Dr. Greg Jorgensen
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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!

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.

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

  1. Hannah says:

    I’m getting my palatal expander & braces on in less than a week. And I was curious if when I have the expander w/ the braces will it not be as a severe gap change as it would be without braces?

  2. Jackie says:

    My granddaughter had a palatal expander inserted and was only able to tolerate it for about five days. She experienced excessive saliva which terrified her into thinking she wasn’t able to swallow and would not eat or drink. Now after nearly five months without it (she only has upper braces now) she still wakes every morning with a build up of saliva, a feeling of choking, and a stomach ache. Could she be allergic to the metal in the braces, or could there have been some damage that might have occurred when she had the expander on? The expander was the new type that automatically expands itself. You do not manually turn it.

    • I have never heard of an expander causing any problems after it is removed. Neither have I heard of allergic reactions causing extra saliva. I don’t think that the symptoms you’re describing are related to her braces and I would have her seen by her regular physician to see if something else is going on.

  3. Mae Jones says:

    I am 46 and have had braces for 2 months. Less than a week ago the orthodontist put in a palate expander for my crossbite. I too have been experiencing extra saliva and difficulty swallowing. Most concerning the expander rests on my tongue and when I swallow it creates a suction between my tongue and the expander, as a result I have a lump across my tongue and some peeling flesh.

    Is this normal in the beginning?

    • All of these things are normal and fortunately temporary. I am a little surprised to hear that you have an expander at age 46. I would not expect any palatal separation at your age, only tooth movement. I hope that is all your doctor is expecting.

      • Angie Hilson says:

        I am also 46 and have an expander. (I submitted a question about puffy, swollen eyes). Why not have an expander at 46? Is there something to worry about?? I will be getting braces in May. I started this process on Feb. 26 and the expander is to come out the end of June.

        • Palatal expanders can widen the upper arch in two ways. If you are young and still growing (below age 16), the expansion occurs by stretching the growth plate in your palate. If you have finished growing, you’ll still see the teeth get wider, but it will be all tooth movement and the jaw will not move with the teeth. This can cause gum recession or even push the teeth out of the bone.

  4. Chikara Goodrich says:

    I am age 14 and I jabe recently gotten an expander, my orthodontist has told me to turn if once a day for three weeks. I have been doing so, tomorrow marks the third week, and the only change I have seen is a gap between my top and bottom teeth. I was told I should be seeing a gap between my upper central incisors, bit that has yet to come.

    Do you know the problem, if there is one.

  5. Haley Wolfe says:

    I’m going to be getting an expander soon. The dentist said it would be in for about 2 months. And in this article thing you said it would be a few months. How long will it take for the gap to close completely?

  6. Mr. Johns says:

    My son is 14 and getting an expander this Wednsday but I’m not sure which type, I heard there were two types. How many types are there and which on is more efficient?

    • There are many types of retainers. If you’ve heard there are only two types, it may be removable or fixed. If so, make sure you get fixed (glued in). Removable ones don’t work as well and they can be removed (so your son can forget or lose it). As for the various designs, they all work. I’m not a fan of the Haus style that has plastic against the roof of the mouth as it is hard to keep clean and the gum tissue can get very irritated underneath.

  7. Victoria says:

    My son is 16 and he started RPE 3 months ago, after the first 3 weeks he got a big gap between the 2 upper incisors, which was very good! but the gap disappeared after turning once per week in the following 8 weeks.

    During his recent visit, the orthordontist has changed his original plan (put on braces and keep expanding), he said the 2 upper-jaw bones have been opened up but he can’t get the premolars back in place with braces.

    Just wonder if the bones are open why we can’t keep expanding with the help of braces to make teeth straight and wide enough to enable the 2 premolars move back in the right place. This may be the last chance before his full growth. Thanks for your advice.

    • There are limits to the amount of expansion that can take place no matter what the age of the patient. If your orthodontist feels he has reached the limit of expansion for your child, then other options must be considered (i.e. distalization or expansion)

  8. Victoria says:

    Thanks for your advice. Just wonder how to define the limit of expansion, I see the post earlier some turned twice a day for 3 weeks and some turned once per day for 6 weeks, but my son did one turn per day for 3 weeks then one turn per week in the following 8 weeks. Now the gap is closed, Dr suggested doing nothing until he stops full growth. Are there any other options for him except teeth extraction or surgery at the moment? Thanks again.

    • All of us receive our training from different places and there are different theories on how much and how quick to expand. Luckily there is more than one way to “skin a cat.” This is something you’ll have to discuss with your local orthodontist as I have not seen your son.

  9. Stephanie says:

    I’m 17 years old and I got my palate expander in 2 weeks ago to fix a crossbite (I also have braces). I have to turn it every three days for the rest of the month. My front teeth overlapped before the expander and they still do now. I have to turn the expander 4 more times before my appointment. Will I get a gap between my front teeth or not since they overlap? Thank you in advance.

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