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!

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

  1. noah says:

    I have a w-arch expander and it is creating a gap is that normal or shiuld I contact my orthodontist?

  2. Catelin says:

    My daughter (age 12) has had her expander for about 4 months now, and we stopped turning it a while ago and her orthodontist left it in, and it created a very large gap between her front teeth, and to this day it doesn’t appear to be getting smaller. How long does it usually take for the gap to go away?

    • Everyone is different. Some patient’s gap goes away quickly. Some never lose their space until after the braces go on and are pulled back together by the orthodontist. Please help her be patient. It will go away!

  3. Mary Getz says:

    My grand-daughter has an expander in her mouth for 2weeks – she is now complaining that she can not hear out of her left ear! Can the expander cause this?

    • Hi Mary. I have never heard of this being a result of palatal expansion… and I’ve done hundreds of expanders. I think is it a coincidence and your grand-daughter should be evaluated by an ENT.

  4. Émilie Gordon says:

    I lost my power chain elastic a few days ago and I have a felling that my 2 front teeth are expanding very quickly I have an appointment the on Friday but should I be worried ???

    • If part of your braces come off, you should contact your orthodontic office ASAP. They can tell you if you need to come in before your appointment. In my office, if you were coming to see me within a few days, I’d tell you not to worry.

  5. Tavia says:

    My 12yo just got her expander yesterday. We were told to turn it twice a day and come back in 3 weeks for them to take a look at the progress. We expect it to be on for about 6 months. Is this a lot of turning and not be seen again for 3 weeks?
    She also feels like she has some rubbing on the inside of her cheeks along her teeth. Says it hurts a little but she’s ok. Is this normal? Thank you!

    • All doctors are different in how they schedule appointments and procedures. Keep your eyes on your daughter’s mouth. If you think something is out of control, report it to your doctor’s office.

  6. Alicen says:

    Just had a consultation for my twin boys. They are nine. Treatment suggested was 2 phases: an expander with braces on the top 4 adult teeth for 9-12 months. Then phase two, full braces at age 12 or 13. My question is will the braces on the 4 top teeth hinder expansion? I see most people get the expander alone. Your thoughts?

    • Great question for your orthodontist. I always expand first, give the new bone time to heal, and then place the braces. Ask your orthodontist if he’s worried about the braces pulling the middle teeth into the gap created by the expander and if that will be a problem.

  7. Concerned says:

    My son had surgery for palate expansion performed two weeks ago. At the time of the surgery, the surgeon turned the expander appliance screw and then informed me that it could not be turned any more since it was such a small device with a small spring. He told me that the orthodontist would fit my son for a larger appliance that would then be turned regularly. My concern is that the wait time for the new appliance is three weeks after the surgery. Will holding the palate in position without any more screw turning cause the bone to start growing back so that the new appliance will not be able to do its job?

    • These are good questions for the oral surgeon. The timing is important because you want healing to continue but not finish before you have the width that you want. There is no way that the bone maturation will be complete in three weeks.

  8. Alexis says:

    hello (: I have braces and today i was looking at my 2 front teeth and it looks like i have or iam getting a gap. Is this normal? i am very worried. and i literally almost started to cry

  9. Susan Kenny says:

    My Daughter had her palatal expander fitted yesterday, and i attempted to turn it for the first time today, am really worried i haven’t done it correctly, are you supposed to hear a click or something? please help

    • There are different types of expanders. Some click, some do not. The best way to know if you’ve gone far enough with the turn is to make sure that the next hole is fully visible. If it is, you’ve probably done things right.

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