What is a Bone Screw?

A bone screw, also known as an orthodontic miniscrew or temporary skeletal anchorage device, is a tiny device typically made of stainless steel or titanium alloy. These small screws are usually implanted in the jawbone between two teeth. With a diameter ranging from 1.2 to 2mm and lengths usually between 4 to 12mm, they are virtually imperceptible once implanted. However, despite their diminutive size, these bone screws play a significant role in orthodontics.

When are bone screws necessary?

Bone screws are employed for various orthodontic purposes. For instance, if one aims to maximize the retraction of front teeth, correcting a protruding profile, bone screws can be used to bring these prominent front teeth back. Alternatively, if there are significant gaps between teeth, bone screws can be used to advance posterior teeth for closing the gaps. They can also be utilized to reduce gum display in a gummy smile by intruding the front teeth or decreasing overbite to prevent excessive biting depth. Furthermore, bone screws can be employed to distalize the entire dental arch, improving the underbite.

For mild to moderate skeletal deformities, bone screws can be highly effective, simplifying treatment and shortening its duration. In cases of underbite, overbite, and gummy smiles, bone screws are often seen as a natural fit.

Is Getting a Bone Screw Painful?

Many people are concerned about pain when they hear about bone screws being implanted, but it’s not as painful as it may sound. Let me briefly describe the bone screw placement process: first, the dentist applies a surface anesthetic, followed by injecting some local anesthesia into the area. There might be a moment of discomfort during the injection of the anesthesia, but you can ask the dentist to go slow and be gentle to minimize the pain. After the procedure, you’ll generally experience minimal discomfort, primarily some slight soreness or aching during and after the bone screw implantation. However, the placement of one screw is quite quick, usually taking only a few minutes. The anesthesia usually wears off after about an hour (specifically depending on your dentist's technique), and you may feel some mild itching or discomfort, but it’s generally bearable. In most cases, the discomfort is similar to that of a mouth ulcer and should subside within two to three days.

How to Care for Bone Screws?

Maintaining good oral hygiene is crucial for the stability of bone screws. We recommend using a small-headed toothbrush with soft bristles to gently push aside the mucous membrane around the bone screw and brush around it in circular motions, reaching the nooks and crannies. You can also use an anti-inflammatory mouthwash to assist in cleaning. In the event that a bone screw irritates your mouth, you can use orthodontic wax to cover it or contact your orthodontist for assistance.

Other Considerations:

1.       Can you be allergic to bone screws?

Most bone screws are made of stainless steel or pure titanium, which have excellent compatibility with human tissue, so they usually do not trigger allergic reactions.

2.       Are there alternative methods to bone screws?

Yes, in the absence of bone screws, traditional headgear can be used, but it often requires wearing it for 12 to 14 hours a day.