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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.

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

  1. Cindy says:

    Dr, my son has a lower jaw expander (don’t know the exact name) and he says his gums are growing over the expander. He’s also bleeding from said event
    Should I be worried? Thank you

  2. Kim Whittaker says:

    My daughter has had about four palate spreaders break. We are going in to have another one put in. Is this normal? Should we abandon this course of treatment and pursue a surgical option?

  3. Leilah Vagerson says:

    I’ve had my expander in for 11 days now and I have no significant showing of a gap AT ALL, is this normal?

    • It all depends upon the individual patient. Some patients have crowding, some do not. Some never get a big gap, others do. You need to discuss your teeth with your local orthodontist.

  4. Sue McCorsin says:

    My 9 year old son had his TAD expander put on Weds. He is complaining of terrible pain where the expander attaches to the 2 upper back teeth. I was wondering if this is normal? The orthodontist said that he wouldn’t feel pain in those teeth because they aren’t moving. Any pain would be in the nose, front teeth and front part of his jaw.

    • It is normal to feel discomfort for the first few days because everything is new. After a week however the only discomfort should be in the nose and front teeth. Those sensations are normal. Any other pain should be discussed with your doctor.

  5. stephanie says:

    My son is 6 years old and has an expander. For the last three days/nights he’s been complaining of an abscess behind his right expander at the roof of his mouth. I’ve cleaned it but there isn’t any way for me to get underneath it! It’s so swollen. I’ve given his motrin. What should I do? It’s 2am and I’m considering the emergency room. He’s so miserable!

  6. Beth says:

    My son has had an expander for ten days and today he showed me the metal ring around his tooth holding the expander in is coming off the tooth. It is a Saturday. Should I call the emergency number or wait until Monday? Should I keep cranking it twice a day while it is loose?

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