Orthodontic Expanders

Certain orthodontic techniques have shifted over the last several years, especially the increased introduction of orthodontic expanders. In the past, it was common to extract teeth in order to create space in the mouth. Now, orthodontists are trying to save healthy teeth by expanding the arches to correct crowding issues. Expanding the arches is successful in creating more space in the mouth in most cases, but it may cause large gaps to form between the teeth. This can be unnerving for patients and their families.

When to Use an Expander

The roof of the mouth contains two bones which are joined in the middle. When children are young, these bones are joined together by cartilage. At around the age of 14, this cartilage begins to be replaced by bone. If patients can be treated prior to this period of maturation, the roof of the mouth can actually be expanded to help avoid tooth crowding. It is important to treat patients long before the bones begin to permanently fuse.

Appearance of a Tooth Gap

When the expander begins to work, a large gap will typically appear between the top front teeth. This is a sign that the two bones of the palate have been separated. The gap will disappear after further orthodontic treatment. While it may be uncomfortable because of the altered appearance, patients should rest assured that this gap is temporary and necessary to effectively correct misalignments caused by crowding.

Stabilization Period

After the palate has been widened, orthodontists will leave the expander in for a few weeks to several months in order to allow the body to adjust to the newly expanded palate. New bone may form to accommodate the spacing. The teeth may begin to come back together because of the elasticity of the gums and the gap may diminish or disappear even before the expander is removed. This is also normal, but does not happen in every case. After the expander is removed, the palate may come back together slightly. Orthodontists typically anticipate this change by expanding the palate slightly more than needed.

Advantages of Using an Expander

An expander can help patients to avoid costly surgeries and treatments later. Crowding issues may cause teeth to become painful or to rot. An expander will help to naturally make space in the mouth. Expanders can be used even before a patient’s permanent teeth erupt so that the teeth can come in comfortably and free from complications.

Palatal Expansion

Palatal expansion works to widen the upper jaw using a device. If an orthodontist has recommended palatal expansion, it means that it is necessary to widen the jaw for best function. Failure to follow the recommendation for palatal expansion may result in complications with jaw and tooth development. These complications may cause difficulties with chewing and speaking, as well as abnormalities in the appearance of the teeth or mouth.

Benefits of Palatal Expansion

Widening the jaw may improve the alignment of the jaws and teeth, which can help to eliminate or prevent complications with chewing and speech. Having the jaw widened before permanent teeth erupt may help patients to avoid extractions, in many cases. In some cases, palatal expansion may help younger patients avoid braces and other costly treatments that would be needed to correct misalignments later in life.

How Palatal Expanders Work

Palatal expansion must be done before the growth plate on the roof of the mouth fuses together, which generally happens between the ages of 14 and 16. Prior to the fusion, the palate is in two parts that are joined together by a suture. The palatal expander works to ease this suture apart. New bone grows to reconnect the two halves of the palate after expansion. The palatal expander may also strategically move specific teeth during the process. The process of palatal expansion is usually complete within several weeks to several months.

Palatal Expander Placement

The palatal expander is placed in the mouth at an orthodontic office. The orthodontist attaches the expander to several of the upper back teeth. This may be done using bands around the teeth or plastic that is bonded over the teeth. Some palatal expanders are removable and some are fixed. After the palatal expander has been placed, patients must turn it every day in order to gradually widen the palate.

Palatal Expansion Expectations

After having a palatal expander placed, many patients feel pressure on the teeth, in the roof of the mouth, and sometimes behind the eyes. This pressure will generally fade within a few minutes. The pressure may recur when the expander is turned, but patients will usually get used to this feeling relatively quickly. As the palate expands, gaps may appear between the teeth. This is normal and teeth will shift to fill the gaps after the palatal expander has been removed.

Caring for Palatal Expanders

Fixed palatal expanders should be brushed along with the teeth after meals and consumption of sugary beverages. The mouth should also be rinsed thoroughly after each cleaning to avoid buildup. Removable palatal expanders should be cleaned meticulously each day after removal. Failure to properly clean palatal expanders may result in tooth decay and other complications.