What Are TADs?
TADs — Temporary Anchorage Devices, also called orthodontic mini-screws, mini-implants, or micro-implants — are small titanium screws temporarily placed in the jawbone to create a stable anchor point for tooth movement. They stay in for a few months, do their job, and come out when the movement is complete.
TADs solve one of the oldest problems in orthodontics: moving one tooth without moving the teeth next to it. Before TADs were available, the only way to anchor an orthodontic force was against other teeth — which meant those teeth would drift in the opposite direction (an effect orthodontists call reactive movement). TADs eliminate reactive movement because they are anchored directly in bone, not in teeth. Whatever force the wire or elastic pulls, the mini-screw holds fast.
Why Bold Bite Orthodontics Plans TADs Digitally First
When TADs Are the Right Tool
TADs are not used for every orthodontic case. They are the right tool when the required tooth movement cannot be achieved predictably with braces or clear aligners alone. Common indications Dr. Marty and Dr. Cao evaluate at Bold Bite Orthodontics:
Molar Intrusion for Open Bite
MARPE (Adult Palatal Expansion)
Impacted Canine Traction
Asymmetric Space Closure
Severe Crowding — Distalization
Gummy Smile Correction
How TAD Placement Works at Bold Bite Orthodontics
3D CBCT Evaluation
Every new-patient consult at Bold Bite includes a Vatech Green CT scan at no charge. Dr. Marty and Dr. Cao use it to measure cortical bone thickness, locate tooth roots, and map nerve canals and sinuses before any appliance or mini-screw is planned. The exact TAD position, angle, and size are chosen on the scan — not guessed chairside.
Surgical-Partner Coordination
Bold Bite Orthodontics coordinates TAD placement with Dr. Doug Storch at Modern Perio in Jacksonville. Dr. Marty and Dr. Cao send the full 3D plan — CBCT, intraoral scan, and the target force system — so Dr. Storch places the mini-screw to the exact specification the orthodontic mechanics require. One team, one plan, two offices with complementary expertise.
Short In-Office Placement Visit
Placement itself takes roughly 10 minutes per mini-screw. A small amount of local anesthetic numbs the gum, similar to a filling. Most patients describe the sensation as pressure, not pain. There is no cutting of gum tissue and no drilling of tooth structure — the self-drilling screw threads directly through the tissue into the bone.
Immediate Loading and Active Orthodontics
Unlike dental implants (which need 3–6 months to integrate), TADs can usually be loaded the same day or within a week. Dr. Marty or Dr. Cao attaches the spring, elastic chain, or wire at the next Bold Bite visit, and tooth movement begins right away. Follow-up checks happen at every regular orthodontic appointment.
Removal
Once the tooth movement is finished, the TAD is removed in a short appointment — usually without anesthetic, usually in under five minutes. The soft tissue heals within a few days and the bone remodels to fill the channel within weeks. There is no visible scar.
Coordinated Care: How TAD Cases Are Handled at Bold Bite Orthodontics
Some orthodontic offices place every TAD themselves; others refer every TAD out. Bold Bite Orthodontics takes a coordinated approach built around the specific anatomy of each case.
MARPE cases — the palatal-expansion mini-screws that go into the roof of the mouth — are placed in-office by Dr. Cao as part of the MARPE appointment. That workflow is described in detail on the palatal expander page.
Standalone anchorage TADs — the mini-screws used for molar intrusion, asymmetric space closure, impacted canine traction, distalization, and gummy-smile correction — are placed by Dr. Doug Storch at Modern Perio in Jacksonville. Dr. Storch is Bold Bite’s trusted surgical partner for all non-MARPE anchorage cases. The reason is technical: many anchorage TADs sit between dental roots or in regions with complex bone anatomy where a periodontist’s surgical training and flap-handling skills deliver a more predictable result than an orthodontist placing the same screw chairside.
Dr. Marty and Dr. Cao design the full orthodontic mechanics from the Vatech Green CT and intraoral scan before the surgical appointment is scheduled. Dr. Storch receives the complete digital plan — 3D imaging, exact target site, angle, and length — so the mini-screw is placed to the ortho specification, not guessed at chairside.
Modern Perio is a Jacksonville practice, not a cross-town referral. Most TAD placements are scheduled within a week of the treatment-planning appointment at Bold Bite, and follow-up checks happen at the regular orthodontic visits without another surgical trip.
Most TAD failures are soft-tissue events, not bone events. A periodontist trained to manage inflamed or thin tissue around the screw head has a real advantage on the sites where TADs most often loosen. Bold Bite concentrates on the mechanics; Dr. Storch concentrates on the biology.
A few Jacksonville orthodontic offices advertise in-office TAD placement. Bold Bite could do the same, but has chosen the coordinated-care model because the outcomes are more predictable when the right specialist handles each part of the case. The goal is the movement, not the marketing badge.
If a TAD Loosens Mid-Treatment
What Does It Feel Like?
The most common question parents and adult patients ask about TADs is whether they hurt. The honest answer: the placement itself is uncomfortable for a few seconds (similar to the first 3–5 seconds of a dental injection), then shifts to pressure rather than pain. Once the anesthetic wears off, most patients report:
Pain Management Note — Acetaminophen, Not Ibuprofen
How Much Do TADs Cost?
When TADs are clinically indicated as part of a comprehensive orthodontic plan at Bold Bite Orthodontics, the orthodontic portion of the case — treatment planning, digital workup, follow-up checks, and TAD coordination — is included in the overall comprehensive fee. There is no separate anchorage surcharge from Bold Bite.
The surgical placement fee for standalone anchorage TADs is billed directly by Modern Perio. That fee varies with the number of mini-screws and the complexity of the site, and is quoted transparently to the family before placement is scheduled. Most PPO dental and orthodontic benefits apply a portion of the cost, and HSA / FSA funds are eligible for both the orthodontic and surgical charges.
MARPE TADs — which are placed in-office by Dr. Cao — are included inside the MARPE appliance fee, with no separate surgical bill. See the expander page for the full MARPE cost breakdown.
For a precise quote with insurance applied, use the braces cost calculator or Invisalign cost calculator, or book the complimentary consultation.
