TADs, or temporary anchorage devices, are miniature implants placed in the bone of the upper or lower jaw during orthodontic treatment. They give your orthodontist a fixed anchor point to move teeth in difficult directions, then they are removed once their job is done.
If your orthodontist mentions a mini-screw or a TAD, it is natural to have questions. The idea of anything being placed in the jaw can sound bigger than it is. In practice, a TAD is a small, temporary tool that solves a very specific problem in tooth movement. Below we explain what that problem is, how TADs help, what placement and removal involve, and how to care for one while it is in.
What Are TADs in Orthodontics?
A temporary anchorage device is a very small implant, often called a mini-screw, that is placed into the bone of the upper or lower jaw. Unlike a dental implant that replaces a missing tooth, a TAD is not permanent and does not hold a crown. It stays in place only for the part of treatment where it is needed.
The device works with your braces or other appliances. Your orthodontist can attach springs, elastics, or wires to it so that force is applied to the teeth from a point that does not move. That stable point is what orthodontists call anchorage, and it is the reason TADs exist.
Speaks Orthodontics uses TADs as one of several temporary anchorage device treatments for cases where control over tooth movement matters most. Not every patient needs one, and many complete treatment without ever having a TAD placed.
Why Do Orthodontists Need Anchorage?
Every push in orthodontics has an equal pull. When braces move a tooth in one direction, the teeth the force is anchored to tend to move in the opposite direction. This is a problem orthodontists must manage in every case. Most of the time, it is handled by how the braces and wires are designed, and the side effects are small enough to plan around.
In some situations, though, the control over tooth movement and the limitation of unwanted movement is critical. If the back teeth drift forward while the front teeth are being pulled back, for example, the space meant for the front teeth gets used up and the bite does not end up where it should. A TAD solves this by giving the orthodontist an anchor that stays put, so only the teeth that are supposed to move actually move.
This idea is not new. Before mini-screws were common, orthodontists often relied on appliances worn outside the mouth to provide anchorage, which you can read about in our guide to headgear. TADs give orthodontists a way to get stable anchorage from inside the mouth.
When Are TADs Used in Treatment?
TADs are used when teeth need to move in a direction that is hard to achieve with braces alone, or when it is important that other teeth do not shift. Common situations include closing large spaces after a tooth is removed, pulling front teeth back to reduce protrusion, moving molars into a better position, and leveling a deep bite where the front teeth need to move in a precise way.
They also play a role in some expansion treatments for adults. MARPE, or miniscrew-assisted rapid palatal expansion, uses mini-screws on the mid-palatal suture along with an expander in the roof of the mouth to widen the upper jaw without surgery. Our article comparing MARPE and traditional palatal expanders explains how that approach differs from a standard expander.
For some patients, TADs can help make a complex case manageable with orthodontics. Whether a TAD makes sense depends on your bite, the direction your teeth need to move, and what the rest of your treatment plan looks like, so it is something your orthodontist decides case by case.
| Question | Braces alone | Braces with a TAD |
|---|---|---|
| Where does the anchor come from? | Other teeth in the arch | A mini-screw held in the jawbone |
| Do anchor teeth move too? | They can drift in the opposite direction | Unwanted movement is limited |
| Typical use | Most routine tooth movements | Difficult directions and cases needing precise control |
| Is it permanent? | Braces come off at the end | The TAD is removed once its job is done |
How Is a TAD Placed and Removed?
Placement is typically a short procedure. The area is usually numbed first, and the mini-screw is placed into the bone at the spot your orthodontist has planned, usually between the roots of neighboring teeth or in the roof of the mouth. Because the device is so small, most patients describe the experience as pressure rather than pain.
After placement, your orthodontist connects it to your braces or appliance with a spring, chain, or wire. It may stay in for several months, depending on how much movement is needed. When it is no longer needed, removal is usually quick, and the small site generally heals on its own.
Will a TAD Be Uncomfortable Afterward?
Most patients feel some tenderness around the site for a few days, which over-the-counter pain relievers and soft foods typically ease. The cheek or tongue may notice the device at first, the same way it notices new brackets. If something feels sharp or loose, contact the office so the team can check it.
How Do You Care for a TAD at Home?
Keeping the area clean is the most important part of looking after a TAD. The basics are simple and fit into the routine you already have with braces. Brush gently around the head of the mini-screw every time you brush your teeth, using a soft toothbrush. Food and plaque that collect around it can irritate the gum tissue, and healthy tissue helps the device stay stable.
Avoid pushing on the TAD with your tongue or fingers, and be careful with hard or sticky foods near it, just as you would with brackets. Keep up with your adjustment appointments so your orthodontist can check that the device is stable and that the attached springs or elastics are doing their job.
Is a TAD Right for Your Treatment?
Only an exam can answer that. Your orthodontist will review your X-rays and digital records, look at how your teeth need to move, and explain whether a TAD would make treatment more predictable. Speaks Orthodontics uses the iTero digital scanner to capture three-dimensional images of your teeth and bite, which helps with planning complex movements. You can read more about it on our orthodontic technology page.
Dr. Clif Speaks completed three years of specialty training in Orthodontics and Dento-Facial Orthopedics at Montefiore Medical Center/Albert Einstein College of Medicine and is board-certified by the American Board of Orthodontics. Learn more about Dr. Speaks and his background.
Frequently Asked Questions
Are TADs the same as dental implants?
No. A dental implant is permanent and replaces a missing tooth. A TAD is a miniature, temporary implant used only to anchor tooth movement, and it is removed when treatment no longer needs it.
Do TADs hurt?
The area is numbed before placement, so most people feel pressure rather than pain. Mild soreness for a few days afterward is common and usually manageable at home.
How long does a TAD stay in?
Only for the part of treatment where it is needed. Depending on how much movement is planned, that can be several months. Once the anchorage is no longer needed, your orthodontist removes it and treatment continues with your braces or appliance.
Does everyone with braces need a TAD?
No. Most patients finish treatment without one. TADs are used when a tooth needs to move in a difficult direction or when limiting unwanted movement is critical.
Ask About TADs at Your Complimentary Exam
If you have been told you might need a mini-screw, or you want to know whether your case could benefit from one, our team can walk you through your options. Schedule your complimentary exam at our Denver office.