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.

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

  1. Natalia Barrientos says:

    Hi, I got my expander two days ago and my front teeth are beginning to feel a bit loose, is that normal? Also, I still cannot get used to food getting stuck so much in my expander, it’s not much pain but I just feel very uncomfortable. Thank you in advance!

  2. Nina says:

    Hi, I have had my expander in for 3 days now, and I still feel some pressure/pain on my back teeth (the ones the expander is connected too), so it’s kind of hard to eat, or just relax my jaw. How long does it normally take to get used to the pressure?

  3. May says:

    My daughter got her expander out today. She says she is having a lot of pressure on the roof of her mouth and teeth. Is this normal? She also won’t get a retainer right away to give time for the back teeth to straighten out. Should I be concerned that the other teeth are going to start moving too close?

    • These are questions best asked to your orthodontist. There are many variables that affect the type of retention necessary after expander removal like how far she was expanded, how long the expander was in place after expansion was complete, and how much over-correction was achieved.

  4. Lina says:

    Dear Dr. Jorgensen, I got my braces on Saturday, and I hate it so much! Please help me! I find it especially hard to talk and eat, and to make it worse, I am very sick. So these couple of weeks will be very hard for me to adjust, and I hope I can survive with it. Whenever I eat, my teeth hurts and food always gets stuck on top of my expander, and I can’t even enjoy my food. I really hope you get this and I would appreciate it if you give me some advice. Do you think this is worth it?

  5. taylor hollada says:

    well in like the next month or to im going to the orthidontist for the first time. im kinda scared but i dont want mest up teeth anymore. can you guys pleas give me some tips on what there going to do first please.

    • It depends upon what problems you have, but here are the steps in general: 1) take pictures and x-rays to help determine the problems, 2) examine your mouth, 3) make a list of all of the problems, 4) determine how to fix the problems, and 5) maybe put braces on your teeth to get treatment started.

  6. Brynn says:

    My 8 year-old son, in my opinion, has a moderate pain tolerance. However, today will be his 3rd trip to try to have an upper palate expander placed because he screams and cries and says it hurts so much. I assured him is only a “pressure” and that the benefits outweigh the difficulty now. Is there anything you recommend that I could do (or should ask) to help him get through this? Thanks!

    • Hi Brynn. I’m sorry to hear that your son is struggling. It is not common, but not unheard of. You know your son better than anyone at the orthodontic office. If this is not the best time for him to have treatment, let them know.

  7. sammi says:

    I already have braces and I am getting an expander put on, is it normal to get one once I already have braces?

  8. Bibbi says:

    Hello, my 10 yearold daughter has had her expansion in for a couple of weeks and last night her front teeth made a big gap is this normal and is there such thing as turning it to much?? even when following Dr orders

    • A space between the front teeth is good. It is to be expected. If you have been following your orthodontist’s instructions, you’re probably OK. If you think something is wrong, better to be safe than sorry. Get daughter in for a quick check up.

  9. Laura says:

    My daughter has had the expander for almost 4 weeks now. The expander has been turned the max amount of turns. The “back” of her palat has separated while the “front” by her front teeth has not. The Orthodontist says sometimes it doesn’t work the way we think it will. Her teeth are still sore. Is this common? Is there something else we can do to make it open? Wat to do?

    • This is not common in younger children, but does happen in older teenagers. If more expansion is required, she may need to have an oral surgeon “re-open” her palatal suture. Ask your orthodontist about a “surgically assisted rapid palatal expander.”

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