How to reduce black triangles with braces or Invisalign?

What methods can be used to deal with it

If you have relatively straight teeth, but do not love your smile because how your “black triangles” are showing, you might consider enhancement orthodontics with a procedure called interproximal reduction, also known as IPR for short.

This technique is where an artistic and trained orthodontic specialist polishes between the teeth, going through the contact point, creating a temporary small space, then closes it to better fill the space with the gums (space usually closes within a matter of days).

Black triangles are quite common, but relatively easy to treat.
The following are factors contributing to black triangles (aka “open gingival embrasures”):

(1) CROWDING of the teeth—the gums are “suffocated” by overlapping teeth, so when the teeth are straightened, the gum recession is more apparent, revealing the black triangle

(2) TRIANGULARLY shaped teeth (as opposed to rectangularly shaped teeth) have a very small point contact near the chewing surface of the tooth. This ultimately leaves a large triangular space between the teeth, often which the gums cannot fill.

(3) BONE position around the teeth—if the point where the teeth touch is more than 5 mm away from the level of the bone supporting the teeth, there will be a black triangle present.

Things to know about why IPR is so beneficial:

• It is NOT harmful to the enamel. There have been university studies that prove that the enamel after polishing is actually smoother than natural enamel. It also DOES NOT mean your teeth are weaker or have a higher risk for cavities/decay.
• Closing the black triangle results in a more BEAUTIFUL SMILE!
• It can promote HEALTHIER GUMS and teeth, because closing the space reduces or eliminates the black triangular space which can be a trap for plaque and tartar
• It promotes better orthodontic STABILITY, which means less likelihood of shifting and relapse after orthodontic treatment. This is because the previous the small “point contact” between the teeth is more prone to shifting than a broad contact with greater surface area between the teeth

There are also a number of ways to perform IPR as well. They range from using IPR discs, strips, burs, and even a reciprocal saw. These tools sound scary, but in the hands of a trained orthodontist, the outcome looks amazing! My personal preference is to use a IPR reciprocal saw to break the contact anterior first. What is great about this tool is that there is no cutting surface towards the gums and is fairly safe. I then use a IPR strip to further polish any rough spots that may occur. For posterior IPR, I generally like to still use a IPR reciprocal saw to open the contact and if more IPR is needed, I will use an IPR bur, followed by IPR stripping. I also try my best to use gauges to measure the IPR performed to reduce the likelihood of removing too much tooth structure. I also try to avoid using IPR discs at my office, as the cutting surface can cut the gums IF the proper precautions are not taken. If an IPR disc is needed, I will apply a cotton roll and a wedjet between the teeth for small separation between the teeth and lightly press the adjacent tooth surfaces to perform the IPR. This also further protects lips from getting cut during the procedure.