Interproximal Reduction (IPR): Purpose, Procedure, Benefits and Risks
Updated: 3 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: November 2026 · How we review
Quick Answer: What is interproximal reduction (IPR)?
Interproximal reduction (IPR) is a dental procedure that removes a small amount of enamel from between the teeth to create space before braces, clear aligners or other orthodontic treatment. A dentist usually removes no more than half a millimeter per tooth. It usually doesn't hurt and takes a few minutes, but the change is permanent. [1]
What the research says
IPR did not raise the risk of cavities or gum problems. A systematic review of 8 clinical studies found no enamel demineralization, no increase in cavities, no gum (periodontal) changes and no tooth sensitivity after IPR. Orthodontic treatment that used IPR also finished faster than treatment that relied on tooth extractions, though the authors rated the overall evidence as low quality. (Gómez-Aguirre et al., Orthodontics & Craniofacial Research, 2022) [2]
In children and teens, about 0.3 mm was removed per tooth surface. Across 10 studies with 61 patients aged 8 to 17, crowded teeth were the main reason for IPR (57.4% of cases), an average of 0.3 mm of enamel was removed per surface, and enamel and gum health did not differ from patients who did not have IPR. (Khoury-Absawi et al., European Archives of Paediatric Dentistry, 2025) [3]
Key takeaways
IPR removes a thin layer of enamel between teeth to make room for orthodontic treatment. [1]
It is also called interproximal stripping or teeth slenderizing. [1]
Usually no more than 0.5 mm of enamel is removed per tooth, so the change may not be visible. [1]
Enamel has no nerves, so most people do not need numbing medicine. [1]
IPR is permanent. Removing too much enamel can weaken teeth, so it should only be done by a licensed professional and never at home. [1]
What is interproximal reduction?
Interproximal reduction is a procedure that gently removes small amounts of enamel, the hard outer layer of your teeth, from the sides where neighboring teeth touch. This creates a little extra space so your teeth can move into better positions during orthodontic treatment with braces or clear aligners. Other names for IPR are interproximal stripping and teeth slenderizing. [1]
IPR removes only a sliver of enamel between neighboring teeth.
IPR is a common step in orthodontic care. One 2022 study found that 71% of 500 people treated with Invisalign clear aligners needed IPR. [1]
Who needs interproximal reduction?
Your dentist or orthodontist may recommend IPR if your teeth need more room to move into place. It may help if you have: [1]
Crowded teeth
Oversized teeth
Teeth that overlap
IPR is not right for everyone. You may not need or be a good candidate for it if: [1]
You already have enough room for your teeth to move
You have very little tooth enamel to begin with
How do you prepare for interproximal reduction?
Interproximal reduction needs little preparation. Talk with your dentist about any questions or worries you have, and keep up good oral hygiene by brushing and flossing every day, which lowers your risk of infection. [1]
What happens during interproximal reduction?
During interproximal reduction, your dentist gently removes enamel from between your teeth using one of two types of tools. [1]
IPR usually takes just a few minutes per session.
Your dentist chooses a thin, flexible sanding strip or a rotating hand instrument.
The tool is placed between the teeth that need more space.
A small amount of enamel is smoothed away, usually no more than half a millimeter per tooth.
Your braces or aligners are fitted the same day or a few weeks later, depending on your treatment plan.
Sources: [1]
Interproximal reduction at a glance
Item | Typical detail |
Tools | Thin sanding strip or rotating hand instrument |
Enamel removed | Usually no more than 0.5 mm per tooth |
Numbing | Usually not needed |
Session length | A few minutes |
Number of sessions | One, or several over weeks or months |
Downtime | None |
Sources: [1]
Some people need only one IPR session, while others need several spread out over weeks or months. [1]
Does interproximal reduction hurt?
Interproximal reduction should not hurt, because tooth enamel has no nerves. Most people do not need local anesthesia (numbing medicine), though you may feel a slight vibration. Tell your dentist right away if you feel pain during the procedure. [1]
What happens after interproximal reduction?
There is no downtime after interproximal reduction, and you can go back to your usual daily routine right away. Your teeth may feel mildly sensitive to heat and cold for a few days. [1]
Depending on your treatment plan, your braces or aligners may be placed on the same day as your IPR or several weeks later. To learn more about these options, read our guides to Orthodontics: Braces, Clear Aligners, Retainers, and What to Expect and Clear Aligners: How Invisible Braces Work, Who They Suit, and What to Expect.
What are the benefits and risks of interproximal reduction?
The main benefit of interproximal reduction is that it creates space for orthodontic treatment while being far less invasive than removing teeth. IPR is usually successful when a skilled, licensed professional performs it and you keep up good oral hygiene and follow-up visits. [1]
Benefits | Risks |
Creates space so teeth can move during orthodontic treatment | The change is permanent and cannot be reversed |
Gives teeth a more even, uniform shape | Removing too much enamel can weaken teeth |
Can improve how your teeth fit together (your bite, or occlusion) | Weakened teeth may be more easily damaged |
Far less invasive than tooth extraction | Temporary sensitivity to heat and cold |
Sources: [1]
Never try to shave or file your own teeth at home. Taking off too much enamel can permanently weaken them. [1]
How does IPR compare with tooth extraction?
When teeth need more space for orthodontic treatment, the only alternatives to interproximal reduction are removing teeth or doing nothing. Of the two procedures, IPR is the less invasive option. [1]
IPR is the less invasive way to make room for straighter teeth.
Feature | Interproximal reduction | Tooth extraction |
What is removed | A thin layer of enamel between teeth | A whole tooth |
How invasive | Far less invasive | More invasive |
Sources: [1]
When should you call your dentist?
After interproximal reduction, contact your dentist or orthodontist if you notice: [1]
Pain
Heavy bleeding
Signs of infection, such as a fever
If you are ever unsure whether a symptom is normal, call your dentist. [1]
Conclusion
Interproximal reduction is a quick, usually painless way to create the extra space your teeth may need for braces or clear aligners. By removing only a sliver of enamel between neighboring teeth, it can help crowded or overlapping teeth line up and avoid the need to remove teeth.
Because the change is permanent, IPR should always be done by a licensed dental professional. Keep brushing and flossing well, attend your follow-up visits and ask your dentist whether IPR is part of your treatment plan.
Keep learning: Read our Teeth Braces: Types, Timeline, Pain Relief and Aftercare Guide to see what to expect once your teeth have room to move, or visit the American Association of Orthodontists for more about orthodontic care.
FAQ
What is interproximal reduction?
Interproximal reduction (IPR) is a dental procedure that removes a small amount of enamel from between your teeth to create space for braces, clear aligners or other orthodontic treatment. [1]
What is IPR also called?
IPR is also called interproximal stripping or teeth slenderizing. [1]
How much enamel is removed during IPR?
Usually no more than half a millimeter (0.5 mm) of enamel is removed from each tooth, and the change may not be visible. [1]
Does interproximal reduction hurt?
It should not hurt, because enamel has no nerves. Most people do not need numbing medicine, though you may feel a slight vibration. [1]
How long does IPR take?
Each IPR session usually takes just a few minutes. Some people need one session, and others need several over weeks or months. [1]
Is interproximal reduction permanent?
Yes. IPR permanently removes enamel and cannot be reversed. [1]
Can IPR damage my teeth?
Removing too much enamel can weaken teeth and make them easier to damage, so IPR should only be done by a licensed professional and never at home. [1]
Will my teeth be sensitive after IPR?
Your teeth may be mildly sensitive to heat and cold for a few days, but there is no downtime and your daily routine should not be affected. [1]
Who should not have IPR?
IPR may not be needed if your teeth already have enough room to move, and it may not be suitable if you have very little tooth enamel. [1]
What are the alternatives to IPR?
The only alternatives are removing teeth or doing nothing. IPR is the less invasive of the two procedures. [1]
How do I prepare for interproximal reduction?
IPR needs little preparation. Talk with your dentist about any questions or worries, and keep brushing and flossing every day, which lowers your risk of infection [1].
When should I call my dentist after IPR?
Contact your dentist or orthodontist if you have pain, heavy bleeding or signs of infection such as a fever. Mild sensitivity to heat and cold for a few days is expected, and if you are unsure whether a symptom is normal, call your dentist [1].
Related Reading
When the bite needs correcting: Underbite Correction: Symptoms, Causes, and Modern Treatment Options
Upper teeth that overlap too far: Overbite: Symptoms, Causes, and Management Strategies
References
Cleveland Clinic. Interproximal Reduction (IPR): Purpose & Benefits. Cleveland Clinic. Last updated November 8, 2024. https://my.clevelandclinic.org/health/procedures/interproximal-reduction
Gómez-Aguirre JN, Argueta-Figueroa L, Castro-Gutiérrez MEM, et al. Effects of interproximal enamel reduction techniques used for orthodontics: A systematic review. Orthod Craniofac Res. 2022;25(3):304-319. PMID 34865310. https://doi.org/10.1111/ocr.12555
Khoury-Absawi M, Nasrallah F, Srouji S, et al. Clinical outcomes of interproximal enamel reduction in orthodontic treatment of children and adolescents: a systematic review. Eur Arch Paediatr Dent. 2025;26(6):1045-1055. PMID 40650721. https://doi.org/10.1007/s40368-025-01081-y
Medical disclaimer
This article is for general education only and does not replace advice from a qualified dentist or healthcare professional. Talk to your dentist or orthodontist about your own treatment plan, and seek care promptly for pain, heavy bleeding or signs of infection.
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