Tooth stripping – what is it and what risks are there?

What does teeth stripping and slicing mean?

Certain dental treatments require to minimally shave a tooth’s enamel, or rather to polish it, in order to create enough space. This might be the case, for example, if teeth need to be shifted in the course of an aligner treatment or to optimally attach dental veneers.

What does it entail?

During tooth stripping or IPR (interproximal reduction), a fine polishing strip is used to remove a minimal layer of the enamel surface. The goal is to create just enough space between the teeth so that the teeth involved in the orthodontic treatment do not block each other. Therefore, teeth slicing is crucial for a successful treatment in the case of crowded teeth. By the way, the necessary mini-gaps are hardly visible to the naked eye, if at all. In dentistry, tooth stripping, slicing, IPR, or tooth contouring describe similar techniques.

Why is teeth slicing or IPR necessary?

There are various reasons why tooth stripping or tooth slicing may be necessary. Videos of teenagers shaving down their own teeth – often with a nail file – are going around the internet and social media. The reasons are mostly aesthetic, for example to correct uneven teeth. This trend is dangerous and should not be imitated under any circumstances. Teeth shaving should always be carried out by a professional dentist with the appropriate instruments and by taking into account the anatomy of the patient in order not to damage the tooth.

Teeth stripping, IPR or teeth filing may be necessary due to the following reasons:

• Chipped or damaged teeth
• For an aligner treatment
• For a veneer treatment
• To apply crowns and bridges
• For aesthetic corrections (shaping, finishing or contouring)

How much enamel can be removed?

As a general rule, in most cases it is absolutely safe to remove 0.5 mm of enamel. This is true especially for aesthetic corrections and for aligners and veneers treatment. Depending on the health of the tooth, for example in the case of cavities, it may be necessary to slice down more enamel to apply a crown. In this case, the diseased hard dental tissue must be completely removed and, depending on the size of the cavity, provided with a build-up filling. bestsmile dentists always file down as little as possible to preserve the maximum possible tooth structure.

What is tooth enamel?

The enamel is the outer layer of the tooth and varies between 1.5 and 3 mm in thickness depending on the tooth and tooth shape.

Reshaping chipped or damaged teeth

Teeth can break off due to sports accidents or by biting on hard objects. Reshaping or filing down a chipped or damaged tooth is considered a standard dental procedure. Depending on the extent of the damage, the dentist can reshape or straighten the chipped tooth. This procedure allows to correct uneven areas and thus restore aesthetics and health of the tooth, for example by polishing sharp edges that could lead to injury.

Slicing for clear aligners

Some tooth corrections with clear aligners may require to gently remove a very small layer of enamel between the teeth (interproximal enamel reduction).

When is teeth shaving for aligners necessary?

Depending on the tooth position, it may be necessary to create more space between the teeth before treatment. Crowding is a classic example where teeth stripping is necessary for the aligner treatment.

Risks and side effects

This procedure is minimally invasive and painless. The newly created space will remain only for a short period of time, as the teeth move into the correct position in the course of the aligner treatment. So there is nothing to worry about permanent tooth gaps.

To create enough space for tooth movement in the case of traditional braces, from a certain point tooth extraction is inevitable. So the interproximal enamel reduction is an alternative to tooth extraction.

During your consultation, our specialist dentists will tell you if tooth stripping is necessary for your aligner treatment.

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In traditional orthodontics

Tooth stripping techniques have been successfully used in classical orthodontics for many decades. It is a very well-studied and worldwide established technique to correct anterior crowding with maximum protection of the tooth substance and surrounding tissues. Many studies suggest that tooth stripping can protect against cavities by dissolving dirt niches and reduce the risks of periodontal diseases by making oral hygiene easier, for example through flossing.

How does teeth shaving for bestsmile Aligners work?

During your Aligner treatment, you will have regular check-up appointments. During these visits, your dentist will check whether there is enough space between your teeth for the planned tooth movement. If there is not enough space, your dentist will polish the interdental spaces. This only takes a few minutes and is painless.

In cases of severe crowding, the dentist may use a mechanical stripping device. The principle is the same: to create more space between the teeth. *

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Teeth shaving for veneers

Unlike aligner treatment, teeth shaving for veneers is always necessary. This is the only way to professionally apply veneers.

During the preparatory appointment, the dentist will shave down a very thin layer of the tooth’s surface – again, we are talking about a maximum of 0.5 mm. In most cases this is not visible to the naked eye.

But this is necessary because veneers do not only cover the front of the tooth and may wrap slightly around the edges. This means that in order to apply the veneers correctly it is necessary to create a little space. To strengthen the tooth’s enamel and to prevent caries, the dentist will immediately apply some fluoride gel to the part of the tooth that has been shaved. Temporary sensitivity may occur, but this will slowly go away.

Please note: Pictures of completely shaved down teeth are going around the Internet. However, in most cases this has nothing to do with veneers. In most cases, what is sold as veneers are in fact full crows, which require to remove a bit more tooth substance. With a healthy tooth it is generally not necessary to shave down the tooth to that extent.

Veneers without shaving teeth: are there alternatives?

There are veneers that do not require teeth shaving, the so-called non-prep veneers (for example Lumineers). Lumineers are a popular alternative to conventional veneers but are not always suitable for the same indications.

Teeth shaving for dental crowns

To apply crowns or bridges the dentist will also need to file down your tooth. Generally speaking, these treatments require to trim your tooth down more than with aligners or veneers. Crowns cover the entire tooth and therefore have thicker side walls.

As crowns are often used for worn down teeth, the dentist will decide how much of the enamel needs to be removed depending on the case. For a crown to be firmly anchored to the tooth, the stump of the tooth must be stable and healthy. Unhealthy tooth substance must therefore be removed beforehand.

Shaping and contouring

Teeth can also be shaved for aesthetic reasons. Chipped or uneven tooth edges can be polished into shape quickly and easily without damaging the tooth at all. Tooth shaping is particularly popular. This technique is used to make minor changes to the tooth shape, such as adjusting or shortening long, pointed canines.

Shaping is also used to make interdental spaces more accessible, for example for correct flossing. In certain circumstances, this could play an important role for a comprehensive oral hygiene.

What is the difference between shaping and contouring?

Shaping involves reducing the tooth substance, whereas contouring involves artificially building it up. Both procedures can add the finishing touch to your new smile after aligner treatment.

If you have any further questions, our bestsmile dentists will be happy to help.

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What are the best techniques for teeth stripping?

Teeth can either be shaved manually or with a mechanical device.

Manual tooth stripping with slicing strips

Manual stripping is performed with slicing strips that come in various thicknesses and grit sizes. These strips are diamond-coated metal bands that are moved back and forth in the interdental spaces like dental floss to remove the necessary amount of enamel. This procedure can easily be performed without anaesthesia, is painless and only takes a few minutes.

Mechanical tooth stripping with a device

Rotating and oscillating devices can be used instead of manual slicing strips. Mechanical stripping devices are used especially in cases of severe crowding where more space is needed between almost every tooth. When choosing this option, there are different strips in different thicknesses available. For example, it is possible to choose between a strip where only one side is rough or one with two rough sides so that both the right and left tooth can be stripped. Both manual and mechanical tooth stripping are completely safe procedures from a medical point of view and are carried out in compliance with limit values.

How do dentists know how much enamel to remove?

Aligner software

When the patient’s treatment plan is created, the aligner software automatically determines how much enamel needs to be removed.* Dental technicians and dentists simulate the tooth movement in the 3D model and break it down into all the necessary steps. The software can easily determine how much space each tooth needs to shift into the desired position.

Check-up appointments

During each check-up appointment, our trained dentists will see how much enamel actually needs to be removed for the intended aligner treatment. The values calculated by the software are for guidance only. Most of the time, however, the dentist remains well below these values.

Tooth enamel varies in thickness depending on the tooth and its shape. The amount that needs to be removed should therefore be measured individually for each tooth, taking into account the anatomy. In most cases, dentists remain well below the recommended threshold of 0.5 mm. In conclusion, if tooth stripping is performed properly there are no side effects, complications or long-term sensitivity.

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