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A temporary anchorage device (TAD) is a temporary mini screw implant used by orthodontists to assist with complex movement of teeth. Newton's third law says that for every action or force, there is an equal and opposite force or reaction. Traditionally, when orthodontists wanted to move a certain tooth, they did it by pulling from other teeth. In most cases, this is still the method used.
There are, however, some cases where it would be beneficial to move a tooth without anything else moving. This is where TADs come in. TADs are mini implants that are temporarily placed to assist with such movements. They are usually 1-2 mm in diameter and 6-8mm (about 1/2 to 1/3 of an inch) in length. The are placed through the gums and into the bone, and usually requires no anesthesia. The picture below shows what a TAD looks like in the mouth.
There are many cases where these mini screws can be very beneficial. Some include:
- Avoiding extraction of teeth
- Closing spaces where teeth have been taken out, in many cases eliminating the need for an implant replacement
- Closing open bites
- Fixing deep overbites
- Avoid surgery
- Avoid headgear and other extraoral appliances
The placement of TADs usually takes 5-10 minutes and is pain free. The TAD usually stays in place until the desired movement is completed, usually for a few months.
TAD mini screws provide fast and reliable treatment outcomes, usually reducing the time needed in treatment. It also gives orthodontists a lot of new treatment options that weren't available before. While the majority of patients will not need one, for the ones that do, it can make a world of difference. In the example below, a TAD and a stainless steel spring are being used to move a back molar forward, something that was impossible to do before without side effects.
Most orthodontists are becoming proficient in the use of TADs, although some orthodontists might refer their patients to a different specialist to place the TAD, usually an oral surgeon. If your orthodontist recommends the use of mini screw TADs during treatment, make sure you discuss with them all the benefits and possible side effects of such treatment. In the right patients, it can provide many benefits to make treatment shorter, easier, and more effective.
Let's face it. As a parent, you want to give your child the best. And even though improving their smile is one of the best investments you will ever make, kids are not usually thrilled about the idea of braces.
I can tell you, that is not the case in our office. And new research has come out to prove why.
A recent independent study from the Ohio State University, published by the AJO-DO and cited in the most recent 5th edition of "Contemporary Orthodontics" shows an acceptance rate for WildSmiles braces of over 70 percent for patients between the ages of 9-11, making them the most popular option in this age group and ranked 25% higher than other alternative appliance options. For patients between 9-14 the acceptance was 44%, also making it the most popular appliance in this age group. (Star shaped WildSmiles braces pictured below)
WildSmiles braces are specially designed orthodontic braces that come in a variety of fun shapes including Stars, Hearts, Soccer Balls, Baseballs, Volleyballs, Footballs, Flowers and Diamonds. Kids can mix and match them to create their own unique styles.
We have been offering these braces to all our young patients and they LOVE them! We even have a few young spirited adults that have chosen them!
Now, it was not an easy decision to offer these braces since they do cost more than traditional braces. But true to our higher standards, we made a commitment to offer these braces to our patients at no additional charge. We are always looking for the best and latest to offer our patients and are proud to see the response we have received.
Not to mention how thrilled parents are to see their kids be on board and excited about braces.
We are proud that Drubi Orthodontics is one of only three offices that offer these braces in all of the Miami area.
Click here to see how you can mix and match these fun braces: http://wildsmilesbraces.com/design-your-smile/
Did you know that 1 in 5 orthodontic patients is an adult?
There are many esthetic options available today to treat every problem in an esthetic way. Clear braces are braces made of a clear ceramic material that makes them much less noticeable. They work in the same way that metal braces work, but provide an esthetic alternative to adolescents and adults that wish to straighten their smiles without having to go through a "metal mouth" stage.
Up until recently, there was a major problem with clear braces. The problem was that the wire was held in place by a little rubber band that stains over time, and can start looking not so "clear" after a while (note how the rubber band has turned yellowish in the picture below)
The staining of the rubber band was a major problem. It went from being clear braces to dirty braces, especially for people that frequently drink coffee, tea or wine. And that was not the only problem. The rubber bands lose their strength and need to be changed about every 4 weeks, requiring you to come in once a month for adjustments, many of them unnecessary.
That was until In-Ovation C braces came out. The problem was solved by replacing the rubber band with a small gate that keeps the wire in place. (In-Ovation braces pictured below. They are also the ones worn by the woman in the picture above) This had a number of benefits.
The first obvious one was that there is no more rubber band, so these braces don't stain. Patients are now able to eat and drink without fear of their braces staining.
The second advantage is that there is no rubber band to change, thus appointments can usually be every 8-10 weeks, reducing the amount of school or work patients have to miss to come in for adjustments.
The third advantage is that the wire is not forcibly held against the braces. This reduces the amount of force placed on the teeth, making them more comfortable to wear.
The fourth advantage is that these braces don't have a rubber band that collects plaque, making them much more hygienic and easier to keep clean.
These clear braces are so good that they are the only ones we offer at our office. We believe in treating our patients the same way we would treat our family, and this would be my first choice for anyone who asks me which braces they should choose. So, if the fear of staining braces has kept you from improving your smile, now there is a new way to do it that is esthetic, efficient, and comfortable way!
Retainers are appliances used after braces to maintain the results achieved and prevent any unwanted movement of the teeth. After treatment, especially in the first few months, teeth have a tendency to move back towards their original position. It usually takes somewhere between 3-4 months for new bone and gums to form and fully adapt around the new position of your teeth.
Teeth also have a tendency to continue moving throughout life, even if no orthodontic treatment has ever been done. That is why it is very important to wear retainers after orthodontic treatment, especially in the first 6-12 months.
Keeping a perfect smile is as important as achieving one. I see many patients that come to me because they had braces some time ago as kids and they never wore their retainers. This situation is usually frustrating for the treating orthodontist as well as the patient, who had gone through years of treatment and invested a significant amount in their new smile.
When it comes to maintaining a perfect smile, there are 3 main kinds of retainers used today. Let's briefly go over each option, including the pros and cons of each.
Hawley retainers are the gold standard of orthodontic retainers. They are made of acrylic material that covers the roof of the mouth, and wires that serve to maintain your teeth in their position. The main pros of Hawley retainers are:
- Durability: they are made of hard acrylic and wire, and can usually last many decades.
- Can be adjusted: your orthodontist can adjust the wire and acrylic, and can usually correct minor tooth movements if they do occur.
The cons are:
- Esthetics: they are not very esthetic, and can look funny if worn in public.
- Speech: Covering the roof of the mouth may slightly affect your speech. This is also only a problem if it has to be worn during the day.
Clear Retainers (also known as Essix retainers)
Clear retainers are retainers made of clear acrylic. They cover all surfaces of your teeth. They usually do not cover the roof of the mouth. The main advantages are:
- Esthetic: The clear acrylic is barely visible on the teeth, making Essix retainers a very esthetic option and very popular among adult patients. This will also usually increase patient compliance.
- Can be used as a mouthguard: for patients that grind their teeth at night, using clear retainers that cover the biting surfaces of teeth can prevent them from the damages caused by teeth grinding.
The main cons are:
- Durability: these retainers do wear down, and depending on amount of use and habits such as grinding problems, will usually last about 3-7 years. They may also stain with time.
Fixed Retainers (also known as permanent retainers)
Fixed permanent retainers are made up of a semi flexible wire that is glued to the back side of teeth. It is usually placed in the lower front teeth, which are the first to move with time. They are also a popular choice to use between the upper two front teeth after having closed a gap (called a diastema), which is also very prone to relapse.
The pros are:
- They are always on and always working, and can be very effective at keeping teeth straight. Compliance is not a problem since the patient does not need to worry about putting them on or losing them.
- Esthetic: fixed retainers are placed behind the teeth, making them invisible on the outside.
- Versatile: permanent retainers can and usually are used in combination with one of the other retainers shown above.
The cons are:
- Hygiene: fixed retainers make it a little harder to floss and properly maintain the area clean. Food, plaque and calculus can accumulate in the area if proper oral hygiene is not practiced. If this is noted, the retainer can always be removed. Getting regular cleanings and check ups with your general dentist is especially important to make sure no problems arise.
- Breakage: fixed retainers can sometimes break and come off. This may require you to see your orthodontist to get it glued back in place. Some orthodontists may charge a fee for this service.
- Limited effectiveness: they will only keep straight the teeth included, usually the front teeth.
Having said all this, all 3 retainer types work well and should keep your smile straight if worn as prescribed. Some are better for some cases than others, and your orthodontist may recommend that you get one specific type according to your situation. Following the recommendations of your orthodontist will guarantee you maintain a beautiful smile for life and prevent headaches in the future!