--- title: "TADs (Mini-Implants) in Braces UK: Uses, Pain, Cost" url: https://virtualconsultant.online/guides/temporary-anchorage-devices-uk description: "TADs are tiny titanium screws that anchor tooth movement. See what they are used for, how placement feels, failure rates and typical UK cost." updated: 2026-10-15T00:00:00Z publisher: Virtual Consultant Online --- Braces Complex Treatment Anchorage TADs # Temporary Anchorage Devices UK A temporary anchorage device (TAD) is a tiny titanium screw placed in the jawbone to give your orthodontist a fixed point to move teeth against, so neighbouring teeth do not shift unintentionally. Placement takes minutes under local anaesthetic and the screw is removed once it is no longer needed. [Start Photo Assessment](https://virtualconsultant.online/evaluations/quote) [Compare Costs](https://virtualconsultant.online/costs) ## What temporary anchorage devices are Temporary anchorage devices, usually called TADs or mini-implants, are very small self-drilling titanium screws typically measuring 1.5 to 2 mm in diameter and 6 to 12 mm in length. They are placed directly into the jawbone — usually between the roots of two teeth in the posterior buccal alveolus, the palate, or the retromolar area — where they act as a fixed point from which orthodontic forces can be applied. Unlike natural teeth, a TAD does not move when force is applied to it. This property is called absolute skeletal anchorage and it is the core reason TADs are so clinically valuable. Before TADs became widely used from the early 2000s onwards, orthodontists often had to rely on headgear or extra-oral appliances to achieve the same effect. TADs remove the need for patient cooperation with bulky appliances and eliminate unwanted movement of anchor teeth. ## How they provide absolute anchorage Every force in orthodontics has an equal and opposite reaction. When a clinician wants to retract front teeth after extractions, the back teeth — used as an anchor — can drift forward unless they are held firmly. With traditional anchorage, molars and premolars used as anchors absorb some of that reaction force and move slightly, consuming space that was intended for the front teeth. A TAD placed in bone does not move. Force applied from a TAD acts solely on the tooth being moved. There is no reciprocal movement of an anchor tooth, which means the full mechanical advantage of the applied force goes precisely where the clinician intends. This level of control was previously impossible with teeth alone and represents one of the most significant advances in contemporary fixed appliance orthodontics. ## Clinical uses for TADs The versatility of TADs means they are now used across a wide range of clinical situations. In deep bite correction, a TAD in the palate or posterior alveolus allows the upper molars to be intruded — pushed upward into the bone — so that the lower jaw rotates open and the bite reduces. Without skeletal anchorage this is very difficult to achieve reliably with fixed braces alone. After extractions, TADs allow the orthodontist to retract the front teeth en masse while holding the back teeth rigidly in place, so that the extraction space is closed where it is needed rather than distributed between front and back movement. Molar distalisation — moving upper back teeth further back to create space or correct a Class II relationship — is another common use, often replacing the need for headgear. TADs are also used to help correct a canted occlusal plane, where one side of the bite is higher than the other, by applying intrusive force to the elevated side. Finally, they are valuable for opening or closing specific spaces in cases where asymmetric tooth movement is required, such as when a tooth has been lost on one side only. ## Placement procedure Placement is straightforward and carried out entirely in the orthodontic surgery chair. Topical anaesthetic gel is applied to the overlying gum for two to five minutes, followed by a small amount of local anaesthetic injected around the target site. Once the area is numb, the TAD is inserted using a specially designed hand driver or a low-speed contra-angle handpiece. The procedure usually takes under five minutes from start to finish. Most patients report feeling pressure and vibration but very little pain during placement because the bone itself contains few pain receptors. No incision is normally required; the TAD passes through the gum and into bone in a single controlled step. Once in position the clinician checks it for primary stability, meaning it should feel firm and not rock. Some practices take a periapical radiograph immediately after placement to confirm root clearance. ## Discomfort and recovery The first 24 to 48 hours after TAD placement are when discomfort is most noticeable. The gum around the screw head is usually tender, and there may be mild aching in the jaw. Standard over-the-counter pain relief such as paracetamol or ibuprofen is sufficient for most patients. Swelling and bruising are uncommon but can occur. Most patients find they can eat normally — albeit carefully — by the following day, and any significant soreness has usually resolved within three to five days. During the healing period of two to three weeks the TAD integrates with the bone sufficiently for force to be applied. It is important to avoid pushing or pulling the TAD with fingers or tongue during this settling-in phase. ## Oral hygiene with TADs Keeping the area around a TAD clean is important because plaque accumulation on the screw head and the surrounding gum can lead to peri-implant inflammation, which is the most common cause of TAD failure. Patients are typically advised to use a small interdental brush around the screw head twice daily, working gently around the perimeter of the gum collar. A chlorhexidine gluconate mouthwash — used for around 30 seconds twice a day during the first two weeks — reduces bacterial load and helps the tissue settle without inflammation. After the initial period, a fluoride mouthwash used daily is sufficient for maintenance. The TAD site should be gently irrigated with water after meals to prevent food debris accumulating. Avoid prodding the screw with toothbrush bristles at high pressure as this can cause gum irritation rather than clean effectively. ## Failure rates and causes TADs have a reported failure rate of approximately 10 percent in clinical studies, making them broadly reliable but not infallible. Failure means the screw becomes loose and mobile rather than remaining firmly anchored in bone. The most common causes include placement in thin cortical bone, screw angulation that places the apex too close to a root, inadequate oral hygiene leading to inflammation, and premature loading before the TAD has had time to stabilise. Other risk factors include placement in the maxillary midpalatal suture in younger patients where bone quality varies, bruxism generating excessive lateral forces, and systemic factors such as poorly controlled diabetes affecting bone healing. If a TAD fails it is usually removed, the area is allowed to heal for four to six weeks, and a new TAD is placed — often at a slightly different position or angle. A single failure does not necessarily compromise the overall treatment plan. ## Removal Removal of a TAD is considerably quicker and more straightforward than placement. In most cases no anaesthetic at all is required, because the bond between the screw and bone is frictional rather than biological — the TAD is not osseointegrated in the way a dental implant is. The clinician uses a hand driver to unscrew the TAD with a gentle anticlockwise rotation. The procedure takes approximately 30 seconds. Patients typically feel pressure and a brief moment of sensation but very little pain. The tiny hole left in the gum heals over within a few days, and bone remodels fully within a few months. There is generally no need for any special aftercare following removal. ## Cost and funding in the UK In the majority of orthodontic practices in the UK, TADs are included within the overall fixed appliance treatment fee when they form part of a planned comprehensive treatment. Some practices list them as an additional item, in which case the cost typically ranges from around £150 to £300 per TAD. NHS orthodontic treatment for patients who qualify will include any TADs deemed clinically necessary as part of the funded course of treatment, meaning there is no separate charge. For private patients, it is worth asking at the treatment planning consultation whether TADs are anticipated and whether they are covered by the quoted fee. If the need for a TAD arises mid-treatment unexpectedly — for instance, because anchorage loss is occurring — the practice should discuss whether an additional charge applies before proceeding. ## Useful related pages [Orthodontic Extractions UK](https://virtualconsultant.online/guides/orthodontic-extractions-uk) [Malocclusion UK](https://virtualconsultant.online/guides/malocclusion-uk) [Orthodontic Treatment Plan](https://virtualconsultant.online/guides/orthodontic-treatment-plan) [Braces for Overbite](https://virtualconsultant.online/guides/braces-for-overbite) [Can Braces Fix My Jaw?](https://virtualconsultant.online/guides/can-braces-fix-jaw-uk) This guide is for general information only. It is not a diagnosis, treatment plan, or substitute for advice from a registered dentist or orthodontist. ### Compare next steps [Orthodontist Near Me](https://virtualconsultant.online/locations/orthodontic-treatment-near-me) [Clear Aligners Near Me](https://virtualconsultant.online/treatments/clear-aligners-near-me) [Invisalign Near Me](https://virtualconsultant.online/locations/invisalign-provider-near-me) [Browse Locations](https://virtualconsultant.online/locations) ### Ready for a clearer starting point? Upload guided photos and receive an indication of likely treatment options and pricing before booking appointments. [Get an Online Quote](https://virtualconsultant.online/evaluations/quote) ### Frequently Asked Questions Do TADs hurt to have placed? Placement is done under local anaesthetic so there should be no pain during the procedure — most patients feel pressure and vibration only. There is usually some tenderness for 24 to 48 hours afterwards that responds well to paracetamol or ibuprofen. Can I eat normally with a TAD in? Yes, though you should be careful not to press hard food directly against the TAD site while the gum is still tender in the first few days. Once settled, normal eating is fine. Avoid biting on very hard foods that could put lateral force through the screw. What happens if a TAD falls out? Contact your orthodontic practice. A loose or fallen-out TAD is not an emergency, but it does need to be replaced promptly so treatment is not delayed. The area will heal and a new TAD can usually be placed within a few weeks. Are TADs the same as dental implants? No. Both are titanium screws in bone, but dental implants are designed to integrate permanently with bone and last decades. TADs are designed specifically not to fully integrate so they can be removed quickly and easily when orthodontic treatment is complete. Will TADs leave any lasting marks? No — TADs do not leave a lasting mark. The screw is very small and sits in the gum and the outer layer of jawbone rather than replacing a tooth, so removing it leaves only a tiny puncture in the soft tissue. That puncture closes over within a few days, usually without stitches. The small channel left in the bone fills in and remodels over the following months, in the same way as any other small bone defect. There is no permanent hole, no visible scar on the gum, and nothing that shows when you smile. Removal itself is quick and often needs little or no anaesthetic. How successful are TADs compared with headgear? TADs have a reported failure rate of around 10 percent but do not depend on patient compliance the way headgear does, since they stay fixed in the jawbone at all times. Headgear requires many hours of daily wear to be effective, and inconsistent use is a common reason for poor outcomes. Most orthodontists now prefer TADs for anchorage cases precisely because they remove this compliance risk. Why would my orthodontist recommend a TAD? A TAD is usually recommended when teeth need to move without their neighbours moving too, for example retracting front teeth after extractions, closing gaps, pushing molars upwards to reduce a deep bite, or avoiding headgear. The screw gives a fixed anchor in the jawbone so the force acts only on the teeth being moved. Your orthodontist will explain at the treatment planning stage whether a TAD is needed and whether its cost is included in the overall fee. Explore your options Quick links Not sure where to start? Use these quick links to explore orthodontic treatments, typical costs, and helpful guides that explain what different options involve. 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Upload guided photos and get a tailored recommendation for your teeth and bite. [Start Photo Assessment](https://virtualconsultant.online/evaluations/quote) [Find an Orthodontist](https://virtualconsultant.online/locations) Citation details Title TADs (Mini-Implants) in Braces UK: Uses, Pain, Cost Publisher Virtual Consultant Online Published 2024-06-01 Updated 2026-10-15 URL [https://staging.virtualconsultant.online/guides/temporary-anchorage-devices-uk](https://staging.virtualconsultant.online/guides/temporary-anchorage-devices-uk)