So, you’ve been told your child or teenager needs to wear a palate expander. This can come as a surprise, but it’s actually a really common orthodontic appliance. At Houston Orthodontic Specialists, we can use expanders in Phase 1 orthodontic treatment or as part of comprehensive orthodontic treatment with expansion. Our treatment plan will depend on your child’s specific orthodontic issues and needs.
Since a palatal expander expands, or widens, the upper jaw, it’s typically reserved for patients who are still growing because, at this point, we can much more easily manipulate jaw and facial development. In certain cases, the payoff of wearing a palatal expander is huge and will ensure your child is able to get a broad, beautiful smile without the need for tooth extractions, lengthy treatment or even corrective jaw surgery in adulthood.
To help give you a better idea of what treatment with a palate expander entails, we’ll be covering everything you need to know about the appliance.
In this post, we’ll go over:
- What is a palate expander?
- How does a palate expander work?
- Why does my child need a palate expander?
- How long does a palate expander stay in?
- Does a palate expander hurt?
- What to expect when wearing an expander
- How to adjust an expander
- How to care for an orthodontic expander
What is a Palatal Expander?
As we said, a palatal expander is an orthodontic appliance that widens the upper jaw. It’s used to make the bone larger in order to fit all of the permanent teeth, as well as to fix discrepancies between the upper and lower jaw so that the top and bottom teeth come together properly. Aside from addressing functional issues, a palate expander can also help to create a broader, more aesthetic smile.
Anatomy of the Upper Jaw
We know the idea of widening the jaw can sound kind of terrifying. However, it’s actually straightforward and painless. The maxilla, or upper jaw, is made up of two distinct halves that don’t fuse together until the mid-teen years. By using an expander before this fusion occurs, we’re able to very gently separate the bones to make the palate wider.
Incorporating an Orthodontic Expander Into Your Child’s Treatment Plan
When your Bellaire or Houston orthodontist uses an appliance like an orthodontic expander to guide facial or jaw growth, we refer to it as dentofacial orthopedics. An expander is responsible for orthopedic correction, while braces or Invisalign® for kids can be used to correct tooth positioning.
Sometimes, a patient will wear an expander on its own during their phase 1 orthodontic treatment. Then, they’ll have a resting period before getting conventional braces, Damon braces or Invisalign® Teen in Phase 2 orthodontic treatment. For other early orthodontic treatment plans, the expander is combined with additional appliances like a habit-breaking appliance. However, an expander can also be used as part of one-phase, comprehensive treatment when a preteen or teen patient is ready to kick-off Invisalign Teen or braces treatment but we need to expand the jaw.
How Does a Palatal Expander Work?
While there are several different designs for orthodontic expanders, they all work in the same general way. Typically, for growing patients, we use a rapid palatal expander, which is a custom-made, stainless steel appliance that fits around several of the back, upper teeth. It has two halves that are joined together by a center screw.
Once the palate expander is in place, you or your child will activate it by turning the screw using a key. This creates tension that puts gentle pressure on the upper molars and the junction (technically called the intermaxillary suture in orthodontist-speak) of the two maxillary, or palatal, bones. This causes the bones to move apart and the jaw to widen. Once the desired amount of expansion has occurred, the expander will stay in place for a bit longer, giving time for new bone to form, stabilizing the expansion.
Why Does My Child Need a Palate Expander?
The three most common reasons why a child or teen requires upper expansion are:
- Crossbite – A crossbite often occurs because the upper jaw is too narrow to fit properly with the lower jaw. This causes some of the bottom teeth to bite outside of the top teeth. While patients can have an anterior crossbite or posterior crossbite, a palate expander is typically needed to fix a posterior crossbite. If a severe crossbite isn’t addressed with early orthodontics, patients may compensate by shifting the jaw to one side, which can lead to permanent, unwanted changes to the facial structure, as well as jaw and TMJ pain and excessive wear of the enamel.
- Severe Crowding – One of the reasons the American Association of Orthodontists recommends kids have their first orthodontic evaluation by age 7 is because an orthodontist can determine if the jaw will lack space to accommodate all of the permanent teeth before they even come in. When we do spot emerging crowding, and it appears as if it will be severe, a palate expander can widen the jaw to fit the permanent teeth, which minimizes future crowding and prevents the need for tooth extractions.
- Impacted Teeth – Sometimes, other teeth can block a permanent tooth’s path, stopping it from erupting into its correct place on its own. When the tooth gets stuck beneath the bone or tissue, it’s called an impacted tooth. This is usually seen with the canine teeth (eye teeth). A palatal expander can help to make enough space for the impacted tooth to erupt without needing more invasive intervention or extractions.
In addition to correcting a crossbite, preventing crowding and making space for impacted teeth to come in naturally, a palatal expander might also be indicated in cases of:
- An underbite
- Breathing difficulties and sleep-disordered breathing (sleep apnea)
- A narrow smile
How Long Does a Palatal Expander Stay in?
It usually takes a few weeks to reach the correct amount of expansion. Afterwards, most patients will continue to wear their orthodontic expander for about six more months. During this time, new bone will form in the gap between the maxillary bones, which stabilizes the expansion.
Does a Palatal Expander Hurt?
Palatal expansion is not usually painful. However, it’s normal to feel some soreness and pressure after the key is turned, especially during the first few days. Discomfort is mild and having your child stick with liquid foods (smoothies, soup, etc.) for a day and then moving on to soft foods for several days to a week will be helpful.
What to Expect When Wearing an Expander
It can take your child or teen a little while to get used to having a palatal expander in their mouth. Patients sometimes find the appliance interferes with chewing and speaking. This usually only lasts a few days. Once your child acclimates to their orthodontic expander, their speech and ability to chew will return to normal.
If you see a space developing between your child’s front teeth during their palatal expansion, don’t panic. This is totally normal and means the expander is doing its job of widening the upper jaw. When your child’s orthodontic treatment is complete, they’ll have straight teeth with ideal spacing and a healthy bite to show for it!
How to Adjust an Expander
In order for the expander to work its magic, it needs to be activated. We usually recommend activating the palate expander at bedtime so by the time your child wakes up, the pressure from the turn has disappeared.
We always show our patients how to adjust an expander so they feel confident doing it on their own. While the exact specifics will depend on the type of expander, for most patients, the basics will remain the same.
Here’s how to adjust an expander step by step:
- Tip your or your child’s head back.
- Place the key you were given into the hole of the appliance.
- Push the key completely towards the back of the mouth until it stops and you’re able to fully see the next hole in your appliance.
- Carefully remove the key by pressing back and down towards the tongue. The new hole for the next activation should be visible.
What if I Forget to Activate My Expander?
If you forget to activate your expander, do not double up and do two turns the next day. Instead, continue with one turn each day until you reach the amount of expansion your Bellaire or Houston orthodontist prescribed. Keep in mind, adjusting the appliance as directed will ensure your child or teenager keeps on schedule with the rest of their orthodontic treatment plan.
How to Care for an Orthodontic Expander
Oral hygiene is important when wearing an orthodontic expander. To keep the rapid palate expander and their mouth sparkling clean, children and teeangers should gently brush the appliance, including the screw and metal bars, in the same way they brush their teeth. Just as we recommend when caring for braces, when your child has an expander, they’ll want to brush in the morning, after meals and snacks, and before bed. If they’re out and about and unable to brush after eating, have them swish water around in their mouth to get rid of any food particles.
There are a few foods to avoid with a palate expander, including anything really hard, chewy or sticky, such as caramels, licorice, hard pizza crust, taffy, and whole, raw apples and carrots (cut raw fruits and veggies into bite-size pieces). Aside from these exceptions, kids can continue to eat most of their favorite foods during their expansion.
Schedule a Complimentary Consultation to Get Started
To find out how we can bring out the best in your child or teenager’s smile, schedule a complimentary consultation at Houston Orthodontic Specialists today! If your kiddo does need a palate expander, we’ll walk you through the process, fill you in on exactly what to expect and answer any questions you have. We’ll also give you instructions on everything from how to adjust an expander to how to keep it clean. Book your child’s complimentary first visit online.