Skeletalanchorage
shorter treatment
no more headgears
predictable results
avoids surgery
avoids tooth extractions

How it works

 
General Principles

While teeth at times may appear to have a mind of their own they are no more or less special than nature in general. Hence they abide by nature's laws. Sir Isaac Newton described some of those laws a long time ago but since they are fundamental laws of physics, they still hold true today and will continue to do so for as long as the earth exist. Particularly his 3rd law of physics has great importance in orthodontics and is at the root of many problems encountered with braces. It states that:

Every force creates an equal and opposite force.

For braces this means simply that if your orthodontist moves your front teeth back (for example to close a space and correct an overbite) your back teeth will move forward. That could be a problem as it might prevent your overbite from being fully corrected. Sounds complicated? Let's use a different example:

Say you are trying to pull a heavy object with a rope, but you are standing on ice. Could you now see how, while the object slides in your direction, you might slide towards the object? It's no different in your mouth. What is happening is basically a tug'o'war between teeth! What could you do to improve your stance so you can better pull the object? How about a spike in the ice?
Perhaps you can envision how this spike will prevent you from slipping, allowing you to stand firmly and predictably pull the object in the desired direction. Well the situation in your mouth is really no different. We can also use a "spike in the ice" to make sure that certain teeth move while others don't. Only that we don't actually use a spike, we use a TAD which stands for Temporary Anchorage Device.


TAD - Temporary Anchorage Device
A TAD is just as non-threatening as the name, TAD, makes it sound. It is simply a very small screw that goes wherever the orthodontist needs "a
spike in the ice" to move your teeth. Just like in the picture on the left side where our goal is to move the last molar forward in a patient that is missing a first molar. This will save the patient an expensive bridge restoration or the even more expensive dental implant restoration. Obviously the TAD cannot move the tooth by itself. It will have to be connected to the teeth - in this particular patient with a light spring. I am sure by now the concept is very clear. The spring will now pull the back molar forward, closing the space without affecting the other teeth. The TAD simply acts as an anchor and it will be removed once it is no longer needed. It is in place only temporarily for as long as it is needed to move teeth. Hence Temporary Anchorage Device, or TAD.

The Power of TADs
Orthodontists are so excited about these little gadgets as they allow us to move teeth in all directions: up or down, forward or backward, in or out, or keep them exactly where they are at! A lot of those movements cannot be performed with braces alone and preventing teeth from moving during orthodontics is nearly impossible. In the old days we used headgears (night brace) and other beloved contraptions to achieve our goals but patients hated them and therefore did not wear them. Unfortunately a headgear does preciously little if it sits in a drawer in your bedroom. On the other hand, my patients tend to not mind their TADs. Some may be a little dubious when they first hear about them but are impressed by the absence of pain and the fantastic results achieved. Especially when compared to the alternatives which can often times be avoided:
  • removal of teeth
  • jaw surgery
  • headgear (night brace)
  • prolonged rubber band wear
Think about it, what sounds worse? Having one little TAD placed, or having four teeth removed? Or worse, jaw surgery? I think it's pretty obvious. But how are TADs actually placed?

 TAD Placement

You're probably going to be surprised to hear that most placements require no shots. TADs are so small that all you generally need is a little numbing gel on your gums. Only if your gums are really thick or not healthy you might need a few drops from a syringe but it will be nothing like the shot you may be used to from the dentist. Once you are numb the TAD is placed by slow and gentle clockwise turning very much like a screw you may have placed before, only much smaller. A lot of my patients don't even realize the procedure started by the time it's over. It takes only a few minutes total to place. After the placement your orthodontist will connect the TAD to your braces. That may be over in a matter of seconds or minutes, depending on why the TAD is used in your case. Either way, you can go home afterwards, do not have to worry about healing or pain, and can expect a wonderful final treatment result.


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