Mini-screws (TADs)
Small anchors placed temporarily in the jawbone for precise tooth movements.
Does this sound familiar
Patients most often come for this with these words:
I have been told I need a mini-screw and I am worried
There is a problem braces alone cannot fix
Too much gum shows when I smile
I want to create space without extractions
My front teeth do not meet
A mini-screw (TAD, temporary anchorage device) is a small titanium screw placed temporarily in the jawbone. It acts as a fixed anchor for moving teeth. A good orthodontic result is rarely built with a single movement, and sometimes extra precision is needed for a beautiful finish. Meta-analyses show that mini-screws considerably reduce anchorage loss compared with conventional anchorage methods.
What they are used for
- Gummy smile correction. See: gummy smile correction
- Preventing the back teeth from coming forward when the front teeth are retracted
- Creating space without extractions by moving teeth backwards
- Correcting an open bite by moving the back teeth upwards
- Correcting over-erupted or tipped molars
- Correcting the midline and asymmetries
- Movements that are difficult with braces or aligners alone
Why a fixed anchor is needed
Every action has a reaction. To pull a tooth, you need an anchor somewhere else, usually other teeth. But they move unintentionally too. A mini-screw stays fixed in the bone and allows only the teeth that need to move to move. More: what is a mini-screw.
How placement goes
- I choose the site with an X-ray and examination: between the roots or in the palate
- Local anaesthesia
- The screw is placed in a few minutes, usually without an incision
- An elastic or spring is attached to the screw
- When the relevant stage is over, the screw is removed easily
There may be mild tenderness in the first days. Often not even a painkiller is needed. The site where the screw was removed heals within a few days.
Mini-screw and implant
| Mini-screw | Implant | |
|---|---|---|
| Purpose | Temporary anchorage | Permanent replacement of a lost tooth |
| Bond with bone | Does not fully fuse | Fully fuses |
| Placement | A few minutes, local anaesthesia | Surgical procedure |
| Duration | Months, then removed | For life |
Care and risks
- Clean around the screw every day with a soft brush
- Do not wiggle the screw with your tongue or fingers
- Sometimes a screw loosens: this is not dangerous and, if needed, it is placed elsewhere
- If there is pain, swelling or inflammation around it, message me
- Rarely, if a screw is close to the roots, we change its position
What the science says
- Meta-analysis (2011): mini-screws are clinically effective and reduce anchorage loss.
- Systematic review and meta-analysis (2017): during en-masse retraction of the front teeth, mini-screws give less anchorage loss than conventional anchorage.
- Systematic review (2021): intrusion of the front teeth with mini-screws effectively reduces a gummy smile without surgery.
A mini-screw is a small detail, but sometimes it changes the whole result.
A mini-screw in daily life
A mini-screw takes up very little room in the mouth and most patients stop noticing it after a few days. Its effect on speech and eating is small. The only condition is keeping the area around the screw clean, because inflammation can make the screw loosen. A soft brush and, if needed, a mouthwash are enough.
When it may not be suitable
- When the quality or thickness of the bone is not sufficient for a screw
- When there is inflammation at the site where the screw would go
- When it is not possible to follow the hygiene rules
Frequently asked questions
Is placing a mini-screw painful?
It is done under local anaesthesia and most patients feel only pressure. There may be mild tenderness in the first days.
How long does a mini-screw stay?
For as long as the relevant stage of treatment, usually a few months.
What should I do if the screw falls out?
Do not worry, keep it and message me. If needed, we place the screw again or somewhere else.
Are mini-screws placed in children too?
They are used in teenagers. In young children the bone is still developing, so the decision is made individually.
Are mini-screws used with aligners too?
Yes, as additional anchorage for movements that are difficult with aligners.
What can I eat on the day the screw is placed?
Once the numbness wears off you can eat ordinary soft food. Avoid very hard food on the side of the screw for a few days.
Read more
Scientific sources
The information in this article is based on the following peer-reviewed scientific articles and systematic reviews.
- Papadopoulos, M. A., Papageorgiou, S. N., & Zogakis, I. P. (2011). Clinical effectiveness of orthodontic miniscrew implants: a meta-analysis. Journal of Dental Research, 90(8), 969-976. [PMID: 21593250] | [DOI: 10.1177/0022034511409236]
- Antoszewska-Smith, J., Sarul, M., Łyczek, J., Konopka, T., & Kawala, B. (2017). Effectiveness of orthodontic miniscrew implants in anchorage reinforcement during en-masse retraction: A systematic review and meta-analysis. American Journal of Orthodontics and Dentofacial Orthopedics, 151(3), 440-455. [PMID: 28257728] | [DOI: 10.1016/j.ajodo.2016.08.029]
- Alshammery, D., Alqhtani, N., Alajmi, A., Dagriri, L., Alrukban, N., Alshahrani, R., & Alghamdi, S. (2021). Non-surgical correction of gummy smile using temporary skeletal mini-screw anchorage devices: A systematic review. Journal of Clinical and Experimental Dentistry, 13(7), e717-e723. [PMID: 34306536] | [DOI: 10.4317/jced.58242]