Dr. Greg Jorgensen
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Rio Rancho, NM 87124

The Jorgensen Orthodontics Blog

My Orthodontic Expander Made a Huge Gap Between My Teeth

Posted by Dr. Jorgensen on January 25th, 2013

Over the past couple of decades there has been a shift in orthodontics from extracting teeth to expanding the arches when there is crowding present. Expanders work great, but there are some side effects that catch parents by surprise. One of them is the appearance and disappearance of a gap between the front teeth.

The palate or roof of the mouth is made up of two bones joined together down the center by a junction called a suture. When a patient is young, this suture is made up of stretchable cartilage that is the area where growth takes place (a “growth plate”). After skeletal maturation somewhere between 14 and 17 years of age, this suture fuses and the palate becomes a single solid structure. Expanders take advantage of the presence of the growth plate if they are used before it is fused. One sign that the expander has actually moved the two halves of the palate apart is the appearance of a space between the front teeth. The central incisors are located on different sides of the growth plate and they spread apart as the palate is expanded. The result is a visible gap between the teeth. This gap is normal and desirable.

After the expander has provided the desired amount of expansion, the orthodontist will typically leave it in place for several months holding the two halves of the palate apart while new bone develops between them. Upon removal of the expander, there is always some relapse or loss of arch width. Most orthodontists over-correct by a few millimeters in anticipation of this change.

During this stabilization period, the gap created during expansion tends to close on its own. This happens slowly over time, but it shocks many parents the first time they notice it is smaller or gone altogether. Understandably, many parents call our office worried that the expander has slipped and that the benefits achieved during the activation phase have been lost.

During palatal expansion there are two forces on the teeth. The force created by the expander pushes the palate apart and a gap appears between the teeth. At the same time there is an opposite force acting on the teeth produced by the gum tissues. Just like other soft tissues in the body, the gums are elastic. As the expander pushes outward, the gum tissue starts pulling the teeth back together. You can tell this is happening by comparing the size of the gap between the teeth with the amount of expansion visible on the expander. Rarely will the size of the gap between the teeth ever get as large as the distance between the two sides of the expander because the teeth start moving back together even before expansion is complete. Another sign that the front teeth are being pulled back together is that they get sore and feel a little loose during expansion for no obvious reason (just like when braces are moving them). Now you know that they are being pulled back together by the elastic fibers in your gum tissue. In fact, it is not uncommon for the gap between the two front teeth to be completely closed by the time the expander is removed.

Knowing ahead of time that an expander will create a gap between the front teeth and that it will go away on its own is reassuring when it happens. Understanding what is normal will save you some worry and an unnecessary phone call to your orthodontist. If what you see in your mouth or in the mouth of your child does not seem to follow the pattern described however, give your orthodontic office a call and let them know. It is better to be safe than sorry!

74 comments so far in response to “My Orthodontic Expander Made a Huge Gap Between My Teeth”

  1. Jeff says:

    Hey Dr. Jorgensen, I am planning to get an upper expander for my teeth. But before this entire process takes place, I actually met with two orthodontist offices. The first one did not speak of an expander at all during the consultation for braces. The second orthodontist office did mention that I should receive an upper expander. I find it a bit odd that both offices didn’t mention a upper expander and I was just wondering if you have a comment on this. Also, I am planning to have four teeth extracted before the braces/expander, is this a common thing to have done? Thank You!

    • Crowding can be resolved by either expansion or extraction. One makes more space by making the mouth bigger. The other makes more room by reducing the number of teeth that need to be fit in the mouth. It is most common to use one approach or the other, but not both. It is not uncommon for different doctors to approach the same condition in different ways. There are no hard and fast rules and good results may be possible via different approaches. Orthodontics is not an exact science. Research your doctors and choose the one that you feel most comfortable with. You will never find two who think exactly the same way.

  2. Kim says:

    Hello. My son just turned 9. The dr wants to put in an expander and then six weeks later four braces on his top teeth. He says there is a good chance he won’t need phase 2 treatment. How often does a child on need a phase one treatment. Is it possible he could be lucky

  3. Kristyn says:

    Hi Dr. My 7 year old daughter got a fixed palate expander about a month ago. We turn it 3 times per week, and I think we have done about 14 turns so far. I am not noticing any difference in her teeth……no gap! Does this mean it isn’t working? She goes back in 4 weeks to get braces on the top 4 teeth, but I’m worried maybe the expander isn’t doing it’s job. What are your thoughts?

    • Every orthodontist has his own way of doing things. Your doctor is having the expansion take place at such slow pace (three per week vs 14 per week in my office) that you may never see a gap form. Your doctor should be able to assess your progress when you return for follow up. Both approaches to maxillary expansion work.

  4. Alexis says:

    So i have the expander on my top jaw and i been turning it. Was working well i even got a gap but now as i keep turning it the gap has been getting smaller! So am i doing it wrong? I been turning it the same way as before but gap seems to be getting smaller. What am i doing wrong?!

  5. Kenya says:

    I got my expander in a month ago. I was told to only twist it once a day for 4 weeks and I noticed my gap already, but are you supposed to get gaps between other teeth? Because I have another tiny gap and it’s not only with my two front teeth it’s next to it? And also how come some people get their braces with an expander? Because I was told I can only have the expander but I don’t understand why?

    • Most of the space will appear between the centrals, but as the centrals drift inward, spaces may appear between them and the laterals too. As for expanders only or expanders plus braces, all orthodontists are trained differently. In my office, if I have spread the palatal suture wide and there is new bone there, I want to wait to move the roots of the teeth into that space until the bone has calcified and is stronger. That’s just how I was trained.

  6. Genesis says:

    Hello Dr, I have an upper jaw expander and ive noticed that there are a bunch of people who, by now, have a gap in their teeth. Ive had it in for 3 weeks so far and I turn it once a day just like my orthodontist told me. I havent noticed any gaps in between my teeth. Is that a good or bad thing?

    • Everyone is different Genesis. At one turn per day you may not get much of a space. The key is for your orthodontist to monitor your progress to make sure the palate is spreading and that you teeth aren’t just being tipped.

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