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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.

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.

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

  1. Alma says:

    Thank you so much for taking the time to answer all of our questions. You’re so very kind.
    My 7yo son had jaw and palate spacers placed and we are now awaiting for the fusing phase. He has a speech impediment, and we were so looking forward for removal but on our last visit Ortho doc said she was going be placing fixed temporary spacers that would be removed until he turns 12. Also, that my son would need to have permanent teeth taken out. Would this appliance interfere with grown/natural expansion? Can we opt to not have it placed? Thanks once again.

    • Unfortunately your son’s “natural” growth is insufficient. The fixed appliance your orthodontist wants to leave in place is probably to maintain the gains she already achieved in the first phase of treatment. As for extractions, none of us want to remove teeth if possible, but sometimes we have no choice.

  2. Peter says:

    Great website and information I wish you lived closer to us.
    Our daughter who is turning 13 in a month has had a severe overbite on the top for several years and she had a crossbow appliance put it while she still had some of he baby teeth a couple of years ago. She now has all her big teeth in and been in braces for close to a year. She still has an overbite it’s improved quite well but there were concerns as the Orthodontist felt that it slipped back or relapsed a bit (while the braces were on). I don’t understand how that is possible and we even had a special xray of the jaw profile and everything looks ok. I realize you can’t see her teeth but now they are speaking about possibly taking some teeth out to correct the overbite but are first trying stiffer elastics for four weeks to see if that works. Any advice you can give is greatly appreciated.
    Does this sound like we are getting the correct advice? Or could she maybe get the crossbow back in before pulling teeth if the elastics don’t work out?

    • The root of most “overbites” is genetic in nature. It is in the bone structure and affected by the genetically controlled growth. If your daughter is programmed to have an overbite, even using a crossbow appliance may be just enough to keep pace with the unbalanced growth. Nothing we can do as orthodontists can change the DNA, so after we’ve done everything we can with braces alone, we must sometimes resort to removing teeth to camouflage the problem or move the jaws (surgically) to eliminate the overbite that remains. It doesn’t mean that anything is wrong. It just means that your daughter’s problem is more complicated and more difficult to fix. Good luck!

  3. Veronica says:

    Hi!!! I have an expander that looks like a retainer since December and I turn it every Saturday and I am getting my 2 bottom wisdom teeth out on Monday (they have to cut the gum open because they still aren’t fully grown yet) can I wear my expander after the surgery? I’m scared that if I dont wear it my teeth will move back and it will hurt to put it back on since my teen have shifted back . ( I’m scared because once I fell asleep without my expanders and I put them on in the morning and they really hurt and were hard to put on)

  4. Alyssa says:

    Does a pallet expander hurt?

    • There is discomfort when the spacers that create room for the bands are placed. Although it is weird when the actual expander goes in, it is not really painful. Each time your expander is activated, most patients feel pressure. Some say it hurts, but that is not the norm. Everyone is different. Good luck!

  5. Wyne May C. Sueta says:

    Before I post my question, I would like to thank you in advance for having time to read this and answer my concerns. I am 22 y.o and last Saturday I visit an orthodontist inquiring about braces. She said that my case is called Crowded teeth with butterfly effect and suggested that she will use palatal expanders attaching it to the braces in ordere for her not to extract a tooth. I would like to know if palatal expanders will work on my case in regards with my age. Should I go for her suggestion or ask another orthodontist for opinion? Best Regards.

    • A palatal expander will only give dental (tooth) movement in adults who have no growth plates. In growing kids the bones themselves will be moved. If your dentist is only trying to move the teeth, an expander will work. If she wants the bones to move at your age, you’ll need surgery to re-open the growth plate.

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