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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.

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

  1. Elizabeth says:

    I got my rapid palatal expander put on yesterday, and only one of the two teeth that the rings are around is bothering me, but it is a horrible constant pain. What can I do to solve this?? Is this normal???

    • It is not uncommon for the expander to be a little sore the first couple of days. You are not used to having bands around your teeth and sometimes they impinge upon your gums. The gums should accommodate fairly quickly and you should feel a whole lot better soon.

  2. Lori says:

    My 9 year old son is scheduled to have a expander put on. I wanted to know is there any other option. I also feel he might be a little young for this, I have very mixed feelings about this.

  3. Buli says:

    My palatal expander was inserted into my mouth 3 weeks ago. When I first started turning the screw, I didn’t experience much pain and even noticed a gap forming between my two front teeth. But over the past week, I’ve been receiving unbearable pain every time I adjust the expander. My orthodontist said it should go away after I used the mouth wash she recommended, but I’ve gained no improvement whatsoever. Should I be worried? My gums are a bit swollen too.

  4. Ashley says:

    My bottom teeth are really crowded, I only got bottom braces on 2 days ago. They said they didn’t wanna pull out any teeth because my jaw is small. In 2 weeks I will go again so they can put an upper expander. My front teeth is similar to the video, except from the middle teeth…2 teeth to the left. That one is a little high up. How will that tooth move down?

    • Teeth move if they have two things, space and force. You can create space with springs, wires, expanders, etc. You can provide force with wires, elastics, springs, etc. Once you have space and force, you then slowly move the tooth from its previous position to the desired position. I say slow because you want the bone and gums to move with the tooth.

  5. Misty says:

    How much does the palatal expander usually cost with no insurance?

    • This is a question that can only be answered when the entire problem is diagnosed and treatment planned. The expander is just a tool used in the correction of a bigger problem. The cost range may be several thousands of dollars depending upon what else is going on. Most orthodontists offer complimentary exams. You should be seen in person to see how much your treatment would be.

  6. Fiona says:

    My daughter is 6 and scheduled to get an expander, she was diagnosed with a crossbite should I wait until she is older? 6 feels so young. Thanks

    • For me, the best starting time is when the 6-year-molars are fully erupted and the patient is mature enough for treatment. This is usually 7 or 8, but your daughter may be further along.

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