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.

1,089 comments so far in response to “What to Expect With Your Child’s Orthodontic Expander”

  1. Amy says:

    My 8 year old daughter has had her expander in for a couple months now because her incisors were coming in too far back on the roof of her mouth. I just wanted to help ease anxiety for anyone also having to get an expander for their little one Going into it, I was super nervous for her. The process seems like a lot more trouble than it actually is. I think the worst part was the slurping we had to listen to for the first week or so until she became used to it, hardest part for her is no more pb&j sandwiches or taffy. Remembering to turn it with the key every day was frustrating in the beginning, but once you make it part of your daily routine (we do it when we brush our teeth in the evening) it will be easy peasy!

  2. Adriana says:

    Hi, I just got my palate expander today, I’m having a lot of pain on the tooth that has the metal part that is holding the expander. It hurts when I bite down and it touches my bottom teeth. Is this normal?

    • It is normal because the band has probably moved your tooth slightly causing pain that is much like what braces cause. Give it a few days and I think you’ll be very comfortable.

  3. Holly says:

    Heya Dr. Jorgensen,
    My 15 year old daughter just got her expander put in today. I did as much research on it as I could before they put it in. The only thing I was caught off guard by is they actually put two screws into the roof of her mouth. I am not sure why they did this. I did not get to ask any questions as her dad took her to the appointment. She had a sub-mucous cleft palate (I am not sure if this closed on its own or not) and I am wondering if that maybe a reason why? All of these questions… I am having a hard time finding information on this specific part of the procedure. Could you lead me in the right direction? I thank you so much for any information you can toss my way!

    • This is a variation on the most common style of expanders used. Placing the screws (TADS) anchors the expander to the roof of the mouth. I don’t do this, but it is not unheard of. I would ask the orthodontist why the TADS were necessary in her case

  4. Dawn says:

    My 7 years old daughter has a long and narrow face and narrow arches with crowding. Her orthodontist is planning to use quad helix to expand Her upper arch. Which appliance has the best skeletal effectiveness? Due to Her face shape i hope to see as much skeletal expansion as possible and minimize dental tipping.

    • I would suggest some type of expander that is cemented to the teeth and has a Hyrax expansion mechanism. My experience with the quad helix is that almost all expansion is dental tipping.

  5. Marchman Smith says:

    Good Afternoon, my 7 year old daughter is very active and plays competitive soccer. Are there any particular precautions I should take to be sure she is safe. I am worried in particular about the ball or another player striking her in the mouth. Do you recommend a mouthguard?
    Thanks in advance.

  6. Anisha says:

    I just want to know that if an adult is going through this palate expansion process how much time will take this process to get things correct.

  7. Jamie says:

    Hi Dr. Jorgensen –
    My son had an expander placed about 6 weeks ago – we’re done turning the screw – but I’ve noticed the bridge of his nose has gotten wider! I really don’t like that and thought I signed up to expand his palate not his nose. He now has a bump on his nose and I’m not happy with those results – have you seen this before? I would hate to take away all the expanding we just did – but if we take it out early does your nose go back to normal?

    • I have not personally seen this in my patients, but I have read about it. From what I understand, it is a temporary side effect and your son’s appearance should return to how it looked pre-treatment. I have noticed a lot of very young patients who look a little wide when we’re done expanding, but they revert to normal quickly after expansion has stopped

  8. Karen says:

    Hi: My daughter just turned 8 and only one of her incisors has come in. The other is there but has not come in. Same with her lower front teeth. She lost 3 of the baby teeth and only 3 have come in. You can see it trying to come through but it’s locked out. None of her remaining baby teeth are even slightly mobile. I took her for a consultation and expanders were the suggested route. The top will be cemented, the bottom I will have to turn. I understand the procedure but I’m a little nervous. She’s only 8. Should I worry?

Leave a Comment

Back to Top

Your account login
Your rewards
Schedule an appointment with our talented orthodontist online