Dr. Greg Jorgensen
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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.

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

  1. Dimples says:

    At the end of the year I will be getting Damon Braces and a top and bottom expander. I am almost 14 and have dimples. Will it get rid of them? I REALLY don’t want to lose them.

  2. angie says:

    Hello Dr. Im a 33 yr old and have a crossbite, missing my left canine and my front teeth are not in the middle they moved to the left, my ortho wants me to get an upper expander, I read you recomended surgery for an older person. What kind of surgery? Thanks so much

    • In younger patients, expansion is possible because there are uncalcified growth plates or sutures that allow expansion. In fully grown adults, surgery is necessary to reopen these sutures so that expansion of the bone can occur. Without surgery the expansion will only be dental (the teeth being pushed out of the bone).

  3. Jasmine says:

    Hello Dr. Jorgensen,

    My daughter has overcrowding on her top jaw and not enough space for her canines to come in. We’ve seen a few orthodontists and one of them has recommended a RPE. A second orthodonist has recommended Damon braces. My question is which one is a better approach? Will the RPE cause too much discomfort/headaches? Any negatives of using the Damon approach?

    Your feedback is much appreciated!


    • The expander is designed to create room by expanding the underlying jaw rather than just moving the teeth in that bone. Damon braces (or any braces for that matter) cannot expand palates. They only move teeth. If your daughter’s upper jaw is too small, she probably would benefit from the expander.

  4. Tomas says:

    Hello Dr. My son is 9 years old he doesn’t have a cross bite. But one orthodontic advise expanders for early treatment preventing taking any teeth out. but another one suggest that expanders won’t work for him, that braces and taking out baby tooth will help in a first phase treatment. So now I am confuse what treatment is better for my son. Could you recommend any link to look for information?

  5. Smith says:

    My son just turned 10 years old. He has been told by Our dentist to see an orthodontist because he will need an expander on the top and possibly the bottom of his mouth. He also will not have a permanent adult tooth in replacement of one of his “eye teeth” because it did not form after the baby tooth falls out. My question… is it really necessary to do the expanders now at the age (10) or can we wait until he is a little older and follow up with much needed braces?

  6. Nina says:

    Hello Dr, I’m 13 years old and I’ve had my expander in for almost 4 weeks, and this just morning I woke up with a gap between my 2 front teeth. It’s rather painful and I’ve already taken Advil for the pain, but it isn’t really helping that much. Should I be concerned?

    • This is probably very normal Nina. It sounds like your suture reached a threshold and finally “gave.” Be patient and the pain should subside within a day or two. If not, get in and see your orthodontist.

  7. Karen says:

    Hello Dr. Jorgenson,

    My 12 yr old son just had his fixed expander placed into his mouth on Monday, bad timing as he just started school yesterday. He’s having a very hard time talking as he has developed canker like sores on his tongue. I’ve applied the wax to the base of the expander, and I’ve given him extra strength Tylenol to help reduce the pain. Because he’s in so much pain, I had to call him out of school on the second day. I know that it takes a few days/weeks to get used to this but we are thinking of having this removed and starting over in the summer time where he can adjust at home. OR, is there a type of numbing liquid that can be used to ease the pain a little more? Thank you

    • I’ve never had to remove an expander for this reason. I would give it another week before you have your orthodontist stop treatment. If there is something causing the canker sores, you could have your orthodontist smooth it with a handpiece. Your son should regain all of his talking skills within a week. This too shall pass as mom would always tell me.

  8. Sounds says:

    I will be getting a palate expander soon. All my life I haven’t been able to whistle, but could whistle with my tounge (some people call it taco tongue whistling so if you don’t know what it is it’s on YouTube). Because my mouth will be expanded, will I lose my treasured whistle? I REALLY want to keep it.

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