Dr. Greg Jorgensen
(505) 891-9440
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 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.

1,057 comments so far in response to “What to Expect With Your Child’s Orthodontic Expander”

  1. Kristine Recinto says:

    hi i just wanna ask if it’s possible to have an expander even if i already got braces? My dentist wants to extract another tooth from my upper because she thinks i still have protruding teeth even if she already removed two teeth

  2. Ariana says:

    My expander is starting to hurt when it is getting tightened. Any suggestions to help the pain?

    • I would see your orthodontist to make sure that it is not pushing against your gum tissues. Sometimes that happens after the expander has been activated for a while.

  3. Holly says:

    Hello! My eleven-year-old son got an expander in a week ago and is miserable. He absolutely hates having it and wants it off. He is very withdrawn, not wanting to be around other kids. I know he will supposedly “get used to it,” but he seems depressed and I am afraid his attitude about the expander will continue. Because he is so upset about this, I am questioning if he really needs an expander. It seems most children get expanders when their teeth are crowded and they don’t have much room for adult teeth. My son’s teeth are not crowded – he has small gaps between all of his front teeth. He has lost all of his baby teeth except three. Does he really need to have his palate expanded? It seems like he will have enough room for all of his adult teeth. I’m not just wondering if I’m causing all of this anguish when maybe it isn’t even necessary. I never got a second opinion with another orthodontist because this is where my 13-year-old daughter got her braces and we have been happy with her treatment. (She never had an expander). Any thoughts or opinions are greatly appreciated!

    • I can’t diagnose the need for your son’s retainer on the Internet, but I am sure that the orthodontist would not have recommended it if it were not necessary. You cannot get the same result without the expander, so he either needs it or doesn’t. You need to trust your orthodontist or get another one. I use at least 100 expanders per year in young patients and have never had to remove one because a child couldn’t cope. Please encourage him and try to make this bearable until he has adapted (pudding, ice cream, yogurt, etc.)

  4. Anoosha says:

    Hi!i have expander in my mouth for about 6 mths plus it has reached to its maximum limit 3 mths before..so can u tell me how much more time will it take

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