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.

1,221 comments so far in response to “What to Expect With Your Child’s Orthodontic Expander”

  1. Elena says:

    Hi Dr. J,

    I got my upper expander in about 1 month ago and the teeth that are connected to the expander both hurt. I can only eat super soft things like eggs and tofu. This just started a few days ago, and just came out of the blue. Is this normal? Should I see my orthodontist about this, because it really hurts.

  2. Tianna says:

    I’m 17 and I got an expander last year in September and got upper braces today. When will they take my expander off because they left it in.

  3. Michelle says:

    Thanks for all of great information! We have gotten consultations from two orthodontist for our 8 1/2 yr old son. He has significant crowding, mild overbite and mod to severe overjet. No other crossbite or jaw problems, except class 2 malocclusion. He has prematurely lost his rt. mandibular canine. Therefore, his mandibular incisors have shifted to the right. Other teeth are good for now, just crowding. Both orthodontist recommended phase 1 expansion. The first dr. recommended the expander device on both upper palate and mandible for 6 months. Then wait a couple of years for braces.
    The second orthodontist also recommended expansion, however, his technique is one that I can not find much information about. He said he uses a traditional expander device only if there was skeletal narrowing. But b/c my son just has dental narrowing (b/c of a small tongue) he would not use an expander. He would put braces on all the baby teeth and permanent teeth, upper and lower, for one year. The arc of the wires would expand the palate and lower teeth in sync. Then wait a few years and then phase 2. I’ve never heard of this method. He said other orthodontist I might see would suggest an expander device, but he likes his method better. I would love to have your comments.

    • I’m kind of in the middle. I like to start with an expander in the top and braces in the bottom. After the upper arch is expanded, I then replace the expander with upper braces so that I can align the teeth in the newly expanded upper arch. Hope this didn’t make your decision even harder!

  4. Maria says:

    I’ve had my expander on for a while now and recently the top one has been hurting my upper mouth and my teeth also have been hurting. What can I do?

  5. Angie Barrera-Garcia says:

    Can you get the expander after you have your braces taken off?

    • In my office we always expand first and then place braces. Expanders create space that can be closed with the braces. Removing the braces and placing an expander seems backwards to me

  6. Missy says:

    I got my expander monday. Is it normal for one side of my mouth to hurt more than the other?

    • It can be normal for one side to feel more comfortable than the other. If it is not a big deal, just point it out to your orthodontist at your next visit. If it is very painful, please see your orthodontist ASAP

  7. Gemma says:

    Dear Doctor,

    My 11 year old Son got appliances for his top and bottom teeth a couple of days ago, he has discomfort which he was expecting but is finding that the ligament under his tongue (Google tells me it called the Lingual Frenulum?!?) is very painful. So much so that he has not been able to get a full nights sleep because of it. It this a normal part of the breaking in period ? Appreciate your time answering all these questions which are so helpful for us newbies:)
    Gemma

    • Usually braces do not affect the lingual frenum. I have seen patients however who get braces and it causes them to get canker sores at first. He may have developed a canker sore or ulcer on the frenum that is making him sore. The only other possibility is that he is rubbing the underside of his tongue against his new braces, but this would be fairly noticeable as he’d be sticking his tongue out

  8. Joyce says:

    My daughter has been wearing braces for 1.5 years. Dr says maybe 2 more months and he’ll take them off. Now he wants to put an expander in. Does that make any sense?

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