfaces can collect plaque more readily.[2]
A literature review also describes the effect of polishing on surface roughness. How the surface is finished matters as well as how much enamel is removed. Fluoride care may be advised where appropriate, but a product cannot compensate for an improperly performed procedure.[2][4]
What about sensitivity and care afterward?
Temporary sensitivity to hot or cold can occur. The BOS leaflet describes this as usually settling within a few days. If discomfort persists or worsens, tell your treating dentist rather than trying to put up with it.[2]
Continue cleaning between teeth and caring for the orthodontic appliance. Follow-up also checks that the space is being used as planned. Useful questions include, “Why do I need this?” and “How do the advantages and disadvantages compare with other options?”[1][2]
Research and institutional sources
- British Orthodontic Society. BOS Statement: Interproximal reduction. October 24, 2016.View source ↗Professional statement on in-person assessment, planning, and the risks of excessive enamel removal.
- British Orthodontic Society. Interproximal Reduction: Patient Information Leaflet. Reprinted 2019.View source ↗Official patient information on polishing, temporary sensitivity, and oral care. The date follows the leaflet imprint rather than its URL.
- Gómez-Aguirre JN, Argueta-Figueroa L, Castro-Gutiérrez MEM, Torres-Rosas R. Effects of interproximal enamel reduction techniques used for orthodontics: A systematic review. Orthod Craniofac Res. 2022;25(3):304–319. doi:10.1111/ocr.12555. PMID:34865310.View source ↗Systematic review of eight clinical studies. Full abstract checked, including low-to-very-low evidence quality and follow-up limitations.
- Livas C, Jongsma AC, Ren Y. Enamel Reduction Techniques in Orthodontics: A Literature Review. Open Dent J. 2013;7:146–151. doi:10.2174/1874210601307010146. PMID:24265652.View source ↗Literature review of planning, tooth differences, and polishing. Instrument details and amounts are not presented as self-treatment instructions.
Bracketed numbers in the text link to these sources. This article provides general health information; individual diagnosis and treatment plans are determined after a clinical consultation.
