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.

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

  1. Shel says:

    Hi there,

    My 8-year-old daughter just got an expander yesterday. She is coping surprisingly well with speaking and eating and coming along okay. But she is finding the presence of the expander in her mouth aggravating and is dismayed at the thought of it staying in there for so long. Our orthodontist wants it in there for a whole year! Does that seem like an excessive amount of time? Do you ever take expanded out early and replace with a removable retainer if things are going well?

    • All orthodontists are trained differently. I don’t keep my patients expanders in for that long, but you’ll have to negotiate the length of time for your daughter’s expander with her orthodontist. Good luck!

      • Shel says:

        Thank you for your comment, Dr. Jorgensen!

        My daughter has adjusted to the palate expander very well! No pain and she is eating and speaking normally (after only a week). Hooray!

        One more question for you – our orthodontist is recommending headgear to accompany the expander (to go on in about 6 weeks). This headgear would be worn at home, at night for 10 months. I am concerned about this though. I have read that headgear can lead to complications like sleep apnea later in life. My daughter already is a mouth-breather when she sleeps and I worry the headgear could make her airway smaller.

        Are there alternatives to headgear for her? She is only 9 so she still has baby teeth, so I would guess full braces wouldn’t work (or Forsus Springs because they require full braces, right?) But could a spring or elastics or something bring her lower jaw forward instead of hindering her upper jaw’s growth? She has a 9mm overjet, some crowding and her lower jaw is small and appears receded.

        I know my orthodontist wants to proceed with the headgear, so I want to bring up some other options to suggest. I am very worried about headgear having a lasting, bad impact on her health. But at the same time, this is a very reputable orthodontist so I don’t know what to do.

        I would appreciate your insight!

        Thanks,

        Shel

        • Headgear is a tried and true orthodontic accessory that has produced great results for more than a century. There is absolutely NO evidence that headgear causes sleep apnea. None!

          • Shel says:

            Thanks you for your response!

            I know I am being overly anxious but my daughter is not quite nine, so I worry! Right now she is feeling self-conscious about the gap in her teeth from her expander, which is hard because she has always been a super-confident girl. She is still loving her braces though, and looking forward to being through with the expanding and getting her wire!

            Thank you again. It’s a totally new world for me because I never had braces so I’m trying to do my due diligence 🙂

            Shel

          • You are welcome. Glad to help.

  2. Bharggav says:

    My 9yr old is a stage III cleft pallete. Arch expansion was advised. Will upper pallete be effected due to this procedure. Will it cause permanent speech damage. Please advise.

    • I’m not an expert in cleft palates. I would advise that you seek the advice of a cleft palate team that typically includes a dentist, an orthodontist, an oral surgeon, and a speech pathologist. They will have the answers you seek.

  3. Ariel says:

    I have had my expander for a while not and my gums are starting to grow around my expander and sometimes has tenderness to it. Is this normal?

  4. Crystal says:

    My daughter (8 years old) just got the expander put in on Monday (April 25). We have cranked it 2 nights now and she is crying and complaining of pain when we do it. Is that normal? She is now able to eat, swallow and talk normally. Thanks..

  5. lori says:

    i am so glad i came here.
    children will be getting xpanders soon and this is great to be able to read the real life effects and questions of others.
    Also to know what to look for and the dangers that could arise.(gums growing over xpander)
    Thank you for all the input.
    Blessings to all!

  6. lori says:

    sounds to me All people are very different.
    Even nerves can be different reactions on some ppl as i read. Prabha, i am no Dr. but nerves came to mind while reading ur post. I hope this all works out for ur babe. This Dr. on here also has wisdom in what he does for living. Thanks for sharing ur wisdom with the world DR.
    🙂

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