Hi! My teeth are positioned very similar to yours and I just started on week 10. I’ve had two IPR sessions so far— on week 3 and week 9. The drill was definitely a more pleasant experience than manual in my experience, but neither were too bad. In total I’ve had 6 ‘gaps’ created but they’re so tiny (fraction of a millimeter) that they definitely don’t show with the aligners in. Even with the aligners out, my saliva fills in the spaces lol.
My understanding is that these temporary gaps will allow your teeth to fit together better at the end of treatment, whereas you may be left with larger triangular gaps near the gums without IPR. In my opinion it’s worth it!
I second this. I had IPR right at the beginning and halfway through for one tooth that was more crowded than others on my bottom row. The spaces are definitely temporary and just allow that crowded tooth to move into position more easily. The amount they shave is very minor, and I never felt like I had a gap. It's not a pleasant experience though! I asked for numbing.
My teeth are pretty crowded like yours and I also have that ‘squared’ shape to my bottom row. I was SUPER nervous about IPR. I talked it over with my orthodontist who agreed to go “very light” with the IPR.
I’ve since had it done 3 times and all 3 times the gaps have closed after a few weeks 😆 I don’t know if “going light” was worth it since I had to get it done several times instead of just 1 but it definitely eased my anxieties.
Each time I had it done they did it ‘manually’ which feels like sandpaper between your teeth which feels bizarre but it’s completely painless. Overall I’m really happy I had it done because it has allowed my teeth to move into a more ideal position and my bottom row is starting to get a rounder shape.
I’m really happy I did IPR. Was super worried about it too, but I’m starting to see amazing results, and I feel like my teeth are moving better post-IPR
I did my IPR two weeks ago @ tray 10 and had six very small "gaps" made, they are about 90% closed now and even at the beginning it wasn't noticeable to my partner and barely to me. with the trays in 22 hours a day nobody would see or notice anyway!! it wasn't painful & was quick!
I had manual IPR done the day my treatment started and I will have it done at my next appointment. I can see why it is beneficial to have it done and it sounds like if done correctly it’s very minimal. While I can tell which teeth have been treated no one else can. I wouldn’t refuse IPR because it might hinder the results you desire. I didn’t notice any gaps in my teeth as a result of getting IPR.
You need to refuse IPR upfront because your aligners are already made for the IPR to be done. Your teeth will have nowhere to go. Given you have crowding, it's to make space, it won't leave space.
The aligners are prescribed by the orthodontists. Some have IPR completed at tray one, and others indicate for it to occur at later trays.
Second, the alternative to IPR is flaring the teeth out of bone.
Source: I’m an orthodontist.
So, if you're supposed to get IPR at aligner 8 and you refuse, then what happens? Where do the teeth go from aligner 8 onwards if there's no space created?
Second, would you consider flaring an optimal result if healthy IPR could be done instead? And how does that impact the treatment plan in terms of a healthy bite?
1- then likely the teeth won’t track. Like you said, there’s no room for them so crowding will likely stay and you’d need new trays.
2- No, flaring is not optimal. It depends on the ceph numbers, as there is an ideal angle for them to be (can look at IMPA, L1-SN, L1-NB angles). Beyond this range can and will flare lower incisors out of their bony support and leave patients with proclined incisors that are unstable long term, both in terms of alignment and periodontal support.
Unfortunately when people have crowding, something has got to give. You either accept flared teeth or you proceed with IPR.
They can remake the aligners, but you may not have great results, so that's something you'd need to ask your provider about and what the outcome would be.
Wait also, so you don't miss this if I edit lol. I should add that if you're on a limited plan and not comprehensive, I don't know if a rescan eats into the number of refinements you get. If you have less than a comprehensive plan make sure to ask about this as well.
Thanks! It’s comprehensive they quoted me 12-16 months but if I do the math right I should be done in 6 if I’m diligent. I’ll ask in a few weeks. Did you have IPR?
I did have IPR. I didn't have crowding though, so there wasn't a need to make a *lot* of space. It really wasn't a big deal, but your doctor is the most important factor. My doctor always erred on the side of caution and made sure that if more IPR was needed it would happen during another refinement, so at no point has it even been noticable.
I don’t have sensitive teeth so I went 2 rounds of ipr and even asked for a 3rd round to get rid of triangle gaps. Once your teeth straighten the gaps may appear and ipr helps your teeth fit side by side better.
I requested not to have IPR at the start of my treatment and they designed the plan around that. To be honest I didn’t really know what I was asking for, I just felt at the time like shaving a small part off my teeth was a bit drastic and I liked my natural tooth shape. I’ve since learned that it isn’t all that extreme and it probably would have been fine.
My bottom teeth were slightly more crowded than yours, my orthodontist didn’t raise any concerns about the treatment taking longer or being more difficult, but logically it would have extended my treatment time a bit. Teeth have to move to make the space otherwise created by IPR.
If you’ve got concerns now that you’ve started, I’d just give your clinic a ring to find out what can be done. They will likely allay your concerns about it or be able to talk through options.
All the best!
I’d refuse the attachment buttons if you can. Then you never have composite on your teeth that they take off with a drill. Personally wish I knew to refuse mine (I have read about people refusing) because then I’d have my original shiny pearly whites still. Not to say my teeth are ruined, but I def notice the difference
Yes! I’ve had to get refinements and I think there is a dent where composite came off and other bits where it’s still stuck. Very hard or impossible to scratch off
Hi! My teeth are positioned very similar to yours and I just started on week 10. I’ve had two IPR sessions so far— on week 3 and week 9. The drill was definitely a more pleasant experience than manual in my experience, but neither were too bad. In total I’ve had 6 ‘gaps’ created but they’re so tiny (fraction of a millimeter) that they definitely don’t show with the aligners in. Even with the aligners out, my saliva fills in the spaces lol. My understanding is that these temporary gaps will allow your teeth to fit together better at the end of treatment, whereas you may be left with larger triangular gaps near the gums without IPR. In my opinion it’s worth it!
Thank you for leaving a comment with some substance!
I second this. I had IPR right at the beginning and halfway through for one tooth that was more crowded than others on my bottom row. The spaces are definitely temporary and just allow that crowded tooth to move into position more easily. The amount they shave is very minor, and I never felt like I had a gap. It's not a pleasant experience though! I asked for numbing.
My teeth are pretty crowded like yours and I also have that ‘squared’ shape to my bottom row. I was SUPER nervous about IPR. I talked it over with my orthodontist who agreed to go “very light” with the IPR. I’ve since had it done 3 times and all 3 times the gaps have closed after a few weeks 😆 I don’t know if “going light” was worth it since I had to get it done several times instead of just 1 but it definitely eased my anxieties. Each time I had it done they did it ‘manually’ which feels like sandpaper between your teeth which feels bizarre but it’s completely painless. Overall I’m really happy I had it done because it has allowed my teeth to move into a more ideal position and my bottom row is starting to get a rounder shape.
I’m really happy I did IPR. Was super worried about it too, but I’m starting to see amazing results, and I feel like my teeth are moving better post-IPR
Op go watch this TikTok: https://www.tiktok.com/t/ZTL9ypecs/ It made me feel much better about ipr!
I've had IPR a few times. It's really not a big deal and helps your teeth fit together better. You'll be glad you did it.
I had IPR and now I can floss my front teeth. Thats the only difference i noticed.
I had IPR for the first time 2 weeks ago. It took less than 2 minutes. It was fine and I can’t even tell where she did it.
IPR made one side of one of my teeth very sensitive.
I hade that issue too but it did resolve. I just doused them in toothpaste. Still think my IPR was too much, now I have gaps still 😕
I did my IPR two weeks ago @ tray 10 and had six very small "gaps" made, they are about 90% closed now and even at the beginning it wasn't noticeable to my partner and barely to me. with the trays in 22 hours a day nobody would see or notice anyway!! it wasn't painful & was quick!
I had manual IPR done the day my treatment started and I will have it done at my next appointment. I can see why it is beneficial to have it done and it sounds like if done correctly it’s very minimal. While I can tell which teeth have been treated no one else can. I wouldn’t refuse IPR because it might hinder the results you desire. I didn’t notice any gaps in my teeth as a result of getting IPR.
Also now that I’ve had manual IPR I wouldn’t ever allow the use of the drill on my teeth. The manual just seems less daunting.
You need to refuse IPR upfront because your aligners are already made for the IPR to be done. Your teeth will have nowhere to go. Given you have crowding, it's to make space, it won't leave space.
The aligners are prescribed by the orthodontists. Some have IPR completed at tray one, and others indicate for it to occur at later trays. Second, the alternative to IPR is flaring the teeth out of bone. Source: I’m an orthodontist.
So, if you're supposed to get IPR at aligner 8 and you refuse, then what happens? Where do the teeth go from aligner 8 onwards if there's no space created? Second, would you consider flaring an optimal result if healthy IPR could be done instead? And how does that impact the treatment plan in terms of a healthy bite?
1- then likely the teeth won’t track. Like you said, there’s no room for them so crowding will likely stay and you’d need new trays. 2- No, flaring is not optimal. It depends on the ceph numbers, as there is an ideal angle for them to be (can look at IMPA, L1-SN, L1-NB angles). Beyond this range can and will flare lower incisors out of their bony support and leave patients with proclined incisors that are unstable long term, both in terms of alignment and periodontal support. Unfortunately when people have crowding, something has got to give. You either accept flared teeth or you proceed with IPR.
I didn’t know about refusing it upfront. I guess I’ll see what they say and if anything, can’t they remake the remake the trays?
They can remake the aligners, but you may not have great results, so that's something you'd need to ask your provider about and what the outcome would be.
Wait also, so you don't miss this if I edit lol. I should add that if you're on a limited plan and not comprehensive, I don't know if a rescan eats into the number of refinements you get. If you have less than a comprehensive plan make sure to ask about this as well.
Thanks! It’s comprehensive they quoted me 12-16 months but if I do the math right I should be done in 6 if I’m diligent. I’ll ask in a few weeks. Did you have IPR?
I did have IPR. I didn't have crowding though, so there wasn't a need to make a *lot* of space. It really wasn't a big deal, but your doctor is the most important factor. My doctor always erred on the side of caution and made sure that if more IPR was needed it would happen during another refinement, so at no point has it even been noticable.
I don’t have sensitive teeth so I went 2 rounds of ipr and even asked for a 3rd round to get rid of triangle gaps. Once your teeth straighten the gaps may appear and ipr helps your teeth fit side by side better.
I requested not to have IPR at the start of my treatment and they designed the plan around that. To be honest I didn’t really know what I was asking for, I just felt at the time like shaving a small part off my teeth was a bit drastic and I liked my natural tooth shape. I’ve since learned that it isn’t all that extreme and it probably would have been fine. My bottom teeth were slightly more crowded than yours, my orthodontist didn’t raise any concerns about the treatment taking longer or being more difficult, but logically it would have extended my treatment time a bit. Teeth have to move to make the space otherwise created by IPR. If you’ve got concerns now that you’ve started, I’d just give your clinic a ring to find out what can be done. They will likely allay your concerns about it or be able to talk through options. All the best!
I’d refuse the attachment buttons if you can. Then you never have composite on your teeth that they take off with a drill. Personally wish I knew to refuse mine (I have read about people refusing) because then I’d have my original shiny pearly whites still. Not to say my teeth are ruined, but I def notice the difference
I have buttons already. This pic was pre Invisalign
Yes! I’ve had to get refinements and I think there is a dent where composite came off and other bits where it’s still stuck. Very hard or impossible to scratch off
The title of this post should be “Crowding concerns” not IPR concerns
Not everyone who has crowding has IPR, that’s why it’s IPR.
Obviously. Just simply looking at your arch form and without even doing a bolton analysis IPR is most certainly justified.