Dr. Greg Jorgensen
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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.

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

  1. Tatiana says:

    Hello Dr. Jorgensen I have a palate expander with plastic on the upper, bottom of my back teeth and one particular tooth is aching badly! Does it mean anything?

  2. mindy says:

    my daughter has a palate expander for the second time, she is 11.(the first time was a couple years ago, for crowding) This time she is complaining about pain, not pressure or mild discomfort, at the bridge of her nose (hurts for her sunglasses to sit on it) and her teeth really hurt, like she can’t bite together, cause they are tender. She has no other symptoms or I would think that it was a sinus illness. Any ideas?

  3. Alvin Jackson says:

    My 7 year old daughter has had her expander on for 2.5 months now and she is feeling pain and pressure. Is this normal?

  4. Mandy says:

    my son has an expander and it has fallen out twice now in 6 weeks…is this common and why would this be happened. Its driving us all crazy

    • It is not common, and I’m sure your doctor is as frustrated as you are. I have seen this happen for three reasons. First, if your son’s teeth are short, the expander has less to hold on to and debonds more easily. Second, some patients have very active salivary glands and tongues that prevent an effective bond between the teeth and the expander. Most orthodontists have alternate techniques for isolating the teeth during cementation that can be tried after a first failure has occurred. The third reason an expander may come out multiple times is that it doesn’t fit right. This can happen because of the impression or the way it was constructed. I will usually only recement an expander twice before I have it remade.

  5. Meghan says:

    My daughter is 16 and recently got a palate expander. We turned it for 14 days and she got a small gap (2.5mm. We were told by the orthodontist that we have to turn it for 14 more days and see what happens then to see if it actually worked or if she needs surgery. Does this mean that it is working? Or is it highly likely that surgery will be needed for the expander to work? Her teeth look worse then they did before, is this normal?

  6. Ashley says:

    My daughter is 14 and she has a expander . She tells me that when she tries to chew that it gives her pain . Is this a bad thing ?

  7. Gabby says:

    hi, I have a pallete expander on the roof of my mouth and at my last appointment they cut the front part off and when they pulled it off my tooth and it caused an immense amount of pain that at literally unbearable and I was crying. What do you suggest when I get the full expander removed in November? what could I do to ease the excruciating pain? thanks

    • Having an expander should not be this painful. You may not have any problem with the remaining part. In your case I would recommend taking some over-the-counter pain medication about an hour before your appointment to help you feel more comfortable.

  8. Jay says:

    Hi I got my expander on today will the excessive saliva stop and will I be able to swallow I’m having trouble swallowing my spit

  9. Evripidis says:

    Im 15 years old and i have had an expander in for about 40 days. I havent had a problem before until now. Today i woke up and it felt abit loose, later ate something and it came completely off, i had to bite it so it attached again. I know thats not normal, what should i do?

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