Dr. Greg Jorgensen
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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.

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

  1. Deanna says:

    My daughter has anterior crossbite and is 7. She will need a retainer. She is actively pursuing an acting career. Strange but this is what she loves to do. Obviously we want to fix her bite but would like to do it with limited visibility of expander? Are their removable expanders to keep in and take out for auditions etc. Her orthodontist is fabulous but seems to not be taking my concerns seriously. I realize it may not be possible, just wondering if their are other options

    • I am not a fan of removable appliances. I’ve treated a lot of child actors and have never had one that couldn’t endure an expander for the 3 to 4 months that expansion requires. It just takes a little planning.

  2. Victoria says:

    Say the child that is receiving the expander is 17. Will there be different effects on the child?

    • 17 is on the older side of things. I would be hesitant to use an expander at that age, and if I did, I would closely follow the progress to make sure that the expander doesn’t push the teeth right out of the bone.

  3. Wilson Brown says:

    After making 32 turns of Hyrax Rapid Palatal Expander for a 10 year old boy, his gap between two front teeth is only 0.5mm. The gap closed after a few days. However a gap was created between left molar and the premolar next to it. And a gap was also created between right molar and the premolar next to it. The Hyrax is attached two molars only. Does this mean the expander did NOT separate two halves of the upper jaw? Is it possible that the expander only tip two molars away from the premolars next to them without separating two halves of the upper jaw? Should I take a X-ray to see the two halves of upper jaw is separating? If not, should the expander be removed or not? What should be the next step please? Thank you.

    • It is extremely rare for a gap NOT to form in a 10-year-old child. I would definitely get an occlusal radiograph and also palpate the bone in the vestibule next to the teeth with the bands to see if the roots of those teeth are palpable.

      • Wilson Brown says:

        Thank you. Your reply is very helpful. I will get an occlusal radiograph. Just in case if a gap is not formed, will the Hyrax expander damaged the molars? Should the expander be removed please?

  4. Phan Mai says:

    My daughter is 11. Her molars (the last one next to the future wisdom teeth) are going to lift up over the gum. I can see them with X-ray, but not by my naked eyes. Do you think that her jaw can still be widened or it’s late now? Thanks

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