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.

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

  1. hi says:

    When will my gap close, yeah I know “everyones different be patient it’s progress, short term for a long lasting goal”, etc. I’ve asked my dentist he just says months, I would like to the average time like approximately how many months. Also you dentists say it with so much ease oh just be patient however I don’t think you understand how embarrassing it really is so just stop with the be patient thing k thanks.

  2. Priya says:

    Hi, Can I get my front top braces and expander on at the same time? If yes, what are the pros and cons? Also When I asked my dentist he said I couldn’t do you know why he may have said that? (I’m 15 and I really hate the toothgap and want it gone by the time school starts (which is in a month)). How long would it take for the braces to close the gap?

    • The reason I don’t put the top braces on with the expander is because it is best to allow the new bone in the suture to heal before you move the roots of the teeth into that area. Doing so could “devitalize” (kill) the teeth or make them so loose that it wouldn’t be safe. Best to follow his recommendations.

  3. Sherry says:

    I have an expander and I am recently noticing that I have a gap between my two front teeth, and it hurts so much! I know the gap is normal, but is the pain?

    Please help me!

    • Yes, the gap and the discomfort are normal. The front teeth are being pulled back together by the gum tissues around the roots of your teeth as the expander moves the underlying bone. That tooth movement makes the front teeth loose and sore. Luckily it is only temporary. Good luck!

  4. Mish says:

    Hi, my 10 year old daughter had expanders on for about 2 months which already created a gap in her 2 front teeth. Her orthodontist said that she is ready for phase 1 in a month’s time which is to put brackets on her upper teeth. Phase 1 will be for about 8 months and after that she will be reassessed, but for sure she will be needing full braces in the future.
    1. Since she’s doing full braces in the future anyways, can I just skip phase 1 and just let her do full braces when she’s 12 or 13? My older kids visited the orthodontist when they were about 13 and both did not undergo phase 1 anymore and their teeth are now fixed. I am wondering if I brought my 10 year old too early which entails more time and expense and the end result is the same since it can be fixed by braces when she’s a bit older already.
    2. If we decide to do away with phase 1, should she just stop wearing her expanders to close the gap? We will just visit again the orthodontist when she’s 12.

    • Please refer to several articles I have written under the category of Early Treatment. You can always wait for Phase 2, but there are advantages to interceptive treatment. I have written several articles that address your question. I hope you find your answer.

  5. Pixel says:

    Hi Dr. Jorgensen,

    I’m 21 and am going to be getting my expanders soon after extracting 4 teeth at the end of this month. I came across your blog and would like to seek your opinion. Will expanders cause protruding cheek bones and sunken temples? Also, how long should I wait after my extraction to put on the expanders?

    • The research has consistently shown that expanders can widen the dental arch in adults, but the movements are dental (teeth only) and not skeletal (the actual bone). Expanders in adults will not change the cheek bones or temples unless accompanied by surgery

  6. Michelle says:

    My daughter is almost eight and it’s done with the activation phase of her palate expander. It has drastically changed the look of her face. Her cheekbones are much more prominent and she has a joker smile. Will this last?? Right now we are supposed to keep the retainer in for three months without turning.

    • This is very common Michelle. Over correction like you’ve described is necessary and TOTALLY reversible. Your daughter’s face will return to normal in short order. I know it is troublesome for a while, but it always improves.

  7. Jessica says:

    My 11 year old daughter just finished the activation phase of her expander. Now she’ll keep it in for 3 months or so. She has an enormous gap and I know that’s normal and it’ll slowly come together. My question is: she plays the clarinet and in the evenings when she’s practicing she’ll often complain that it feels like her front teeth are loose. Do you think she’s doing harm to the whole expansion process playing the clarinet? Should I be concerned?

    • What your daughter is describing is absolutely normal. They feel loose because the gum tissue around the teeth is tipping them back together. Their are elastic fibers in all of our body tissues and that is what is producing the force. When teeth move, they must get mobile as your daughter is discovering.

  8. Kathy says:

    My son has had the palatal expander on for 13 days and there is no gap in his front teeth yet. His ortho said we should notice a gap in 5-7 days. Is that true? Should I be concerned that it’s not working properly?

    • Everyone is different. Most patients develop a space within the first two weeks, so I would definitely have the orthodontist check to make sure everything is OK. some problems could be 1) the expander is slipping backwards after you turn it, 2) some how the turns are not being done correctly, or 3) the teeth are tipping but the jaw is not expanding. Your orthodontist can help you determine if any of these is the answer. Good luck!

  9. Jackie says:

    My daughter was recommended for a palate expander by one orthodontist and another said he could correct her teeth without one. All of her teeth have come in and the expander isn’t necessary for space for teeth but she has a narrow upper jaw and hoping an expander will help breathing. I’m confused what to do. What’s your advice about palate expanders? Are there any long term downsides? Are they necessary when all teeth have come in? Thank you for your advice.

    • I like palatal expanders in the right patients. They can be used for crowding or arch development. There is some evidence that they do increase the size of the upper airway in some patients, but that is not a reason in and of itself to place one. You have to discuss the appropriateness of one for your daughter with your orthodontist and decide if you understand and trust his training and experience. I have not seen any long term downsides.

  10. Liz says:

    Hi, my son’s palatial expander has created 2 different gaps. One in between her two top front teeth and another gap between her 2nd & 3rd top teeth. I was expecting a gap between two top teeth in the middle but not the other gap. Is this normal?

    • It is very normal. Even though the original space will probably be between the two middle teeth, the gum tissues can pull those two teeth together causes spaces elsewhere. Glad to hear that progress is being made!

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