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.

1,239 comments so far in response to “What to Expect With Your Child’s Orthodontic Expander”

  1. Jody says:

    Is it normal to have frequent nosebleeds with a rapid maxillary expander? My daughter is on day 7 with her expander and turning it twice a day. The nosebleeds just started and shes had 5 nosebleeds today.

    • It is not normal, but I have heard of it. Expanders actually do stretch the nasal mucosa and that can cause tiny capillary tears in some patient with very thin tissue. I would talk to the orthodontist about slowing the rate of expansion and maybe giving her a couple weeks off before the turns start again. Good luck!

  2. Eva says:

    Does the orthodontist always give you the option of either removing teeth or a palate expander?

    • No, because the two are not interchangeable. Sometimes a patient’s problem can be solved with an expander, but sometimes it cannot. Severe crowding in the lower arch due to a small lower jaw cannot be fixed with an expander. There are just some mouths that don’t have room for all 32 teeth.

  3. Qasim says:

    So I’ve had my expander in yesterday and I had dinner as normal. Besides the fact it was annoying and a bit odd to eat. The next morning I’ve had severe pain in my molars. Could it be that I chewed on that side or could it be that I pushed up the expander with my tongue to make it more adapted to my roof shape?

    • It may be that the expander is moving the teeth to which it is attached a little and you’re experiencing the same discomfort that patients feel when they get their braces. Give it a couple of days and see if it doesn’t calm down a little.

  4. Suzanne says:

    Hey there! My 14 year old has been receiving orthodontic treatment for almost two years due to a crossbite. A new doctor saw him after several months of just braces and recommended a Xbow expander in August 2016. They removed it a couple of weeks ago and his teeth look worse than ever, his bite is only touching it looks like in two places. His next appt is to put wires back in next week. Is it normal to have the expander removed and it to look so much worse than it ever did?’
    Thanks in advance. I greatly appreciate it before going for a second opinion.

    • It is common for the BITE to look worse after expansion. We commonly over correct the arch width and this makes the bite bad for a while. Placing the braces and coordinating the arches will make a big difference. Be patient and you’ll see a lot of improvement soon!

  5. Jana M says:

    Dr. Jorgensen, My son is 9 years old, he’s an avid dirt bike rider (competitively) and he is getting his expander in 2 days. I can’t seem to get a straight answer from his orthodontist whether he should take a few weeks off from riding immediately after placement, or even if we should just be extra cautious, or no precautions at all? He always, ALWAYS wears a helmet when riding, but he also does some pretty crazy jumps and unfortunately for him, I happen to be a “retired” surgical assistant from an oral surgery practice. Personally, I think he should take a 2-3 week hiatus from riding all together, initially after placement however my husband and son want some real answers! The orthodontist basically left it up to me, stating there’s really no research about motocross/expanders. Would love to hear your opinion if you can. Thanks so much.

  6. Joel says:

    Hi Dr. Jorgenson. My son got his expander a week ago. We just got a call from school that it fell out!! We called the ortho and they are closed so we left a message. Is it normal that it fell out?? We are starting to question the competency of our ortho. Thanks for your feedback.

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