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

One 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.

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

  1. Sarah says:

    My 14-year-old son just got his expander Thursday (today is Sunday). He is very frustrated because food keeps getting caught in the hole of the expander. Is there anything he can do to keep that from happening? Is it ok to use ortho-wax?

    • Hi Sarah. This is not uncommon. In fact, I can’t think of one patient who didn’t have this happen initially. Your daughter will learn how to eat so food doesn’t go up there, but it will take a few weeks. Give him encouragement until he’s “over the hump.” My patients report that they have found water picks and proxy brushes useful. Both can be found in the dental products department of your local discount store. Good luck!

  2. Dawn Starr says:

    My son is 7. His pediatric dentist has been following him since age 1.5. Over the years he has been watching my son’s crossbite and at his last cleaning in March recommended a palatal expander, which is clearly what he needs. His dentist can do that in his office. I took him to an Orthodontist for a second opinion. He is recommending the expander and then braces to immediately follow. My question for you is , is it necessary to follow with braces when he is this young?

    • I always follow an expander with partial braces. Although the crossbite can be fixed with the expander alone, the expander will move the front teeth apart which will not only look bad, it will also steal space from the unerupted permanent teeth. Following up the expander with a few brackets to put the front in their ideal position helps prevent more serious problems later on. Hope that makes sense.

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