Temporary anchorage devices, or TADs, are tiny titanium screws that an orthodontist places just beneath the gum tissue to act as a fixed, unmoving point of leverage for moving teeth. Unlike your teeth, a TAD doesn’t shift when force is applied to it, which lets our orthodontists move specific teeth more precisely — often accomplishing bite corrections that would otherwise require jaw surgery or reliance on a patient’s cooperation with headgear.
How TADs Work
Every orthodontic movement needs two things: a force and something for that force to push or pull against. Traditionally, that “anchor” is another tooth or group of teeth — which means the anchor teeth also move a little, sometimes in directions you don’t want. A TAD solves that problem by anchoring directly into bone. Because bone doesn’t move the way teeth do, an orthodontist can attach a spring, wire, or elastic to the TAD and apply a controlled, one-directional force to a specific tooth or group of teeth without disturbing the rest of the bite.
Placement is a quick, minimally invasive procedure done right in the orthodontic office, usually with just a local anesthetic. Most patients describe the sensation as similar to a routine dental injection, and any soreness afterward is comparable to what you’d feel after an adjustment to braces.
When Are TADs Used?
TADs come up most often in cases that need precise, complex tooth movement:
- Closing large gaps without tipping or drifting the neighboring teeth
- Correcting an open bite by pulling back teeth into proper vertical position
- Intruding or moving a single tooth that has erupted too far, without affecting the rest of the arch
- Correcting significant midline discrepancies or asymmetries
- Reducing the need for jaw surgery in certain moderate skeletal bite problems by allowing dental movement to compensate for it
They’re also a helpful alternative when a patient’s bite correction would otherwise depend on headgear or rubber bands worn between the jaws, since a TAD does its job without requiring extra cooperation at home.
Are TADs Uncomfortable?
Most patients adjust to a TAD within a few days. There can be mild tenderness at the placement site initially, and you’ll want to keep the area clean the way you would around a healing dental site, but TADs don’t interfere with eating, speaking, or daily brushing and flossing once you’re used to them. Because they’re small and tucked against the gum line, most people find them far less noticeable day to day than they expected.
How Long Do TADs Stay In?
A TAD stays in place only as long as it’s needed for that specific movement — often a matter of months rather than the full length of treatment. Once the tooth movement it was supporting is complete, your orthodontist removes it in a simple in-office procedure, and the small opening where it sat heals quickly on its own.
At Davis & Goldberg Orthodontics, we use TADs selectively — only in the cases where they genuinely give us better control over a tooth movement than we’d have otherwise. Whether a TAD makes sense for your treatment plan comes down to what your specific bite needs, which our orthodontists can map out using digital scans and X-rays during a consultation.
TADs vs. Headgear and Elastics
Before TADs became widely available, orthodontists relied heavily on headgear or intermaxillary elastics (rubber bands worn between the upper and lower jaws) to accomplish many of the same goals — moving a group of teeth, or correcting a bite discrepancy, using anchorage from outside the mouth or from the opposite jaw. Both of those methods depend heavily on patient cooperation, since they only work if they’re worn as prescribed, and both apply force to a broader area rather than a single precise point.
A TAD sidesteps that cooperation problem entirely, since it’s fixed in place and working continuously without any daily effort from the patient. It also allows more targeted movement of a specific tooth or small group of teeth, rather than distributing force across the whole arch. That said, TADs aren’t a wholesale replacement for headgear or elastics — each tool has situations where it’s genuinely the better choice, and our orthodontists select based on what a specific bite actually needs.
What to Expect at Placement
At your appointment, the gum tissue around the placement site is numbed with a local anesthetic, and the TAD itself is placed with a small handheld driver — the process typically takes only a few minutes per TAD. You’ll be able to eat and go about your day afterward, though we’ll usually recommend softer foods and gentle brushing around the site for the first few days while it settles in. A follow-up visit confirms the TAD is stable before we begin attaching the springs, wires, or elastics it will support.
Planning a TAD With Digital Technology
Deciding exactly where to place a TAD, and how much force to apply once it’s in, benefits enormously from precise imaging. At Davis & Goldberg Orthodontics, our orthodontists use digital X-rays and 3D scans to map the bone density and root positions around a proposed placement site before we ever pick up a driver, which helps us choose a spot that’s both stable for the TAD and safely clear of the surrounding tooth roots. That same digital record lets us track the specific tooth movement the TAD is supporting over time, so we know exactly when its job is done and it’s ready to come out.
What Makes a Good Candidate for a TAD?
Not every patient needs a TAD, and not every case benefits from one. Good candidates typically have a specific, well-defined movement that would otherwise be difficult to achieve with conventional anchorage — closing a large space evenly, correcting an open bite with more precision than braces alone allow, or managing a significant asymmetry. Bone density and gum health around the proposed site also matter, which is part of why an evaluation and imaging always come before a placement decision, rather than adding a TAD as a routine, default step in every treatment plan.
Frequently Asked Questions
Do TADs hurt to place or remove?
Placement and removal are both quick procedures done with local anesthetic, and most patients report only mild, short-lived soreness afterward — similar to what you might feel after a routine orthodontic adjustment.
Can a TAD fall out on its own?
It’s uncommon, but a TAD can occasionally loosen, especially if the area isn’t kept clean or if it gets bumped. If a TAD ever feels loose or falls out, contact our office so we can evaluate whether it needs to be replaced.
Are TADs used for adults, kids, or both?
TADs can be used in both adult and adolescent patients once the jaw has developed enough bone density to support one securely, which your orthodontist will assess as part of treatment planning.
Will insurance cover a TAD?
Coverage varies by plan. Our team can help you understand how a TAD factors into your overall treatment cost and what your specific insurance covers before treatment begins.
Can a TAD be used alongside clear aligners, not just braces?
Yes — TADs can provide anchorage for aligner treatment as well as braces, giving your orthodontist a fixed point to attach auxiliary forces to when a movement needs more precision than the aligner alone can provide.
Disclaimer: The content on this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.