Behl Orthodontics

TADs in Orthodontics: What They Are, Whether They Hurt and How Long They Stay

November 1, 2026

Reviewed by Dr. Yugal Behl, orthodontist · November 1, 2026

TADs (temporary anchorage devices) are tiny titanium mini-screws that an orthodontist places in the jawbone to give teeth a fixed point to push or pull against. They let us move specific teeth without the other teeth drifting, and they come out when that job is done. Placement takes a numbing step and a few minutes, and most people say it feels like pressure rather than pain.

What does “TADs” mean in orthodontics?

TADs stands for temporary anchorage devices. You may also hear them called mini-screws, miniscrews, mini-implants or skeletal anchorage. Unlike a dental implant, a TAD isn’t designed to fuse with the bone or stay forever. It’s held in place mechanically for as long as treatment needs it.

Every tooth movement pushes back on something. With braces or aligners alone, the “anchor” is usually other teeth, and those teeth can shift too. A TAD gives that force a stable anchor in bone instead, so the teeth we want to move go where we plan and the others stay put.

What are TADs used for?

Your orthodontist may suggest a TAD when using teeth as the anchor isn’t enough, for example to:

Move back teeth forward or backward to close or open space
Pull front teeth back after extractions, without the back teeth moving forward
Move teeth up or down to help correct an open bite or an over-erupted tooth
Straighten or upright a tipped molar
Correct a midline that’s off-center

In some cases, TADs can take the place of headgear. A 2019 review of clinical trials found mini-screws held the back teeth in place better than headgear or a palatal bar while the front teeth were pulled back.

TADs work with braces and with Invisalign clear aligners. Whether you need one depends on your bite. Many patients don’t.

How are TADs placed?

At Behl Orthodontics, our orthodontists place most TADs in the office during a regular visit. For more complex placements, a periodontist (a gum and bone specialist) we work with may place them instead. Either way, the steps are similar:

Numbing. The gum around the spot is numbed with a gel and a local anesthetic.
Placement. The TAD is gently placed through the gum into the bone between or near the roots of the teeth. You may feel pressure, but you shouldn’t feel sharp pain.
Connecting. Your orthodontist attaches a small elastic, spring or wire from the TAD to your braces or aligners, either right away or at a later visit.

The placement itself usually takes just a few minutes, and you can usually go back to your day afterward.

Do TADs hurt?

Most patients describe placement as pressure, not pain, because the area is numb. Afterward, the gum may feel tender for a day or two. Over-the-counter pain relievers, taken as the label directs, are usually enough. If the head of the TAD rubs your cheek or lip, a little orthodontic wax over it helps.

Once the tissue settles, most people stop noticing the TAD. Removal is quick, and it usually doesn’t need any numbing.

How long do TADs stay in?

It depends on what the TAD is doing. Some stay in for a few months to complete one specific movement. Others stay for most of treatment. Your orthodontist will tell you the plan for your TAD at the start, and check it at each visit.

When the movement is done, the TAD is removed, often at a routine appointment. The small spot where it sat usually heals quickly.

How do I take care of a TAD?

Brush gently around the TAD twice a day with a soft toothbrush. Keeping the gum around it clean helps it stay stable.
Rinse after meals if your orthodontist recommends it.
Don’t touch or push on the TAD with your fingers or tongue.
Avoid chewing very hard or sticky food right on that spot.
If you smoke or vape, ask about quitting. Smoking was linked to more TAD failures in research.

What if a TAD gets loose?

A loose TAD isn’t usually a sign of a serious problem. Two large reviews of the research each found that about 13.5% of mini-screws, roughly 1 in 7, came loose or failed during treatment. The gum around the TAD and smoking both affected that risk. If a TAD feels loose, comes out, or the gum around it gets swollen or sore, call us. We’ll check it and, if it’s still needed, may place a new one nearby or adjust the plan.

Are TADs safe?

TADs have been used in orthodontics for many years and are made of medical-grade titanium. The most common issues are gum irritation around the screw and the TAD loosening. Your orthodontist plans the position carefully to stay clear of tooth roots and other structures, and checks the TAD at each visit.

When to see an orthodontist

If another orthodontist or your dentist has mentioned TADs, or you’d like a second opinion on a complex bite, a consultation is a good place to start. We’ll explain whether a TAD would help in your case, what it would do, and what the alternatives are. See how we treat common bite problems and when jaw surgery is considered instead.

Request a free consultation or call or text us at (757) 224-3004.