Braces are a common part of many teenagers’ life experience — but not every bite problem is alike. Sometimes, there’s a need for accurately moving only a few teeth while making sure others don’t. This is where Temporary Anchorage Devices (TADs) can help streamline that effort and even reduce treatment time.
Orthodontics wouldn’t work at all if we didn’t already have a natural tooth movement mechanism in our mouths. That ability rests with the periodontal ligament, a tough, elastic tissue between the teeth and the bone that firmly attaches to both with tiny collagen fibers. Though quite secure in holding teeth in place, the ligament attachment also allows teeth to move in response to changes in the bone and jaw structure.
Braces are made of brackets cemented to tooth surfaces through which tiny wires pass. The wires are anchored, usually to other teeth or groups of teeth, and tightened to apply pressure against the other teeth. The ligament does the rest: as the teeth are “pressured” to move in a certain direction, new bone, ligament and an anchoring substance known as cementum forms behind it to secure the tooth in its new position.
The anchorage teeth are not intended to move. In some situations, though, it’s difficult to keep them from not moving — much like trying to keep a boat anchor from not dragging through sand on the sea bottom. TADs help alleviate this problem: it’s a mini-screw or mini-implant that’s temporarily placed in the jawbone to which the tension wire can be secured. They’re placed in the best positions for isolating the teeth that need to be moved without compromising the position of nearby teeth that don’t.
With the site numbed with a local anesthetic, we install the TAD through the gum tissue into the bone with a special device; their screw-shaped design holds them securely in place. They’re then removed when the orthodontic treatment is complete.
While a simple procedure, precise placement requires collaboration between the orthodontist and the oral surgeon or dentist who installs them. They also need special attention during daily hygiene to keep them clean. Still, with difficult bite situations they can help bring about the right outcome — a straight and beautiful smile.
If you would like more information on orthodontic treatment options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What are TADs?”
Professional basketball player Lamar Odom is sometimes known as “the candyman” because of his notorious fondness for sweets. But when his sweet tooth finally caught up with him — in the form of a mouthful of decayed teeth — the six-foot-ten-inch, 230-pound hoops star admitted that he had been avoiding treatment… because he was afraid of going to the dentist!
It took two Kardashians (Khloe and Kim) and a painful toothache to finally persuade Odom to sit in the chair. Once he did, it was found that he needed a root canal, a wisdom tooth extraction, and several fillings. Yet the fretful forward sailed through the whole set of procedures in a single visit, and walked out with a big smile afterward. How did his dentists make that happen?
Put it down to the “magic” of sedation dentistry. With anxiety-relieving medications that can be delivered orally (in pill form or by gas) or intravenously (into the bloodstream), the techniques of sedation dentistry can help even the most fearful patients get the dental care they need. That’s good news for about 50 percent of the population, who admit they’re at least somewhat afraid of the dentist — and even better for the 15 percent who avoid dental care completely due to their fear.
Dentists have a number of ways to ease apprehensive patients through a dental visit. An oral anti-anxiety drug can be given in pill form about an hour beforehand. Nitrous oxide (sometimes called “laughing gas”), which is administered by a mask placed over the mouth or nose, may also be used to relieve anxiety. The calming effects of these medications help make any nervousness melt away — and in many circumstances, mild sedation is all that’s needed to ease the fear.
For lengthier or more complex procedures, intravenous (IV) sedation may be recommended. Unlike deeper (unconscious) sedation, IV sedation doesn’t cause “sleep.” Instead, it puts you in a comfortable semi-awake state, where you can still breathe on your own and respond to stimuli… but without feeling any anxiety. And when the procedure is over, you probably won’t have any memory of it at all.
IV sedation can be administered by dentists who are specially trained and equipped with the proper safety equipment. While sedation is being provided, you will be monitored at all times by a dedicated staff member; when it’s over, you will rest for a while as the medication quickly wears off. Then (as is the case with oral sedation), you’ll need another person to give you a ride home.
Does sedation dentistry really work? Lamar Odom thinks so. “I feel so much better,” he said when his 7-hour procedure was over. “I feel like I accomplished something.”