Temporary Anchorage Devices (TADS)

Your child won't keep his or her first teeth forever, but that doesn't mean those tiny pearly whites don't need conscientious care. Maintaining your child's dental health now will provide health benefits well into adulthood, as primary (baby) teeth serve some extremely important functions.

Kids developing jaws and teeth.

For one thing, primary teeth serve as guides for the eruption of permanent (adult) teeth, holding the space into which these new teeth will erupt. The crowns (tops) of the permanent teeth actually push against the roots of the baby teeth, causing them to resorb, or melt away. In this way, the adult teeth can take their proper place.

What's more, your child's primary teeth will be there for most of childhood, helping your child to bite, chew and speak. For the first six or so years, he or she will be relying on primary teeth exclusively to perform these important functions. Until around age 12, your child will have a mix of primary and permanent teeth. You will want to make sure those teeth stay healthy and are lost naturally — when it's time.

Your Child's First Teeth

Kids mouth anatomy.

Your child's 20 baby teeth will begin to appear usually between six and nine months, though in some cases it may start as early as three months or as late as twelve months. The two lower front teeth tend to erupt first, followed by the two upper ones, these teeth are called the central incisors. Then the neighboring teeth called lateral incisors will erupt too. The first molars come in next, followed by the canines (eyeteeth). And finally, the last teeth to erupt are the two-year molars. Sometimes your baby can experience teething discomfort during this process. If so, there are courses of action to help make your child more comfortable.

Your infant's gums should be gently wiped after each feeding with a water-soaked gauze pad or damp washcloth. As soon as the first tooth erupts, establish a daily brushing routine with a small, soft-bristled toothbrush and no more than a thin smear of fluoridated toothpaste. Your child may need your help with this important task until about the age of 6.

Your Child's First Dental Appointment

Age one dental visit

The American Academy of Pediatric Dentistry recommends that your child see a dentist by his/her first birthday, or as early as the first tooth erupts. Though this may sound early, learning proper pediatric oral hygiene techniques, checking for cavities, and watching for developmental problems is extremely important.

There are a number of forms of tooth decay that can affect babies and small children. Early Childhood Caries (tooth decay) can develop rapidly, progressing from the hard, outer enamel layer of a tooth into the softer, inner dentin in six months or less.

Most of all, it's important for your child to have a positive experience at the dental office as he/she will be a regular visitor for years to come.

Pediatric Dental Treatments

There are a variety of dental treatments offered to prevent tooth decay in children, or to save or repair teeth when necessary. They include:

Topical Fluoride — Fluoride incorporates into the enamel of teeth, making it harder and more resistant to decay. Although there is a small amount of fluoride in toothpastes and in some drinking water supplies, a higher concentration can be applied professionally to your child's teeth for maximum protection.

Dental Sealants — A plastic coating can be applied at the dental office to prevent cavities by sealing the little grooves on the chewing surfaces of back teeth known as “pits and fissures.” These little crevices become the perfect environments for decay-causing bacteria. Immature tooth enamel is more permeable and therefore less resistant to tooth decay. Dental sealants are easy to apply and provide years of protection (Watch Dental Sealant Video).

Root Canal Treatment — Perhaps you have had a root canal treatment yourself, to save an injured or severely decayed tooth. Well, sometimes children need root canals, too. In children these are called pulpotomies or pulpectomies. As mentioned above, baby teeth are important guides to the permanent teeth that are already forming beneath your child's gums. Therefore, saving them from premature loss can help prevent a malocclusion (“mal” – bad; “occlusion” – bite) that requires orthodontic treatment.

Bonding — Chips and minor fractures to front teeth — common childhood occurrences — can be repaired with tooth-colored bonding materials. These lifelike resins made of plastic and glass can be used on baby teeth as well as permanent teeth and last until the youngster has completed facial growth (Watch Bonding Video).

Orthodontic Concerns

Orthodontic Problems.

By around age 7, most malocclusions have become evident. Interceptive orthodontic treatment around this time can help direct proper tooth positioning and/or jaw growth, eliminating or simplifying the need for later treatment. There are many orthodontic problems that can be detected early and are examples of why a trained professional should evaluate your child during his/her growth and development.

Sports & Your Child's Teeth

If your child is active in sports, a custom-made mouthguard is a highly recommended safeguard. According to the American Dental Association, an athlete is 60 times more likely to suffer dental harm when not wearing one of these protective devices. A custom mouthguard is made specifically for your child using a model of his or her teeth. This will offer greater protection than an off-the-shelf model. It's an investment that pays off highly in the form of reduced pain, suffering — and dental expenses down the road!

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Every so often, in dentistry and other fields, a new technology comes along that promises to change the standard practices. TADS (Temporary Anchorage Devices) aren't exactly new — orthodontists have used them since the 1980s — but they're gaining widespread acceptance today. The benefits they offer some orthodontic patients could even be called groundbreaking. Let's look at what these devices are, and what they can do.

Temporary Anchorage Devices (TADS).

Essentially, TADS are small, screw-like dental implants made of a titanium alloy. As the name implies, they're temporary — they usually remain in place during some months of treatment, and then they are removed. Their function is to provide a stable anchorage — that is, a fixed point around which other things (namely, teeth) can be moved. But why is anchorage so important?

Moving teeth in the jaw has been compared to moving a stick through the sand. With the application of force, sand moves aside in front of the stick, and fills up the space behind. The “sand” in this case consists of bone cells and cells of the periodontal ligament, which attaches the tooth to the bone. These tissues slowly move aside and reform as force is applied to them by orthodontic appliances, such as wires and elastics.

But to do its work, that force needs a fixed point to push against. For example, imagine trying to move the stick while you're floating free in the water: Not so easy! But with two feet firmly planted in the sand, you can do it. When possible, orthodontists use the back teeth as an anchor — but sometimes, cumbersome headgear may be required to provide the necessary anchorage. In many cases, using TADS can change that.

What TADS Can Do

While it's generally preferred, the use of teeth as orthodontic anchors can have drawbacks in some cases. For example, there may not be a viable tooth located at the point where an anchor is needed. Also, when a greater force is required, the teeth used as anchors can themselves start to move. This is one instance where TADS are beneficial: These mini-implants can eliminate the need to use teeth as anchors, or stabilize a tooth that's being used as such.

TADS can also provide an anchorage point for a pushing or pulling force that would otherwise need to be applied from outside the mouth: generally, via orthodontic headgear. Wearing headgear can be uncomfortable, and compliance is sometimes a problem. In many situations TADS can eliminate the need for headgear, a welcome development for many patients.

The use of TADS offers other benefits as well: It may shorten overall treatment time, eliminate the need to wear elastics (rubber bands) — and in some cases, even make certain oral surgeries unnecessary. It also allows orthodontists to take on complex cases, which might formerly have proved very difficult to treat. This small device can really do a big job!

Getting (and Maintaining) TADS

Like dental implants (which have been in use since the 1970s) TADS are small, screw-like devices that are placed into the bone of the jaw. Unlike implants, however, they don't always need to become integrated with the bone itself: They can be fixed in place by mechanical forces alone. Plus, they're much easier to put in and remove when treatment is complete. How easy?

Placing and removing TADS is a minimally-invasive, pain-free procedure. After the area being treated is numbed (with an injection or other numbing treatment), a patient feels only gentle pressure as the device is inserted. The whole process can take just minutes to complete. Afterwards, an over-the-counter pain reliever can be taken if needed — but many patients need no pain reliever at all. And taking TADS out is even easier. So if you're worried that it may be a painful procedure: Relax! It's far less stressful than you may think.

While they're in place, TADS require minimal maintenance. Generally, they should be brushed twice daily with a soft toothbrush dipped in an antimicrobial solution. You will receive specific instructions regarding maintenance when your TADS are placed.

Not every orthodontic patient needs TADS — but for those who do, it's a treatment option that offers some clear benefits.

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