Dr. Greg Jorgensen
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Rio Rancho, NM 87124

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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!

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

  1. Bridget says:

    Whats up doc! Okay, I am 11 and I just got my expander in and noticed a massive gap in between my two front teeth. The turning is only for three weeks (I have one more week of turning 2 times a day) and all together, my expander will be in for a total of 9 months (with only 3 weeks of turning twice a day) Will the gap be there for the whole of that nine months? or will there be progress when the turning twice a day ends? Do Consider doc that I got my bottom braces in and I got my top braces in about 6 or 7 more weeks to come (I am wearing my braces for an estimate of 2 years according to my orthodontist. Thanks a lot !!! (I am extremely self conscious about the gap )
    :( :( :(
    Thanks Doc :)
    -Bridget

    • I sympathize with your concerns about your gap. It is not attractive, but it is necessary and it is only temporary. Your gap will get smaller or disappear after you stop activating the expander. Good luck!

  2. Jalyn says:

    Okay I’m jalyn and I’m 14 years old. I got my expander on the 18th of December and the dentist said I will have it for 6 months turning it once a day for 6 weeks. I’m on my second or third week. When will this gap go away?

    • The gap means your expander is working Jalyn. Your gap will be there as long as you are activating the expander. After you stop turning it, the gap will start to go away. It will probably take a month after your last turn. I know it is not fun or attractive, but it is better than pulling teeth or doping surgery. As my mom used to tell me, “This too shall pass!”

  3. Sofie says:

    My daughter just turned 7 so we consulted 2 orthodontists. The first orthodontist recommended we install rapid palate expander on the top and braces on the bottom to correct bite problem (lower jaw is bigger than the upper one so upper teeth don’t cover the lower ones) and teeth overcrowding. The second orthodontist recommended we install rapid palate expander on the top and face mask to pull the upper jaw but no braces for now. It makes sense however I’m worried about side effects from the rapid palatal expander: Should we expect speech impediments? Will my daughter sound differently and how long would it last? I’m very worried about her voice, she is part of the theater club so she sings and performs. Also, what are your thoughts on using removable palate expander instead?

    • I’m a fan of fixed palatal expanders. 7-year-olds adapt quickly and I don’t think her treatment will affect her longer than a week or two. As for the need for a facemask, I use them in cases of underbite in children the age of your daughter too, but that is a call your local orthodontist will need to make.

  4. Cindy says:

    Hi, My son is 17 and just had the palatial expander installed. If his suture has fused, what could happen? His first appointment is 6 weeks after install. I’m nervous that I could break something…

    • The worst thing that can happen is that the suture does not re-open and the teeth just get pushed out of the bone causing defects in the bone and gum recession. That is something that your orthodontist needs to evaluate constantly during the expansion process. If the suture does not open naturally, there is an oral surgery procedure that can re-open it so expansion can proceed safely. Ask your orthodontist if your son is a candidate.

  5. DeMornay says:

    Hey! A couple of weeks ago I went to the dentist and they inserted my palate expander. About 2 weeks later my top one fell out and I had to go back so they could redo it all. Well now, my bottom expander is the one that I’m having trouble with. It seems to be pushing my gums through the expander. My gums are like sticking out of the expander and sitting on top of my teeth. It’s really visible. And hurts really bad! Is that normal?

    • Sound like the gums have swelled since you got your expanders placed. Concentrate on brushing around the expanders especially where the tissue is puffy. You may want to ask your orthodontist for a prescription for chlorhexidine rinse to help you get where your toothbrush won’t reach.

  6. Kaitlyn R. says:

    I am 12 years old and will be getting an expander for the top of my mouth in about 4 weeks. I am extremely nervous about the gap it will cause! I will be having the expander for exactly 3 months, about how long will it take before the gap between my teeth is back to normal?

    • Hi Kaitlyn. I wish I could tell you that you won’t get a gap, but if your expander works, you will! The gap will probably be there for several months. You can handle it one of two ways, either not smile and try to hide it or just have fun. Show it off. Make goofy faces. Laugh at yourself. Soon enough your braces will be on and off and your smile will be beautiful. Good luck!

  7. Dolores Marie says:

    My 7 year old son has an upper tooth growing in the wrong place(in the upper jaw)and crowding in the lower part; and i had to see 2 orthodontists: the first says we should put upper & lower expander and upper partial braces to correct the problem( widen the jaw and move the tooth to its place); and the second one says no expanders needed, just put upper & lower partial braces and the problems will be fixed. Which one is the best option? Please help me out i’m confused!

    • It is possible to expand with braces alone, but the results are not obtained the same way. Upper expanders actually move the bone to make more room. Lower expanders only tip the teeth away from the bone. Expansion achieved with braces only is ALL accomplished by tipping teeth. The one that is most appropriate for your son would be determined by what kind of expansion he needs. Your orthodontist must make that decision.

  8. Sam says:

    Hi doctor, I got my pallete expander recently and now the area around my eyes hurt. Is this normal? Also I get marks on my tongue from the expander and it hurts like crazy. And my front teeth hurt too much!

    • All of these things are normal Sam. The expander actually widens the bone between the eyes and behind the nose. That feeling should only be temporary and your structures will adjust with time. The marks on your tongue are normal. Just tell your tongue to stop playing with the expander (good luck with that one!). Your front teeth are sore because they are being pulled back together by your gum tissues as your expander is pushing them apart. Your front teeth may even feel a little loose, BUT DON’T WIGGLE THEM. Good luck!

  9. Hailey says:

    Okay so I received my expander on Monday morning and I keep it in for four months and he said 12 turns before the next visit. (One turn per day, every night). Can you tell me approximately when I will recieve a gap and some eating and saliva tips. I keep having to suck in because my mouth thinks its food and is producing saliva (A LOT) any help?

    • The timing of the gap is impossible to predict because it depends upon the maturity of your bone (age), the number of turns, etc. Some of my patients see a space right away, some have one appear over night a week or two into treatment, and some never get a gap at all! As for the extra saliva, just be patient. Within a week or so your body should adapt. Good luck!

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