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.

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

  1. Bob says:

    My 7 year old is about to get an expander. She has crowding and is having one baby molar extracted first. I am hopeful that this will relieve the crowding and possibly prevent the need for braces. It is only on top and all teeth are straight, also no visible wisdom teeth on pano. Is this a possibility? not having to get braces after expansion.

    • The chances that your daughter’s teeth will line up on their own after having an expander are very low (almost never happens). I always place braces on the teeth and move the teeth to their best position after I create the necessary room.

  2. Colbert says:

    My daughter has the expander in the roof of her mouth. She has had it for about 2 weeks. Everything is going ok, but she has indents in her tongue from the metal laying on her tongue. She saids that it has made her tongue sore. Is there anything I can get her, or put in her mouth to help the soreness? We have tried wax but it is not staying in place.

    • After the orthodontist gets as much expansion as he needs, ask him to cover the expansion screw with light cured plastic (mention Triad material). That will really make your daughter more comfortable.

  3. Taylor says:

    Hi, I just got my top expander yesterday, and I turned it tonight (with the key) and I am expiriencing a little bit of soreness over by the bands connected to my teeth. Is this normal? Thank you!

    • There is an adjustment or accommodation period after you get your expander and what you are feeling is perfectly normal. Return to your orthodontist if something seems wrong after a week or so.

  4. Paige says:

    My daughter just got her palate expander and she is having trouble eating and can only eat certain foods because with her expander her front teeth don’t touch anymore so she can’t chew do you have any food suggestions that she can eat or drink?

    • Finding things that are easier to eat with an expander is always an interesting challenge at first, but our kids always figure it out. For starters, make it fun the first week–yogurty, pudding, ice cream. I guarantee your daughter will hunger for normal foods and figure out how to eat them soon enough.

  5. Andi says:

    My 9 years old daughter h
    Just got expander and she is not eating , not drinking and not talking because of the glue taste.
    She has no pain but complaining about the taste. She refuses to eat or drink to get tux if the taste ant not swallowing either.

    Any suggestions?


  6. Heidi Mermis-Cava says:

    We are US Diplomats living in Brazil and my son who is 8 years old just had a palatal expander put in two days ago. I have been turning the screw the last day and one half and when I turn it there is some slight resistance and after my son tells me he feels the “pain” or pressure. Tonight I put the key in the hole and turned and nothing….. no resistance, nothing. It actually turned, I watched the key turn all the way to the back of the throat, removed the key and found the next hole and did it again. Does this mean the expander is broken? It was made here in Brazil so now I am freaking out that after two days it has broken and I can’t expand it. I literally tried 10 times tonight, got the key in the hole, moved it around from side to side to make sure it was in the hole, and nothing. No resistance, just an easy slide back following the arrow. Nothing like the first 3 turns I have already done. Stressed out in Brazil and of course the orthodontist is not answering her cell phone like she told me she would at night. Any advice or thoughts??
    Thank you, Heidi

    • If there is no resistance at all there is probably something wrong. At the end of treatment it is common to “max out” the appliance, but that shouldn’t happen in only two days.

  7. Jane says:

    My daughter is 14 years old. Is it possible to determine if she is still growing and can benefit from an expender?. If growth cannot be determined and she does try an expander but has already stopped growing are there any downsides to using an expander?

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