Dr. Greg Jorgensen
(505) 891-9440
1401 Barbara Loop SE
Rio Rancho, NM 87124

The Jorgensen Orthodontics Blog

What to Expect With Your Child’s Orthodontic Expander

Posted by Dr. Jorgensen on August 22nd, 2011

ExpanderOne of the most common orthodontic appliances used in young children is the palatal expander. These appliances look intimidating to patients and the thought of having to “do the turns” every day scares a lot of parents. What can you expect while your child has an expander in their mouth?

Arch expansion is one of the most common ways to eliminate crowding and crossbites in growing patients. Successful expansion requires that the growth plate in the room of the mouth (the midpalatal suture) is not fused. This fusion usually occurs between 14 and 16 years of age.

An expander is attached to the upper arch by bands placed around the teeth or plastic bonded over the teeth. Although there are removable expanders, fixed ones have an important advantage in that they cannot be lost or forgotten.

While there may be some initial discomfort when an expander is placed just because there has never been anything like that attached to the teeth before, for the most part upper arch expansion is relatively painless. Patients report that they feel pressure on the teeth, in the roof of the mouth, behind the nose, and even between the eyes as their expander is activated. This pressure fades within minutes.

Besides pressure, you can also expect your child to speak differently for the first few days. Additionally, you may hear them slurping as their mouth creates extra saliva after expander cementation. One of the most visible signs that the suture is opening (the desired effect) is the appearance of a space between the upper central incisors. The space is created as the expander pushes the two halves of the palate in opposite directions. Once you have stopped activating the expander, it is normal for the space to close spontaneously. This occurs as the elastic fibers in the surrounding gum tissues return to their original positions. The underlying bone, however, remains expanded. It is also normal for the front teeth to feel a little loose and get sore as they move back together.

To make the first couple of days more bearable for your child as they adapt to their new expander, you may want to find some fun foods for them to eat that don’t require a lot of chewing. Examples include yogurt, pudding, mashed potatoes, ice cream, etc. A day or two after their delivery appointment, the expander will feel natural in their mouth and normal eating will resume. While expanders are more forgiving of hard and sticky foods than are braces, it is recommended that patient avoid jelly like candies that would get stuck in the expansion screw.

Because there is always some relapse (movement back towards the original size), your orthodontist may choose to over-expand your child’s palate. He will decide how much expansion is necessary as part of the initial diagnosis and treatment plan. After your orthodontist indicates that you’ve reached your target, he will instruct you on how long the retainer should stay in place to stabilize the results. This may range from two months to the entire length of treatment.

NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist who is in the private practice of orthodontics in Rio Rancho, New Mexico (a suburb on the westside of Albuquerque). He was trained at BYU, Washington University in St. Louis, and the University of Iowa in the United States. Dr. Jorgensen’s 25 years of specialty practice and 10,000 finished cases qualify him an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, Suresmile, and lingual braces). This blog for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in the state of New Mexico. He cannot diagnose cases described in comments nor can he select treatment plans for readers. Because he has over 25,000 readers each month, it is impossible for him respond to all questions. Please read all of the comments associated with each article as most of the questions he receives each week have been asked and answered previously. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.

1,290 comments so far in response to “What to Expect With Your Child’s Orthodontic Expander”

  1. Alisha W says:

    Will the expander change the shape of my daughters mouth? I have read on other forums that they alter the look/shape of the patients mouth and face.

    • There may be some TEMPORARY change in the shape of your daughter’s mouth. The widening is done quickly and everything changes in the short term. As the body adapts to the teeth in the new position, everything will settle back to normal. Not once in 25 years have I ever had a parent concerned that their child had an adverse change of appearance in their child. Not one! The alternative to expansion is extraction which causes much bigger changes.

  2. Scott says:

    What is the effect, if any, on the need for traditional braces? Do expanders eliminate the need for braces or just reduce the time braces are needed?

    • Expanders are a device that performs a different function from braces and may or may not be used as a part of treatment. They do not replace the need for braces, nor are they an option that an orthodontist can use if he wants to shorten treatment time. Rather, expanders are used when the arches are too narrow. They widen the jaw. Braces align the teeth. If you only get an expander, you’ll have a wider jaw, but the teeth won’t get straight on their own. If you have only braces, you’ll get straight teeth, but not a wider jaw. If you need jaw widening and straight teeth, you’ll benefit from both.

  3. Crystal says:

    My daughter 8 was told she needed a dental expander. Ive been to two orthodontists and the first said they would glue the expander to the molars and i would turn once a day for about 8-9 months. The second said the expander would be put in with bands and be turned once a day for 30 days and then she would wear a face thing thats padded on forehead and chin and it would hook to expander and she would wear it 12 hrs or more a day for approx 16 months. My husband and I are trying to find out which procedure will work better, be less invasive and painful for our daughter. Any advice would be welcomed!

    • Both are expanders that will widen the jaw. The second option includes a facemask designed to treat an underbite. If your daughter has an underbite, only the second option will help correct it.

  4. Susan says:

    Can my child have soda if they just got there expander removed

  5. Ken says:

    My 7 year old has had her expander in for 14 days. And as predicted her front teeth have a gap …however her front teeth seem to stick out more ( goofy style). Why ? Is this ok

    • I’m not sure why they seem to stick out more, but it is not uncommon for them to move during the expansion process. I’m sure everything is fine, but run it by your orthodontist at your next visit

  6. Patty says:

    My daughter 12 year old get last week Braces but the Dr only put on front then Dr said need it the expander. Then take the impresión, but my daughter fall up left side second molar , but the Dr never take again the impresión what happened the impresión take with the all teeth.

    • This is a very specific question that you need to address with your doctor. He can explain how the expander will be made and can repair anything that has fallen off.

  7. Christina says:

    Hello my son is 8 now turning 9 in October I had one consultation with one of top child orthodontists in my area Dr Hershey who recommended he will need phase 1&2 in addition a pallet expander because he has my tiny mouth n jaw but his dad’s larger teeth I didn’t ask but is the expander just for the top or do they also have bottom expanders also? In addition even after his bday when he’s 9 I’m concerned that he’s so young n still has many baby teeth is that pretty normal to start so early with braces or the steps leading up to braces?? I guess common sense tells me it would be easier to help the teeth move into place as the child is growing instead of waiting till he gets older n trying to force them back? Just a concerned mother of one I appreciate any feed back thanks in advance!

  8. Sarina says:

    Hi. My child is almost 9 years old. Our orthodonist said he needs an expander for crossbite. He already has a space between his front 2 teeth.

    We went to another doctor for another opinion and she said he does not need expander. She said its only 1 tooth that is in crossbite and rest are baby teeth back there. She said if we did an expander when his permanent back teeth comes in there is no guarantee they will not be in crossbite so no need to do it yet.

    So now we are totally confused. Can you advise us?

    • I cannot advise you on your child specifically, but I’m a big believer in using expanders in young kids. Early expansion doesn’t guarantee the permanent teeth will not be in crossbite, but I can almost assure you that if the baby teeth are in crossbite, the permanent ones will be too.

  9. Allie Hayes says:

    Hi I just got my expander put on two days ago, I’m 15. Is the bar part supposed to wiggle on both sides when i touch it? It’s not detached and it still pushes my jaw forward it just wiggles when I touch it.

  10. Tiffany says:

    Hello my son is 8 years old and he just got his expander in today.He lost his permanent front top tooth playing football,he’ll be getting partial braces but what I do wanna kno is by all this work being done will that space close or what!!!!

    • The space where a permanent front tooth has been lost will not close on its own. This is a big deal and you need to specifically ask your dentist how the missing front tooth will be replaced. We do not usually close a front space as it will cause the smile to be off-center.

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