TADs in orthodontics: temporary anchorage devices

Page updated October 22, 2026.

TADs, short for temporary anchorage devices, are tiny screws an orthodontist places in the jawbone for part of your treatment. They give the braces or aligners a fixed point to pull or push against, so teeth can be moved in ways that are hard to manage otherwise (AAO) (Patel et al., Cureus). Here is what they're used for, how they go in and come out, whether they hurt, how often they fail, and what to ask about cost.

What TADs are

Conventional anchorage relies on things like headgear and elastics, which depend on the patient wearing them (Patel et al., Cureus). A TAD gives a stable anchor point in bone instead (Patel et al., Cureus). The AAO defines one as a miniature surgical screw placed temporarily to serve as an anchor (AAO), and lists TADs, with expanders and rubber bands, among the tools an orthodontist may add to braces (AAO).

They're small: a 2025 review gives lengths of 4 to 12 mm and diameters of 1.2 to 2.7 mm, and lists materials including titanium and stainless steel (Patel et al., Cureus). Cleveland Clinic describes them as mini-implants placed in the upper or lower jaw between the roots of neighboring teeth and removed afterward (Cleveland Clinic). You may also see them called mini-screws or mini-implants.

What TADs are used for

• Moving back teeth backward or upward (molar distalization and intrusion), and pulling front teeth back as far as possible (Patel et al., Cureus)
• Open bites. Cleveland Clinic reported two adults with anterior open bites treated with braces and TADs instead of jaw surgery (Cleveland Clinic). See open bite
• Gummy smiles caused by upper front teeth sitting too low, by moving the teeth up (J Clin Exp Dent review). See gummy smile
• Widening the upper jaw in adults. MARPE anchors a palate expander to miniscrews in the roof of the mouth (BMC Oral Health review). See MARPE
• Instead of headgear. Healthline lists TADs among the alternatives to headgear (Healthline); the review notes they give anchorage without relying on the patient to wear anything (Patel et al., Cureus). See orthodontic headgear

How TADs are placed and removed

1. Numbing. Placement is usually done under local anesthesia (Patel et al., Cureus).
2. Placement. The review describes removing a small circle of gum with a punch, drilling a shallow pilot hole and turning the screw into the bone (Patel et al., Cureus).
3. Use. The orthodontist connects the TAD to the teeth being moved, for example with elastics (Patel et al., Cureus).
4. Removal. When it's no longer needed, the screw is unscrewed, with or without a numbing gel or injection (Patel et al., Cureus).

X-rays are part of planning, because the screw has to sit between tooth roots: in the 2018 meta-analysis, screws that touched a root were 8.7 times as likely to fail (Mohammed et al., Prog Orthod).

Do TADs hurt?

Less than most people expect. The 2025 review says patients typically have little to no pain, and when there is pain it usually lasts no more than a day or two (Patel et al., Cureus). For general soreness from braces, see do braces hurt.

How often TADs fail

A TAD can loosen or come out before it's done its job. A 2018 meta-analysis pooling 61 studies found failure rates varied with where the screw was placed (Mohammed et al., Prog Orthod):

The authors concluded that miniscrews have acceptable success rates (Mohammed et al., Prog Orthod). If one comes loose, contact your orthodontist.

Looking after a TAD

• Keep the area clean. Inflammation or infection of the gum around a screw can lead to it failing (Patel et al., Cureus); brush gently around it as your orthodontist shows you
• Report looseness or swelling to your orthodontist. Too much force from elastics can loosen a screw (Patel et al., Cureus)

How much do TADs cost?

We haven't found a reliable published price for TADs, so we don't give one. The AAO advises asking exactly what an orthodontic fee includes (AAO), so ask whether TADs, their placement and their removal are covered, and what replacing a failed one costs. For the overall cost of braces, typically $3,000 to $7,000 for metal braces (CareCredit), see the braces cost calculator.