Teeth shaving for braces

Getting braces can straighten your teeth, but the process is faster and more effective if your teeth are properly prepped first. One preparation method is teeth shaving – selectively smoothing and reshaping certain teeth to optimize how the brackets interface.

Teeth shaving involves gently contouring or removing a tiny layer off the enamel of particular teeth prior to getting aligners or braces affixed, to make some extra room between your teeth so they can be properly aligned.

Indeed, your orthodontist might recommend teeth shaving in order to improve the alignment of your teeth. This is done strategically to:

  • Ensure proper bracket positioning and adhesion
  • Prevent brackets rubbing or irritating cheeks/lips
  • Minimize the risk of periodontal complications
  • Accelerate orthodontic tooth movement

Specifically, shaving may target overlapping front teeth, irregularly angled teeth, and teeth with bumps, ridges, or uneven enamel. Only 0.3mm to 0.5mm of enamel is removed to prep them for ideal bracket bonding.

Teeth shaving for braces

Why Shave Teeth Before Braces?

There are multiple benefits to optimizing tooth surfaces and angles with selective shaving:

  • Allows accurate bracket placement without bonding issues
  • Prevents bracket edges from irritating oral tissues
  • Removes overlapping areas that obstruct movement
  • Enables use of lighter, more comfortable archwires
  • Decreases treatment time and number of adjustments
  • Reduces chances of decalcification or gum recession

Overall, judicious teeth shaving facilitates an easier, shorter braces experience.

The Teeth Shaving Procedure

This is a quick, painless procedure where you can expect the following:

Step 1: Comprehensive Planning

To start, a thorough assessment and planning phase is essential for your orthodontist to determine which teeth need shaving based on occlusion analysis.

Measurements from study casts help determine how much correction is needed. It’s ideal to visualize the final position and shape of the teeth, often aided by diagnostic setups. This may involve the use of calibrated X-ray images to precisely calculate the amount of enamel that can be safely removed.

Step 2: Access to Interproximal Areas

Before starting enamel reduction, it’s advisable to place fixed appliances and correct any tooth rotations.The first phase involves aligning and leveling the teeth to establish proper contact points. This not only improves the results but also enhances visibility and mechanical access to the proximal surfaces.

Tools like coil-springs, separators, or wooden wedges can help create space and make the proximal areas more accessible.

Step 3: Protecting Soft Tissues

Ensuring the safety of the soft tissues in the mouth is crucial. Guidelines suggest placing a thin brass or steel wire gingival (toward the gums) to the contact point. This wire acts as a barrier, protecting the interdental tissue. The use of metal separators or wedges can also minimize the risk of soft tissue injury during the procedure.

Step 4: Interproximal Enamel Removal

The actual enamel reduction process can be done manually or mechanically.

In the past, handheld abrasive strips were used, but these methods were time-consuming and could leave irreversible furrows on the treated surfaces. Hand-operated strips are now reserved for minor cases or as introductory or finishing procedures.

Today, more sophisticated tools like safe-tipped ARS burs, metallic strip systems, diamond discs, and segment discs with oscillation movement are preferred. Segment discs provide better access to tight spaces.

  • Local anesthetic is applied for a painless process.
  • A fast-spinning dental drill with a fine shaving disc precisely contours the enamel.

Special disc guards can protect adjacent teeth during the procedure. Orthodontists try to be conservative, starting with small enamel amounts and grinding symmetrically from all contact areas before removing the maximum acceptable amount per site.

Step 5: Finishing and Polishing

After enamel reduction, it’s crucial to refine the surfaces. Cone-shaped triangular diamond burs and fine sand and cuttle discs are used to round interproximal corners and contour proximal walls.

  • Teeth are smoothed without damaging interior layers.
  • After shaving, teeth surfaces are polished to remove any rough areas before affixing brackets

The goal is to achieve an acceptable morphology and texture. Final smoothing can be done with even finer finishing instruments or phosphoric acid gel.

Step 6: Topical Fluoride Treatment

To enhance remineralization and protect the stripped proximal surfaces, a fluoride gel is prescribed after the enamel reduction procedure.

It’s worth noting that some orthodontists don’t consider a special fluoride application necessary for ground and polished tooth surfaces unless the patient experiences tooth sensitivity. In such cases, a weak fluoride solution mouthwash is recommended.

FAQs

How Much Enamel Can Be Safely Removed?

There are some rules about how much enamel can be safely removed without causing any harm to your teeth and gums. When we talk about removing enamel, we mean taking away a bit from the sides of your teeth, where they touch each other.

Experts say that it’s generally safe to remove up to 50% of the enamel on the sides of your teeth without causing any problems. By removing some enamel from certain spots you can create a bit more room.

For example, removing enamel from five of your front teeth could give you about 2.5 millimeters of extra space, and doing it for eight of your back teeth might give you around 6.4 millimeters. For the lower back teeth, premolars and molars, you could gain nearly 10 millimeters of space by carefully removing some enamel.

That said, the amount of enamel that can be safely removed can vary from person to person. Some people have thicker enamel than others, and some might have teeth with unusual shapes or sizes. So, your dentist or orthodontist will always take your individual characteristics into account when deciding how much enamel to remove.

And if you have dental work like fillings or crowns, this can affect the amount of enamel that can be safely taken away. They’ll need to be careful not to damage any existing dental work.

How do Dentists Prevent Heat Damage during Teeth Stripping?

The process of teeth stripping can generate some heat, and too much heat can be bad for your teeth. To keep things safe, there are a few things the dental experts do:

  • Water and Air Cooling – They use a special tool that sprays a little bit of water and air while they’re working on your teeth. This helps keep the temperature down and prevents your teeth from getting too hot.
  • Smooth Tooth Surfaces – They make sure that the parts of your teeth they’ve worked on are nice and smooth. This not only helps prevent heat but also makes it easier to keep your teeth clean.
  • New Tools: They use new instruments for each person they work on. This is important because it ensures that the tools are sharp and won’t cause any extra heat or discomfort.
  • Assistant’s Help: Sometimes, a dental assistant might blow a gentle stream of air to keep things cool while the dentist is working.

This further enhances the safety of the procedure if done by a skilled dentist or orthodontist.

How does Stripping Change Your Tooth’s Appearance?

Stripping, which involves smoothing or polishing the sides of your teeth, can change the way your teeth look and feel. The surface of the stripped teeth can become a bit rough and bumpy. To make the surface smooth again, dentists have to gently polish the teeth with something called Sof-Lex discs. These are like the fine-grit sandpaper used in woodworking – they help refine the enamel’s surface and make it smoother than even intact enamel.

Does Teeth Stripping Make Cavities More Likely?

Some studies have suggested that the little grooves and rough spots created on the sides of your teeth during stripping could harbor plaque, leading to cavities. However, other studies have looked at this question too, and found that in the long run, there isn’t a big difference in the number of cavities between teeth that were stripped and those that weren’t.

This is because we naturally have ways to repair and protect our teeth, like with fluoride from toothpaste, and even the way teeth rub together when we eat, which can help smooth out those rough spots over time.

So, while stripping might create some temporary grooves and bumps on your teeth, it doesn’t necessarily mean you’re at greater risk of cavities. Just keep up with your regular dental check-ups, brush, and floss as your dentist recommends, and your teeth should stay healthy.

What measures do orthodontists use to prevent potential issues after tooth stripping?

  • One crucial step is to maintain excellent oral hygiene. This includes regular brushing and flossing to remove dental plaque, the sticky film of bacteria that can lead to tooth decay. Patients should be educated on effective plaque control techniques.
  • Dentists may recommend concentrated fluoride mouthrinses and specialized toothpaste (dentifrices) to patients who have undergone enamel stripping. These fluoride products help strengthen and protect the enamel. When fluoride is applied topically, it can encourage the growth of crystals on the enamel surface, akin to fortifying the teeth’s defenses.
  • Another approach is the use of customized, form-fitting dental retainers that contain a solution with fluoride. Patients wear these retainers for a part of their day. This method provides a sustained release of fluoride, which can further aid in remineralizing the stripped enamel.
  • Dentists may recommend the use of casein phosphopeptide-amorphous calcium phosphate (GPP-ACP) to reverse the development of white spot lesions on teeth that can occur after orthodontic treatments.

Final Note

Consult your orthodontist to learn if strategic teeth shaving could benefit your upcoming braces treatment. Preparing your teeth can lead to better aligned brackets, lighter wires, and less irritation for a smoother orthodontic journey.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3831306/

Authors

  • Editorial team

    A team comprising oral health care professionals, researchers, and professional Writers, striving to impart you with the knowledge to improve your oral health, and that of your loved ones. 

  • Lilly

    Lilly, aka, Liza Lee, is a passionate community oral health officer and our lead writer. She's not only well-versed in performing a multitude of dental procedures, including preventive, restorative, and cosmetic, but also an avid writer. Driven by the significant oral health burden all around her, Lilly strives to build capacity and promote oral health. She envisions making a lasting impact by advancing research, prevention, and promotion efforts to alleviate oral health disparities. Please share your views and opinions on my posts.

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