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!

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.

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

  1. Jackie says:

    I’m getting an expander and braces in 3 days and I wanted to know if it interferes with the wire ? Because If it is made to widen your upper part of your mouth , wouldn’t the wires come loose ? Or a bracket break from the stretching ? Or do they change the wires within time so that doesn’t happen. I’m concerned with that.

    • Your expander will be on the inside of your mouth. There may be bands that go around the teeth that have braces on the outside. If so, your wire will attach to the expander via these brackets. It will not make your other brackets come loose.

  2. Dalina G says:

    I have to have braces for 2 years because of my gap. I have an expander then i noticed my gap was bigger than it was. but the dentist said thats great because thats what its supposed to do .. i was trying to get rid of my gap not make it bigger

  3. Lucy says:

    My expander isn’t making a big gap in between my teeth. Should I be concerned?

    • There are so many variables that there is no single answer. Typically you’ll get a gap if the palate is expanding. If only the teeth move you won’t. You need to ask your orthodontist what is goal is for you.

  4. Katy says:

    I am a 29 year old females who is wearing and “cranking” a palate expander prior to getting Invisalign in order to widen my upper arch.
    So far, I have had the expander cemented I. Place for three days, cranking it twice a day, and my mouth is about a 10 on a 1-10. The pain fluctuates from about a 5 (after taking 800 mg ibuprophen) back up to a 10 after I have eaten. I feel like I can’t chew or bite anything, and the metal expander is bothering my tongue and soft inner mouth tissue. My teeth feel extremely tender and I am starting to worry that they might be getting loose. I am starting to get anxious about having to,wear this device for 2 more mos., but really want to stay strong and get through it. Are these symptoms normal, and do you have any tips for me to make it through this? Thank you in advance for your time!

    • I never use expanders in 29-year-olds without also doing surgery to reopen the palatal suture. Your expander is not widening your palate, it is only tipping your teeth outward. It does not surprise me that this is so painful.

      • Katy says:

        Whatt is the cause of the large gap forming in between my two front teeth? I thought it was a result of the palatial expansion…

        • Only your local orthodontist can diagnose your specific case. Some possibilities are 1) thick frenum, 2) narrow teeth, 3) tongue habit, 4) changes in the shape of the gums, or 5) a deepening bite.

  5. Catherine says:

    Hello! I got my expander six days ago. My orthodontist said i have to turn it 2 times per week (every 4 days). The strange thing is that the last time i turned it i felt the “push” only on my left side. Also, my right doesn’t feel like it has healed yet. Is there any possibility that my expander has been put awry? thank you

  6. Phan Mai says:

    I have a 11-year daughter who has crowding teeth on the upper jaw. Her 4 front teeth are large and stretch out. She also has deep bite. She doesn’t have wisdom teeth. I took her to 2 orthodontists. One advised to use Quad Helix expander to widen both jaw for 1.5 years, then will use braces. One said that this way won’t work as the lower jaw hardly be wider and advised me to pull 4 teeth. I don’t know which way is better? I remember you answer sb here that: “Upper expanders actually move the bone to make more room. Lower expanders only tip the teeth away from the bone”. Maybe I don’t understand clearly. But I don’t like the idea of pulling teeth. If the expander can widen the upper jaw, can it do the same for the lower? Is there any case that the two jaws and/or the two sides of one jaw can be wide asymetry. And about the Quad Helix expander, is it good and popular? I’m very worried. Pls give me advise. Thank you very much

    • Anatomically there is a growth plate or suture in the upper that allows expansion. There is nothing comparable in the lower. All expansion in the lower will be tooth tipping. If your daughter has enough bone to do this safely, any form of expansion will work. If not, the expansion in the lower may push the teeth out of the gums and bone. There is no magical appliance that will expand where there is no suture.

  7. Phan Mai says:

    And is there any side effects of the expansion, i.e. easy root resorption in future, facial change?

    Pls help me. Thank you

    • In very young children with narrow jaws there may be TEMPORARY changes to their facial appearance as the expander widens their palate. There has never been a correlation found between expansion and root resorption.

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