Short answer: An orthodontic mini-screw (TAD) is a very small titanium screw placed temporarily in the jawbone. It provides a fixed anchor point while teeth are moved and prevents other teeth from drifting unintentionally. It is placed under local anesthesia, is easily removed when its job is done and, unlike dental implants, is not a permanent structure.
In orthodontic treatment, moving teeth always requires an anchor point. While one tooth is being moved, the neighboring teeth must not shift unintentionally. This is where the orthodontic mini-screw comes in. Also known as a TAD (Temporary Anchorage Device), these small screws are used in braces or clear aligner treatments to make certain movements possible or more predictable. Below you will find, in plain language, what a mini-screw is, how it is placed and in which situations it is preferred.
What is an orthodontic mini-screw (TAD)?
An orthodontic mini-screw is a small screw, usually made of a titanium alloy and a few millimeters in diameter, placed in the jawbone or the palate area. Its job is to provide a fixed support point, that is, anchorage, during tooth movement. When teeth are moved by taking support from one another, some teeth can shift unintentionally; the mini-screw takes support from the bone to reduce this.
A mini-screw is a temporary structure that will be removed when treatment is over. In this respect it differs from permanent dental implants placed in the position of missing teeth; its size, purpose and duration of use are different.
What is anchorage and why is it important?
Anchorage is the fixed support that stands against the force applied to the teeth in orthodontics. Just as a ship's anchor must hold its place, if the support point moves, the tooth we want to move will not progress as planned either. In traditional methods, other teeth, or extraoral devices attached to the neck or head, can be used for anchorage. Extraoral devices cannot always be applied easily because they depend on patient compliance.
At this point the mini-screw offers an option that depends less on patient compliance; once it is placed in the right location, it provides steady support throughout the day. For this reason, in some treatments doctors may prefer a mini-screw, especially when the bone structure and tooth movement plan are suitable. For anchorage and related terms, you can look at our dental glossary.
In which situations is a mini-screw used?
A mini-screw is not needed in every orthodontic patient. Most treatments are completed successfully without a screw. The main situations in which a doctor may recommend a mini-screw are as follows:
- Moving back teeth backward: When the molars need to be moved back to relieve crowding or to open space for the front teeth.
- Space closure: When spaces left after extraction are to be closed without the back teeth drifting forward.
- Moving teeth up or down: To press the back teeth inward (intrusion) in conditions such as open bite, and to bring the front teeth up in a controlled way in conditions such as a gummy smile.
- Uprighting a tilted tooth: When a molar that is lying sideways or has tipped forward needs to be straightened.
- Midline correction: When teeth need to be shifted sideways to align the upper and lower midlines.
- Bite support in adult patients: In some adult patients, as a non-surgical alternative, in partially correcting the bite.
This list does not mean that a mini-screw works in every situation. Every patient's bone structure, tooth position and goal are different; the decision to use one is made by evaluating the exam, X-rays and measurements together. You can also read our article on open bite, which describes bite problems in more detail.
Is a mini-screw used together with clear aligners and braces?
Yes, mini-screws can be used with both fixed braces and clear aligner treatment. In clear aligner treatment, a mini-screw can be planned to provide extra support for certain movements where aligners alone may be limited. At our clinic, clear aligner treatment is carried out only with Invisalign; whether a mini-screw is needed is evaluated at the planning stage.
If there is a mini-screw during aligner treatment, special cut-outs can be prepared so that the aligner does not press on the screw. Because these details are worked out digitally at the planning stage, use is generally easy for the patient. You can review the scope of clear aligner treatment on our clear aligner treatment page.
How is a mini-screw placed?
Placing a mini-screw is generally a short intraoral procedure and in most cases is done in the chair in a single visit. The general flow of the procedure is as follows:
- Planning: With X-rays and, if needed, three-dimensional imaging, the area where the screw will be placed is determined so as not to harm the roots of neighboring teeth.
- Numbing the area: The site is numbed with local anesthesia. In some patients a surface numbing gel is also used. The aim is that no pain is felt during the procedure; a sensation of pressure may be felt.
- Placement: The mini-screw is screwed into the bone with a small hand tool. Most of the time no large surgical incision is needed.
- Check: It is checked that the screw is firmly seated, and if needed the appliance or elastic that will apply force is attached right away.
After the procedure there may be slight tenderness or swelling in the area. These symptoms usually go away within a few days. Choosing soft foods and keeping the area clean as your doctor recommends is enough. If the symptoms increase, or you notice redness or a pus-like discharge in the area, you should contact your doctor.
Is a mini-screw safe?
The use of mini-screws in orthodontics is a common and well-known method; with correct planning and appropriate patient selection it is generally considered safe. Still, like every medical procedure, it has some possible risks:
- The screw loosening or falling out over time; in this case it may need to be replaced.
- Irritation, redness or infection in the gum around the screw; oral hygiene is important for this risk.
- The screw coming close to neighboring tooth roots; this risk is minimized with correct planning and imaging.
- Extra care being needed for placements near sensitive areas such as the palate or sinus.
Smoking, uncontrolled systemic diseases and inadequate oral hygiene can negatively affect healing and the screw's hold in the bone. For this reason, it is important to inform your doctor in detail about your health history.
How is a mini-screw cared for?
Keeping the gum around the screw healthy directly affects how long the screw can stay in the mouth. It is important to clean the area gently with a soft toothbrush, to use a mouthwash or gel if your doctor recommends one, and not to keep touching the screw with your tongue or finger. You should also take care that very hard, sticky foods do not catch on the screw. For daily oral care, our article on correct brushing technique can be a guide.
How is a mini-screw removed, and does it leave a mark?
When the targeted tooth movement is completed, the mini-screw is removed in the office, usually in a very short time. In many patients it can be taken out by loosening it with just a hand tool, without anesthesia; surface numbing is applied if needed. After removal, the small hole where the screw was usually heals quickly. No permanent mark is expected on the gum; still, healing can vary from person to person.
After the mini-screw is removed, treatment is completed with the final arrangement, protected by a retainer. For the teeth to stay in their new position, retainer use should be continued according to the doctor's recommendation.
Orthodontic exam in Ankara
If you would like to find out whether your orthodontic treatment needs anchorage support or to ask questions about mini-screws, you can have an exam at our clinic in Park Oran Ofis, Çankaya. After the exam, your treatment plan, possible alternatives and pricing are shared with you in writing. For an appointment, you can use our contact page.
Frequently asked questions
Does an orthodontic mini-screw hurt?
The area to be treated is numbed with local anesthesia, so no pain is expected during the procedure; there may only be a sensation of pressure. Slight tenderness may be seen for a few days afterward and usually eases on its own.
Is a mini-screw the same as a dental implant?
No. A dental implant is placed permanently in the position of a missing tooth. An orthodontic mini-screw is a temporary device that provides support only during treatment and is removed when the job is done.
How long does a mini-screw stay in the mouth?
The time varies according to the teeth to be moved and the treatment plan. It may be a few months in some cases and longer in others. The doctor removes the screw when the target movement is completed.
Is a mini-screw necessary in clear aligner treatment?
Not in most patients. It can be planned for extra support only in certain special movements where aligners alone may be limited. Whether it is needed is determined after the exam and planning.