Orthodontic Treatment for Adolescents

Temporary anchorage devices — commonly referred to as TADs or mini-screws — are small titanium implants placed temporarily into the jawbone to serve as a fixed, stable point from which orthodontic forces can be applied. They allow tooth movements that are difficult or impossible to achieve reliably with braces or aligners alone, significantly expanding what can be accomplished during the adolescent growth years without surgery.

At Lusk Orthodontics, TADs are used as part of complex adolescent treatment plans where standard mechanics would be insufficient, giving patients access to a level of precision and capability that was not available to previous generations of orthodontic patients.

Why TADs Matter in Adolescent Treatment

Conventional orthodontic treatment uses teeth as anchors — when force is applied to move one tooth, the tooth used as the anchor is subject to an equal and opposite force. This can limit what is achievable, particularly in cases involving significant bite problems, severe crowding, or complex tooth movements.

TADs eliminate this limitation by providing an anchor point fixed in bone that does not move under orthodontic load. This allows forces to be applied with full directional control, enabling tooth movements that would otherwise require surgery or simply could not be achieved.

During adolescence, when the jaws are still growing and the dentition is developing, TAD-supported mechanics can address problems at the optimal biological moment — before growth is complete and while the tissues are most responsive.

What TADs Can Achieve in Adolescents

Closing Extraction Spaces

Where teeth have been removed as part of the orthodontic plan, or where there is severe crowding requiring extraction, TADs allow the remaining spaces to be closed efficiently and without unwanted movement of the anchor teeth. Space closure over significant distances is more predictable and better controlled with skeletal anchorage than with tooth-to-tooth mechanics.

Correcting Severe Bite Problems

Large overjet (prominent upper front teeth) — in adolescents with a significant horizontal discrepancy, TAD-anchored mechanics can retract the upper front teeth or support the advancement of the lower arch with a level of control not achievable with conventional braces. This is particularly useful in growing patients where the full extent of the correction is planned in combination with the ongoing growth of the lower jaw.

Underbite (skeletal class III) — where the lower jaw protrudes relative to the upper, TAD-supported mechanics can be used to compensate for the skeletal discrepancy through careful tooth positioning, achieving a functional result while monitoring whether surgical correction may be needed once growth is complete.

Closing Anterior Open Bites Without Surgery

An anterior open bite — where the front teeth do not make contact when the back teeth are together — is one of the more complex problems in orthodontics and is prone to relapse. In adolescent patients, TAD-supported intrusion of the back teeth allows the bite to close at the front as the jaw autorotates. This can achieve significant open bite correction without surgery, and doing so during adolescence — when the tissues are responsive and growth can be used advantageously — often produces more stable outcomes than treatment attempted in adulthood.

Correcting Gummy Smiles

Where a gummy smile is caused by over-eruption of the upper front teeth, TADs allow precise vertical intrusion of these teeth, reducing the amount of gum visible on smiling. This is a movement that is extremely difficult to achieve with conventional brace mechanics and benefits greatly from the controlled, bone-anchored forces that TADs provide.

Supporting Complex Tooth Movements

TADs can also be used to move teeth that have erupted in the wrong position, to guide impacted teeth into the arch, or to support any movement requiring sustained, directionally precise forces over a significant distance.

The TAD Placement Process

Placement is a straightforward, minimally invasive procedure carried out in the orthodontic clinic under local anaesthetic. No incisions are required — the mini-screw is placed directly through the gum tissue into the bone. Most adolescent patients tolerate the procedure very well and report only mild pressure during placement and some soreness for one to two days afterwards.

TADs are removed once the tooth movements they were supporting are complete, which is similarly quick and comfortable. In most cases, removal does not require a local anaesthetic.

Book a Consultation

If your teenager has a complex bite problem, a previous provider has suggested surgery may be needed, or you want to explore the full range of what modern orthodontics can achieve, book a specialist assessment at Lusk Orthodontics.