Straight teeth contribute to healthy teeth and gums.  There have been many studies that demonstrate how properly aligned teeth and jaws can decrease the likelihood of TMJ, sleep apnea, and even heart disease.  Having a beautiful smile elevates self-esteem, self-confidence, and self-image.  We have seen many of our patient’s lives transformed from having their teeth straightened.  Their heightened self-confidence improved their social lives, careers, and general attitude towards life.

Teeth that are well aligned are less prone to decay, gum disease, and injury.  Straight teeth collect less plaque.  Decay starts when the bacteria in plaque feed on simple carbohydrates (sugar and starch) and produce acid resulting in cavities.  Plaque accumulation also leads to increased risk for periodontal disease.  Proper alignment of the teeth decreases the risk by creating improved access when cleaning.  Finally, protruded teeth can be unattractive and at risk for trauma.  When repositioned the upper front teeth are protected from accidental damage.

Interproximal reduction (IPR) is the removal of small amounts of the outer enamel tooth surface between two adjacent teeth. It is a means to create space to eliminate crowding and establish a healthy position for the teeth in the bone.  This technique is used for patients in full braces as well as Invisalign.

The benefits of IPR include: creating space to improve tooth alignment; assisting in bite correction; improving the appearance of the teeth by reshaping them for a better esthetic outcome; decreasing the “black triangles” which are created by the absence of gum tissue (gingival papilla) between the teeth; eliminate the need for permanent tooth extractions; and reducing the tightness of the contacts between the teeth to increase the long-term stability

Dr Walkow carefully identifies which teeth need IPR through clinical examination and reviewing the radiographs.  Dr Walkow uses a painless technique that does not require anesthetic.  Only 0.25-0.5mm of enamel is removed per surface.  Research studies have shown that reduction of this level does not lead to long term sensitivity or increased risk of decay.   

There are several factors an orthodontist must consider to determine if IPR is appropriate treatment: the size and shape of the teeth, position and alignment of the teeth, and patient’s facial features and profile.