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.

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

  1. Fatma says:

    Hi I have quick question my daughter has expander about 3 weeks age and she’s having very sharp pain on her back tooth one with expander attached so I stop turning her expander I call orthodontist and they said stop turning until next appointment about week from now is this normal please some information thanks

  2. Brendan says:

    Hi Dr.Jorgenson I have an expander on the roof of my mouth and I have an appointment after school today and they are taking it out … But here’s the thing I’ve only had it for 3 weeks and we turn it every night… What happens after this do I get braces retainer I’m really confused… Thanks..

    • If you’ve only had the expander for three weeks, chances are that the expansion you’ve achieved will be lost almost immediately after it is removed. Three weeks is not long enough for the bone to heal or mature after it has been changed.

  3. carol says:

    Do you have any knowledge of expansion plate affecting the Vasovagal nerve in the palate? Causing child to faint three times within days of key being turned?

  4. mark says:

    Hi Dr.Jorgenson
    Please explain a benefit of using a bonded palatial expander? I was told my daughter (7) would need this as opposed to the Hyrex type. She has a slight underbite as well. The bonded type just seems more bulky and harder to adapt speech to. Any thoughts?

    Regards,
    Mark

    • I like bonded expanders when there are primary teeth because they hold everything together and don’t loosen them. They also give the kids a nice even surface to bite against while the palate expands. Hyrax-style expanders work too, but they sometimes loosen baby teeth and the tooth-on-tooth contacts are a little harder to deal with. Hyrax expander are easier to get out than bonded ones however.

  5. Nancy says:

    I just got an expander and someone told me that the expander is to break on the last turn. Is this true?

    • It doesn’t really “break,” but you do get to the end of the expansion screw. In expanders made by some companies the screw stops turning. In others is starts spinning. Either way, there is a limit to the amount of expansion that can be achieved.

  6. John says:

    My 6 year old son had a crossbite/underbite due to narrow palate. Ortho said he had some trapped adult teeth, too. My son has already lost 8 primary teeth. He has had the expander turned for 5 weeks and will now have for 3 months to stabilize. Ortho is recommending braces to close gaps and free trapped adult teeth. He has previously noted that my son will still likely need Phase 2 braces when he’s older. 1. Does opting out of phase 1 braces hurt what we’ve done with the expander? 2. If we’re going to need Phase 2 braces, what are the benefits to having Phase 1 braces in for the year that is being recommended? 3. Does it hurt to wait 3 months or more after the expander is removed to see how things go rather than getting braces on a week after as is currently being recommended? Thanks for your help.

    • I am a believer in following up an expander with interceptive braces because after I have created additional space, I like to deliberately move the already erupted permanent teeth into their appropriate positions so the unerupted teeth can come in better. They won’t go there on their own.

  7. Nusrat says:

    My son has serious crowding problem.his orthodotics gave him 2 option. 4 baby teeth extraction and see what hapens or expander to creat jaw bigger .which one is the best option

  8. Em says:

    I’ve heard that the expander Breaks a bone on the roof of your mouth is that true? And if so does it hurt?

    • “Breaks” is a harsh word. There is a growth plate BETWEEN the bones of the palate and it is made of cartilage. The expander stretches this cartilage up until about age 15 or 16. There is some discomfort as the expander is activated, but it is short lived and not a big deal

  9. Dr. Jorgensen says:

    I was wondering if you have an upper expander on for two weeks and then it is removed but upper braces are places with a thick wire will it prevent movement? The wire will be worn for two months to maintain it, but I am doubtful it will. Please help relieve my doubts or confirm it??

    • I have never had an expander in place for only two weeks. That just seems way too short. I can’t imagine what could be accomplished that quickly that would not relapse just as quickly.

  10. Alexa says:

    Dose an expanded hurt when it is getting put on. What can I eat what can’t I eat

  11. Getting an expander on may be a little uncomfortable at first, but you’ll get used to it quickly. The most annoying things will be slurping (extra saliva), food getting stuck, and learning to pronounce some words. You can eat most things but will discover that there are some that will get caught more easily than others. Keep it simple at first with things that are easy to eat without a lot of chewing (yogurt, pudding, ice cream, soup, etc.)

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