Dr. Greg Jorgensen
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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.

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

  1. Elisa says:

    My Daughter getting an expander tommorow can she eat popcorn

    • I’ll defer to your orthodontist on this one. I usually have braces on the bottom teeth at the same time my patients have their upper expander in place, so I would have to say no to my patients. If they didn’t have the braces on, I would probably say yes.

  2. Besa says:

    when you get a pallet expander are you supposed to get your braces done at the bottom or top at the same time? or it doesn’t matter

  3. Kim Brown says:

    Hello. My 10-year-old boy is in the Phase 1 treatment of over crowding. After 3 months of Hyrax, his doctor removed Hyrax and started to 2X4 braces. My question is:

    Without Hyrax, will the expanded space go back to original? Should he wear retainer now or should he wear retainer after 2X4 braces are removed?

    Thank you.

    • There will be some relapse after an expander is removed. I always over expand to compensate for that. You can’t wear a retainer while the braces are on however and the 2×4 should preserve the arch width if the wire is heavy enough.

  4. Karina says:

    My son has seems to need one I think, but he is only 7. Is it time for him to get it? His teeth really don’t have space to come out

  5. Amber H says:

    My 11 year old son had a palatal expander and headgear to correct his underbite and narrow upper jaw. The expander was placed when he was 10 and came out less than a year later. After being done expanding it was only lace for a few months. The expander broke just after his upper teeth jumped his lower teeth. We are talking just jumped, no real space between the top and bottom teeth when he bites down. His orthodontist chose to remove the broken expander and instead of ordering and placing a new expander to take a wait and see approach. We are now about 8 months from when the expander was removed. He was not given a retainer, when we walked out his mouth was completely empty of any devices. My son showed me earlier this week that his underbite was back and not in a small way. If he forces it he can make his teeth meet and be directly over each other but he cannot get his top teeth in front of his bottom teeth anymore. His natural bite is back to an underbite and upon looking myself I can tell his upper jaw has narrowed. He was due next month for his check up appointment so I bumped it up to right away.

    We saw his orthodontist today and he again wants to wait 6 more months before doing anything. I’m concerned that my son HAD to have this work done immediately and now he is back to having alignment issues and we are “waiting it out” instead of fixing it. In this situation should I ask the orthodontist to put the expander back in immediately and get his bite fixed? Should he have been given a retainer after the expander came out?

    Honestly I’m concerned waiting it out will mean fixing the issues will be more involved and complicated the older he gets (He will be 12 when we see the ortho again). I’m also concerned that the ortho is hoping that he will need braces at that point so he can just say he needs “Phase 2” at that point so that I again have to pay to have fixed what I already paid over $3000 to have fixed. My son has very straight teeth and even with the expander his teeth did not twist at all. I’m worried that as his adult teeth finish coming in with a narrower jaw his teeth will crowd and then he will need braces to straighten then back out.

    Please help, I just need to know if we need to push to get the issues corrected now or if we should be waiting another 6 months.

    Thank you SO much for your help!!!

    • There are several issues here. First, expanders do not correct underbites. They widen the arch. When an expander is used, it must be held in place for at least 3 to 6 months or more to allow the new bone to solidify. If the expander is removed, something must be used to support the expansion (a wire, a retainer, etc.). Second, at age 11 there is very little any orthodontist can do to prevent further lower jaw growth that is genetic in nature. Even facemasks and reverse headgear provide only temporary improvement of underbites. Our treatment does not change the DNA. As for how your orthodontist is providing Phase 1 and Phase 2, you’ll have to discuss the costs and objectives with him or her.

      • Amber H says:

        Thank you for your reply. The orthodontist told us that we needed to get his upper teeth in front of this lower ones to keep the lower jaw “in check” so it would not grow uncontrolled. From that information I understood that it was important for those teeth to stay in front of the bottom teeth. I appreciate you clarifying for me that the lower jaw continues to grow no matter what you do.

        My son did have an expander to widen the arch and then after it was widened a bit they had him use the headgear to bring his upper jaw forward. His upper teeth again are sitting inside of his lower teeth which led me to believe the expansion did not hold and from what our orthodontist told us his upper jaw will not sit forward if it can fall inside of the lower jaw.

        I think the biggest issue here is a lack of clear communication on the part of our orthodontist. He led us to believe that this expander and head gear would fix my sons issues permanently. Never was a phase 2 discussed with us or even mentioned that more work might need to be done down the road. Since I have no experience with this I took him at his word. I will be calling and talking to him about this to get clarification and more information.

        • It sounds like you have a good grasp on your son’s situation. Tooth position does not keep jaw grown “in check.” It can eliminate trauma to the teeth and shifting due to interferences, but it does not change the growth of the jaw.

  6. Madeline C. says:

    I have had an expander for 8 hours now. How long will it take until it starts to feel more normal. And how long will it take for the pressure to go away once I have turned it twice for the day.

    • It usually takes a week or two for you to feel completely normal with a palatal expander, but it does happen! As for the pressure, most of my patients report that things feel normal in only 5 to 10 minutes after the suture starts to spread.

  7. Dana says:

    My 9.5 year old son has an open bite and we were told he needs a palatal expander with braces to the superior anterior teeth and as well a tongue guard. is this a common procedure when it comes to open bite? we just need a bit more info before we are committing to such procedure. Thank you for your time!!!!

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