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Profile: orth65flag538@msn.com
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Joined: Thursday, April 20, 2006
Last Visit: Friday, June 6, 2008 9:04:39 PM
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Topic: Who places miniscrews?
Posted: Friday, June 6, 2008 9:03:51 PM
I am not placing TADs. I have had some issues introducing laser tissue removal into my practice with some reservations from the patients/parents about “cutting” tissue. Screwing a screw into the bone requires a better sales job than I am ready to do.

I have taken about 5 courses on TADs but I am not ready to do them yet. This is my problem, i.e., not a treatment problem. It takes some education in the office for the parents and patients to understand about this issue-–and it takes some experience for the Doctor putting them in. Since I have the Ortho Clinic at the dental school available, I will put some in there to build my confidence before I do them in the office---but it will become a routine part of treatment in the future because orthodontics needs a better anchorage system than we have now.

In my understanding, the problem with referring them out is that the oral surgeon may place a TAD that doesn’t have the correct head for connecting wires or springs to it. Plus the patient has to pay for the procedure. Also, TADs can come loose, which means that the patient has to go back to the OS to replace it – at an additional charge in most cases. This causes some trepidation on the part of the parents/patients about the wisdom of doing this “experimental” procedure and puts the orthodontist in a real bind about his recommendation to do this.

I think some bad experiences of these types will force the orthodontist to become the controlling person in this process.

--Randy Womack, DDS

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