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 roof of the mouth (the midpalatal suture) is not fused or calcified. 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 taken out, 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 pull the teeth 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, soup, 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 nearly 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 is 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. Please understand that because he has tens of thousands of readers each month, IT IS IMPOSSIBLE FOR HIM TO RESPOND TO EVERY QUESTION. 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.

1,324 comments so far in response to “What to Expect With Your Child’s Orthodontic Expander”

  1. Mike says:

    My daughter is getting an expander soon and I was doing some research and came across your site. I have no question but only want to thank you for taking the time to answer all of these questions. I’m amazed at all of the time you have taken to help these folks. I admire your professionalism. Thank you.

  2. Jacklyn says:

    Dr. Jorgensen. I just came from a meeting w/our dentist. My 9yo is having her expander put in in “3” stages, a week apart. (She has a tiny mouth and large teeth)I am so worried about the pain and discomfort. The dentist brushes me off but yet in the same breath tells me she will have to learn how to swallow all over again. IM FREAKING OUT!!! She is tiny and can’t afford to “not eat”. Please help. She does not do well with even a small canker sore ..my poor baby…signed…a very nervous mom. I read about the toothbrush. Ill get that. SHould I stock up on Oragel? Tylenol??

    • Your nervousness is understandable Jacklyn, but you don’t need to worry. Your daughter will do great. Rather than stocking up on Oragel and Tylenol, get some things to make this fun. She will need a few days to get used to eating with her expander, so stock up on pudding, yogurt, ice cream, etc. Her success will be determined in part by how well YOU respond, so BE BRAVE! Good luck.

  3. Lauren says:

    Hi, I Got My Expander Put In Yesterday And Have Had Trouble Chewing And Swallowing Foods And Saliva. It Is Extremely Painful Near My Upper Back Teeth. I Was Wondering If Chewing And Swallowing Will Get Any Easier And If And When The Pain Will Stop? Thank You.

    • Yes and Yes! It takes a few days to get used to your expander and any discomfort you’re feeling will go away soon. Treat yourself to some comfort food and good luck!

      • Lilismom says:

        My daughter is 9 at first she had trouble eating she at ice cream yogurt and I bought ensure shakes this only lasted a couple of days then she was fine she does use the little straight oral brushes to get food out on occasion but she has adjusted it’s been a month and she eats pretty much everything except popcorn or chewy candy hope this helps scary but it’s all good

  4. Lilismom says:

    How long is a expander on

  5. Chris says:

    My daughter has had this in for a week. Her doctor’s office only called it an appliance and said it would make space. I only just found out exactly what it is from my sister who had a couple kids need one. So thank you for the description so I can understand better. But you did not get quite specific enough for my questions. My sister said basically you are splitting the cartilidge in the palate, and then the space from the widening will fill in with cartilidge. That there will be a time turning the device when it actually splits and the child will be in a lot of pain for a few hours when this happens.

    Is this correct? Why would our doctor not tell me this so I am prepared for when it happens? This makes me upset, because I believe knowledge is power…..

    • Your orthodontist could have been better at communicating what is going on with your daughter, but your sister is being overly dramatic too. Palatal expanders SLOWLY stretch the growth plate that is made of cartilage. The stretched growth plate calcifies then becomes bone. Expanders do not split the cartilage and they do not cause the patient pain for several hours. Both my son and my daughter had these expanders and they did fine. Good luck!

  6. Daphne says:

    My daughter’ dentiste suggested to put this expander. He is not an orthodontist but he treats kids with those expanders that one can take off (he doesn’t glue them to the teeth). He has experience with that and had been doing that for a while. He explained very well the whole procedure. However, I still have a question…. if my daughter will take off the expendars just for brushing her teeth, is this removable expander is a good option or should we go with the one that they glue to the teeth?
    Thank you in a d’avance for your help!

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