What is a TAD? A TAD is a miniature screw that we position in the mouth.  It serves as an anchor for moving specific teeth in the most controlled and predictable way possible.  TADs are made of a sterile medical-grade titanium alloy.  They eliminate cumbersome appliances (e.g., headgear) and allow us to treat certain cases better and faster than ever before.  TADS are truly revolutionizing orthodontic treatment.  How exactly is the TAD positioned? After numbing the area where the TAD is to be placed, we use gentle pressure to insert it through the gums and into the bone between your teeth.  While it’s normal to assume that the procedure would be painful, it is actually pain-free.  We apply a fast-acting numbing gel where the TAD will be inserted.  After the gel desensitizes the area topically we use a small amount of local anesthetic that completely numbs it.  You may feel some slight pressure during insertion but no pain.  The entire procedure takes only a few seconds.  How long will the TAD need to stay in place? As the name implies, the anchorage device is temporary and is typically removed in a few months when it is no longer needed to assist in tooth movement. Will it hurt to remove it? No.  Before we remove it we’ll place numbing gel around the TAD and then back it out gently. The entire process takes only a few seconds. CARE INSTRUCTIONS FOR TADS Will I have pain after the TADS are placed? No.  Some patients say they feel a little pressure for a short period afterward.  Only a few patients have reported needing to use an over-the-counter medication such as acetaminophen or ibuprophen. What if it aches the next day? There is no call for alarm.  Minor aching associated with a new tooth movement is not only normal, but expected; however, if you have concerns, simply call our office and we’ll make an appointment to see you.  We’ll probably suggest that you take an over-the-counter remedy to lessen the ache. What if the TAD or its attachment causes an irritation inside my cheeks or lips? For immediate relief, you may be able to cover the attachment that is causing the irritation with a cotton swab or a small amount of wax.  Call the office and we’ll give you instructions and/or make an appointment to see you. What if the TAD comes loose? On occasion, a TAD might become a little loose.  In most cases this minor mobility is nothing to be concerned about; however, if you feel the TAD is excessively loose, or it is causing you discomfort, call the office and we’ll make an appointment to see you to determine if the amount of give is normal. How do I keep it clean? Rinse with chlorhexidine two to three times per day for the first seven days.  Dip a soft toothbrush in the chlorhexidine and brush lightly around the miniscrew during the first week.  Brush the "TAD" as if it is a tooth thereafter.  Contact the office if you experience andy swelling or persistent pain. Orthodontists have used TADs since 1983 and oral surgeons and orthopedists have used miniature screws like this for decades longer.  Recent refinements in the devices and the procedures for their use have propelled the application of TADs to a heightened level in orthodontics.  With TADs, orthodontic treatment options have never been greater.  We are proud to be at the forefront of this exciting technology and feel confident that your experience with it will be comfortable and the results exemplary. "I'M TOO OLD FOR BRACES!" You are NEVER too old to improve your smile, your bite or your self-esteem! With the average life expectancy continuing to to rise, why live 30, 40, 50+ years with problems that can be corrected in 16-24 months? WHAT ABOUT ADULT TREATMENT? Adult orthodontic patients discover that dramatic improvements in appearance and dental health can be obtained due to incredible advancements in tooth movement. Dr. Bhatia finishes most of her adult cases in 12-18 months with excellent stability and esthetics. Our adult patients make up about 20% of our practice. (see Complex Adult Treatment) WHY DO ADULTS WANT BRACES? Our adult patients represent a wide range of issues. Some patients had braces as a child and didn't wear their retainers. (We now teach our patients that retainers are a lifetime commitment of night-time wear only, as teeth can and will move for a variety of reasons. . .retainers are FOREVER!) Some patients come to us after their children are grown, when they have decided it is "now their turn to have a beautiful smile." Financial stability may have been attained, and many employers now offer orthodontic insurance benefits. We also see patients who need to close space from missing teeth in order to restore (crowns, bridges, etc) remaining teeth properly. Others merely want to straighten front teeth for esthetic reasons. As you can see, each case is unique and requires customized, individual attention. Dr. Bhatia offers the following treatment options to her patients who seek results later in life: invisalign® ---- the new 3-D computer technology that can now help straighten mild to moderately crowded and/or spaced teeth WITHOUT BRACES The less visible clear and gold brackets in addition to the traditional silver stainless steel High tech materials that decrease the amount of treatment time and frequency of visits with minimal discomfort during tooth alignment An office that is professional and specialized in all aspects: technically proficient clinical assistants, and friendly front staff