Dr. Greg Jorgensen
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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 roof of the mouth (the midpalatal suture) is not fused or calcified. 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 taken out, 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 pull the teeth 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, soup, 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 nearly 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 is 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. Please understand that because he has tens of thousands of readers each month, IT IS IMPOSSIBLE FOR HIM TO RESPOND TO EVERY QUESTION. 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.

1,368 comments so far in response to “What to Expect With Your Child’s Orthodontic Expander”

  1. Andre says:

    My 6-year old was recommended an expander due to a very narrow jaw + crowding. One orthodontist recommends just that, saying that lower jaw crowding will also partially resolve itself after that. Another recommends adding braces to move the teeth during/after the expansion. (Both say braces in teen age will very likely also be needed.) Is it too early for braces now when she only has 3 permanent teeth? Thanks in advance!

    • An expander may be necessary to create the room needed for the permanent teeth to come in. I am a believe in placing brackets in Phase 1 in addition to using an expander. Good luck!

  2. Greg (not a doctor) says:

    Just a quick note to say thanks for publishing this description – written seven years ago but seems to be accurate still. Our 8-year-old son is scheduled to have an expander installed in his mouth next week in metro Denver, and your words have made him comfortable with the process.

  3. stacey says:

    my son 14 has been wearing top and bottom plates for 6 months his father was paying the bill and recently my son moved away with him and is no longer having his check ups and widening his top plate im worried this will affect his mouth some how …should he still wear them untill he finds a new orthodontist whenever that may be or should he take them out ???

  4. Brooklyn says:

    I have had my expander in for about 6 months now and they are planning to take it out this week. I have braces and I was wondering how they take it out and how much it will hurt. Thanks

    • Taking expanders out is quick and easy. There is a special set of pliers that just slips the bands right off of the tooth. It takes less than a minute and is not bad at all. Just a little pressure when your doctor “breaks the seal.” Good luck!

  5. kathy F. says:

    My 10 year old, in consultation, was told that he needed an expander and braces to correct his tooth problem. I brought him in and he was given braces, no expander AND I was told that he needed 4 teeth extracted to make room! When I questioned the dentist, he said that the expander was planned for later. Is that true OR did he make a mistake, as I suspect?

    • I can’t answer because I haven’t examined your son. Typically I either prescribe an expander or extractions. Only if your son is extremely crowded AND has a posterior crossbite would he need both.

  6. Man says:

    I went to a few orthodontist for my 11 year old daughter. There is one tooth that is not coming out yet and its dues to crowding. They all recommended expander and braces. I thought the process was to get expander first to create room for the tooth to come out and then get braces to attach a chain to that tooth IF it wasnt coming out by itself. BUT now, in our first appointment which we thought it was for expander only…he is putting on braces for the top (which is where that tooth is) only. Is this common practice to put braces on before expander? I am afraid that the orthodontist was afraid to lose my business and rush to braces first. Please help.

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