Sometimes, braces alone can bring about fantastic results. In other cases, however, we need an anchorage point for a pushing and pulling force to help facilitate movements that can’t be achieved with just brackets and wires. In the past, headgear was the go-to treatment in many of these instances. As you can probably guess, not too many patients were thrilled with the prospect of having a large, bulky, highly visible appliance attached to their hardware. Thankfully, these days, there’s an alternative: a temporary anchorage device (TAD). I believe in using modern techniques that can make treatment more effective and easier for my patients at Richard Chan Orthodontics, which is why I’m trained in the use of TADs. Though TADs are an amazing tool, not a lot of patients are all that familiar with them, so I’m covering the basics.
What is a TAD in Orthodontics?
An orthodontic TAD is a tiny dental implant that looks like a mini screw that’s temporarily placed through the gum tissue and into the jawbone. I know, that sounds a little scary but, as I’ll get to shortly, the process is actually painless. TADs are usually made of titanium alloy, which is a durable, safe, biocompatible material. Once the TADs are in place, they serve as an anchorage, which means they are a fixed point that can be used to provide force to shift the teeth in the desired direction. With breakthroughs like TADs, orthodontists can move teeth in ways that weren’t possible in the past, allowing us to treat some seriously complex cases. Essentially, it lets me create a customized system for exerting pressure that’s tailored to your smile needs. When I achieve the movements I want, I remove the orthodontic TADs. Some patients will have their temporary anchorage devices for several months, while others will have TADs for the duration of their orthodontic treatment.
How Can TADs Help Straighten Teeth?
When we straighten the teeth with braces or Invisalign, the continuous force that’s exerted from the appliance causes the cells in the bone and periodontal ligament to break down, allowing the teeth to move to their new places. Then, the bone and tissue reform and hold your teeth in position. To be able to get the necessary force to do this, there has to be something fixed to push or pull against. Often, the back teeth can serve this purpose. But, if we need the anchor to be somewhere where there isn’t a tooth that can do the job or the force is strong enough that it will shift the anchor teeth in a way that’s undesirable, then, it’s not an option.
As I noted, a temporary anchorage device serves as this fixed anchor point instead. Depending on your needs, I may push or pull a tooth (or teeth) in a certain direction directly from the TAD. I can also use it to anchor a tooth in place so that it doesn’t move while your braces wire shifts its neighbors into place. With an orthodontic TAD, I’m able to accomplish asymmetrical tooth movements too, meaning I can move teeth in the same arch in different directions. Because TADs give orthodontists the ability to achieve more complicated tooth movements than ever before, they can help patients avoid orthognathic surgery (jaw surgery), in some cases, and get dramatic, lasting results with just braces. They can also reduce treatment time by moving the teeth more efficiently.
What is the Procedure for Getting Temporary Anchorage Devices?
First, I use x-rays of your mouth to make sure there is enough space and bone density in the area I want to insert the TAD. When the ideal positioning is determined, I inject a local anesthetic into your gums to numb the area (the same shot you get when you have a cavity filled). This way, you won’t feel a thing during the procedure. I then place the TAD through the gum tissue and into your jawbone. Once it’s in place, it almost always stays there until it’s removed.
The first thing patients usually ask is, “Do orthodontic TADs hurt?” and the answer is, no. You should never feel serious orthodontic TAD pain. While your gums can be a little sensitive for the first 24 hours after your temporary anchorage device is placed, the discomfort is minor and can be managed with an over-the-counter pain reliever. As soon as the procedure is over, you can go about the rest of your day and there is no downtime. Removing TADs is just as painless as getting them put in and your gums and bone will heal quickly.
How do You Care for TADs?
It’s extremely important to keep the TAD and the area around it clean and free of plaque. Otherwise, the gums can get inflamed, leading to infection and, occasionally, implant failure, which is when the body rejects the implant. Throughout your treatment while the TAD is in, you’ll gently clean it and the surrounding gums with a normal, soft toothbrush. You shouldn’t use your electric toothbrush directly on the TAD. It can take a few days to get acclimated to having the TAD in your mouth. If it causes any irritation, simply cover it with some orthodontic relief wax.
It’s rare but, every so often, a TAD can become loose before it’s supposed to come out. This isn’t painful. However, let us know right away so that we can determine if it needs to be replaced. This will ensure your treatment stays on track.
Now that you’re well-versed in what a temporary anchorage device is and how it works, if you’re ready to learn more about the modern, high-tech approach to care at Richard Chan Orthodontics, book a free consultation. I’ll help you decide on the treatment that will give you your best smile. Schedule your visit at our Alaska, Bothell, Monroe or Mill Creek orthodontic practice today!
