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.

1,115 comments so far in response to “What to Expect With Your Child’s Orthodontic Expander”

  1. Maddie says:

    My daughter has had expanders for a couple of months now and she says that on the roof of her mouth right above the expanders a lump has formed what do I do? Is it serious?

  2. joe says:

    Hi Dr Jorgensen,

    My son just got a palate expander on 4 days ago. He has braces on his four front teeth. I haven;t seen a gap yet but he does have braces on teeth there should be a gap.. Would the braces help from keeping him from having a gap?

    • Braces could prevent a gap if they are holding the teeth together (i.e. they are chained together or laced together). I’m not a fan of that as this can theoretically move the teeth into the newly expanded suture (growth plate) in the middle of the palate. That’s just my opinion and why I don’t pull the front teeth back together for a couple of months after expansion.

  3. Brandy says:

    My son’s 8 and his top expander has these metal pieces that come in front of the incisors… They move when he eats and talks and have rubbed the inside of his lips raw. Is this normal?

  4. Penny says:

    Our son is 10 and has braces and it has now been recommended to also have the expander because of sleep apnea. I am wondering if it is normal to do braces and the expander at the same time

  5. andrea says:

    my child has an expander. she says that her gums hurt in the back where the part is attached to her teeth. should I see her orthodontist or will it go away?

    • Sometimes the bands around the molars must extend below the gums. I would give things about a week to see if they resolve themselves. If not, return to your doctor to see if something can be done

  6. Lindsay says:

    Hi I am 21 and this is my second time going through braces and they just put an expander in 3 days to see if it helps however I have had three days of turns and I can only turn once a day instead of the two they want when I turn it the pain radiates from the tooth to my jaw and even my cheek is this normal?

    • I don’t use expanders in 21-year-olds without surgery. All movement will be dental only (teeth) because the growth plates are no longer functional. Expanders create a lot of force and that is probably the source of your pain.

  7. Ben says:

    Hi Dr. Jorgensen
    Regarding palatal expansion in adults: I understand that the thinking is that it cannot be done without surgery, and that attempting this would likely only outwardly tip the teeth or move the alveolar bone.
    -Would you personally be doubtful of any study or orthodontist that claims skeletal expansion of the palate of an adult can be achieved without surgery? (I have recently read a few such studies.)
    Thank you

    • I don’t prejudge anything. I read the studies, look at how they were conducted, examine the evidence (i.e. models, pictures, x-rays, etc.) and then form my opinion. The scientific research on palatal expansion over the past 50 years supports my current opinion that expansion in adults is primarily dental without surgery. If there is new evidence I welcome it.

  8. Anietie says:

    My daughter is 16 and just got expanders put in. I missed the 1st day to turn them. But we have turned it twice. She is in extreme pain and her throat is feeling swollen to her along with extra saliva production. She is wanting them out. Is 16 too old in some cases? How do we know?

    • Age 16 is borderline for girls. I would monitor her progress every week or so during the process to make sure that all is going well. The pain may get better if the growth plate actually opens. If the expander doesn’t open the growth plate, she may be too old for expansion by itself. The extra saliva is normal, but I can’t explain the sore throat.

  9. Jessica says:

    My 8 y/o child has an expander now for about 4 months and his tissue is growing over the appliance is this normal?

  10. Sanyukta says:

    My daughter has a palete expander and there is a small ump that is bothering her at the side of the teeth ,the interior. What should we do ?

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