Harwell & Cook Orthodontics



The procedure you are about to undergo is a revolutionary advance in the orthodontic world. Quite simply, a TAD (temporary anchorage device) is a mini-implant placed into the bone of the upper or lower jaw. Since the implant is placed into the bone, it will not move. This allows us to use the device as an anchor to move teeth, or in some cases, your jaw. This development has allowed our office to complete procedures and tooth movements previously impossible with traditional orthodontic techniques. In other words, using the TAD in your mouth is often the only way we can successfully achieve the desired goals with your treatment without the need for surgery or other restorative procedures. Here are some facts, hints, and expectations for your mini-implant:


  • In most cases, we do not give shots but simply numb the immediate area with a gel or topical anesthetic prior to placement. You should expect to feel pressure but no sharp pain. In a few cases, an injection or subgingival MadaJet is needed.
  • There will be some discomfort associated with the device for three to four hours after the insertion. The best explanation is a tightness or pressure associated with the TAD. This feeling arises from the bone and tissue changes and their adaptation to the new appliance.
  • We recommend taking Tylenol® or Advil® 30 minutes before your appointment. Additional doses of pain medication every two to four hours afterward for up to 24 hours will be beneficial.
  • ICING the area after your appointment is the best way to reduce swelling and discomfort from your procedure. The more you ice, the better your results!
  • We recommend rinsing or brushing the area with hydrogen peroxide (Peridex™) two to three times daily. We will provide you with a supply. Simply dipping a toothbrush in the hydrogen peroxide and brushing the TAD is ample in most cases.
  • The time the TAD remains in your mouth is dependent on the movement we are trying to accomplish, the placement, and the overall case. In other words, it is a case-by-case situation, and the exact length the mini-implant will remain in your mouth is merely an estimate. The normal time is three to eight months. Please understand that the majority of the time, we have no other way to accomplish the goals we have set forth without the use of these TADs. There is often no other reasonable way to treat your case without these devices.
  • It will take some time to get used to the device. Soft tissue — lips, gums, and other muscular areas — will have to adapt to this new device. Please be patient; expect ulcers in the areas where the tissue rubs the TAD or associated braces. Please understand that we will try to keep this discomfort to a minimum. Wax is the key to avoiding this soft tissue trauma.


If you have any other questions or concerns, please do not hesitate to ask. An informed patient is our best patient.