What is an Orthodontic Expander & When is it Necessary?

Dr. Gibbs suggests an orthodontic expander depending on specific orthodontic issues relating to the upper jaw and the extent of damage these issues have caused. To find out why an expander is necessary to widen the jaw and palate, how it allows room for normal teeth growth, and prevents jaw misalignment and crossbite, visit Gibbs Orthodontic Associates. The teams of top-rated orthodontists provide comprehensive information on adjusting an expander to what to expect while wearing it.

The American Association of Orthodontists (AAO) suggests that seven years is the right time for a child to get an initial orthodontic visit. By the time they turn seven, children have some of their adult teeth, and their bite also begins to take shape. At this point, the specialist can look for potential orthodontic issues and assess if the child will benefit from early orthodontic treatment like an expander.

What is an orthodontic expander?

An orthodontic expander is a special appliance designed to widen the jaw and palate or the roof of the mouth, allowing room for teeth to grow normally or to correct jaw misalignment. Also known as a palate expander, this device widens the upper jaw in patients whose jaw is too narrow to accommodate incoming permanent teeth.

Orthodontic expanders are recommended when the specialist detects a width issue with the upper jaw, which can result in crowding and bite alignment, particularly among children, as they still have growth potential. They are also used in adult patients in certain cases. Every expander is custom-made to fit the natural palate of the patient for the best results.

Orthodontists recommend palatal expanders in early orthodontic treatment to widen a narrow palate early, helping big teeth fit into little mouths.  If a narrow upper jaw is left untreated and crowding and bite problems occur, the patient may experience difficulty in chewing, speech, and other functions. It may also require extensive dental work as an adult.

The specialist may suggest a removable or fixed expander that is made up of two halves connected by a tiny screw in the middle.

How does a palatal expander work?

There are several different designs for palatal expanders, but they all work the same way.

A palatal expander is a custom-made, stainless steel appliance attached to the upper jaw against the palate and held in place with wires around the molars. It consists of two halves that are joined together by a center screw. It works by applying gradual pressure to widen the space in the mouth, over 3 to 12 months.

Once the appliance is in place, it can be activated by turning the screw using a key. It creates tension that puts gentle pressure on the upper molars and the junction of the two palatal bones. This slowly and gradually makes the bones move apart, and the jaw to widen. Once the required expansion has been achieved, the expander will remain in place for some months for the bone to form and stabilize the expansion.

It is essential to understand that the right and left sides of a child’s upper jaw develop as two halves. Also known as maxillary or palatal bones, they do not fuse until around or after puberty. Thus, a palatal expander can play a crucial role in widening the two sides independently and correcting the jaw alignment.

When is a palatal expander necessary?

The orthodontist may suggest a palatal expander if you or your child suffer from severe crowding, a crossbite, or impacted teeth that look as if they will worsen as the teeth and bones develop any further.

If your child’s teeth are crowding even before all their adult teeth have erupted, widening the jaw with an expander may lessen the need for tooth extraction or braces in the long run. Crowding is not only a dental problem, but it can also affect the way you brush or floss your teeth and leads to cavities or gum diseases.

The three most common reasons why upper expansion may be needed are:

• Crossbite – A crossbite often occurs when the upper jaw is too narrow to fit properly with the lower jaw. This upper teeth misalignment causes some of the bottom teeth to bite outside of the top teeth. If severe crossbite is not addressed with early orthodontics, it may shift the jaw to one side. It can lead to permanent and unwanted changes to the facial structure as well as jaw and TMJ pain and excessive wear of the enamel. A palatal expander widens the jaw, stacking the top and bottom teeth correctly.
• Severe crowding – Severe crowding can occur if the jaw does not have sufficient space to accommodate all of the permanent teeth. With careful oral evaluation, orthodontists can spot emerging crowding and determine this condition, even before the teeth come in. If crowding is spotted or it appears to be severe, the orthodontist will recommend a palatal expander to widen the jaw to fit the permanent teeth as they erupt. Timely action can minimize future crowding and prevent the need for tooth extractions.
• Impacted teeth – There are times when other teeth can block the path of a permanent tooth, preventing it from erupting into its correct place naturally. When a tooth gets stuck beneath a bone or tissue, it is called an impacted too. Widening the upper jaw can make sufficient space for the impacted tooth to erupt on its own, into its designated position without needing an extraction or more invasive intervention.

In addition to correcting crossbites, preventing crowding, and making spacing for impacted teeth to make their way to the surface, a palatal expander can also help with the following:

• An underbite
• Breathing difficulties
• Sleep-disordered breathing, known as sleep apnea
• A narrow smile

Orthodontists understand how these problems cause significant complications later in life, such as pain and discomfort with the bite and permanent tooth damage. At times, a palatal expander also provides an aesthetic solution and helps you enjoy a nice grin.

Pros and cons of orthodontic expander

Early orthodontic treatment, like an ortho expander, is a major decision. In most cases, teens and preteens are seen wearing braces, as compared to young children. Treatment becomes necessary in certain cases.

Orthodontic expander pros and cons

Early ortho treatment can be a big step, especially if it is a young child who will be wearing it. It is rare to see younger children going through orthodontic care, which often increases the parent’s apprehensions when they are told about severe crowding, a crossbite, or impacted teeth their child suffers from.

The good thing is that highly experienced and trained orthodontists, such as Dr. Gibbs, follow the American Association of Orthodontists’ suggestions regarding delaying it and only propose early orthodontic treatment if it is absolutely necessary.

Here are some pros and cons of orthodontic expander treatment you must know about:

Pros

• It can cut down the time your child will need braces later on
• It reduces the need for tooth extraction
• It creates room for emerging adult teeth as your child grows up
• It leads to straighter teeth and better-aligned jaws, which ensures effective brushing and flossing
• It offers an aesthetically pleasing smile and improves confidence
• It can enhance your child’s breathing patterns
• It helps in chewing and eating

Cons

• It takes some time for your child to get used to the device
• Eating with the expander may take some time and practice
• Children are not as careful about extra cleaning needed for their expander
• It can cause some tenderness or soreness when adjusted, even though it goes away within a short time

What to expect when wearing an expander?

Wearing an expander is not fun. You may find that the appliance is interfering with your chewing and speaking abilities. This usually lasts for a few days, and once you have adjusted to wearing it, you will be able to speak and chew as before.

A palate expander only widens your jaw, it does not change the actual appearance of your face. It can have a positive effect on the nose. As the nasal cavity widens, it reduces the resistance in nasal airflow and helps you breathe better.

How to get used to wearing a palatal expander

Wearing an orthodontic expander for the first time can feel like an overwhelming experience for you, as well as your child, as it takes some time to get used to the heavy and different appliance in the mouth.

Here are a few orthodontists’ tips on how you can make the transition more comfortable.

• Begin with expander-friendly foods – The first few days of wearing the expander will no doubt be a bit difficult, but you can make them easy, and more comfortable with the right choice of foods. It is best to eat soft foods like yogurt, smoothies, soup, or mashed potatoes as they do not require a lot of chewing and will not put any pressure on the teeth or the expander.
• Be ready for some discomfort – Whether it is you or a child, expanders take some time to get used to. There will be pressure or discomfort on the teeth or palate in the beginning. This pressure or pain may sometimes extend to the nose or mouth when the expander is activated. Being ready for discomfort will help to deal with it in a much better way. Over-the-counter pain medications can keep away the pain and discomfort, and cold treats will make you feel better.
• Focus on oral hygiene – It is easy to miss oral hygiene while you are trying to focus on the expander and adjusting to it. Brushing and flossing are vital parts of keeping the teeth and expander clean. Food particles stuck between the teeth or the expander not only lead to cavities and dental decay but also affect the treatment time. A little extra care and the time it takes will give you the chance to enjoy the best results.
• Keep in touch with the specialist – Even though problems with orthodontic expanders are rare, do not take any concerns lightly. Consult the specialist and discuss whatever is troubling you to have it addressed timely without causing further complications.  If you see a gap in the top front tooth, don’t be alarmed as this is normal and a sign that the palate is expanding. This gap can be fixed in the teen years with braces.

How to adjust an expander

The expander can only work its magic when it is activated. Experts recommend activating the appliance at bedtime so that it is easy for the users, particularly children, to get accustomed to it, and the pain or pressure has disappeared by the time they wake up.

Your orthodontist will show you how to adjust the expander so that you feel confident doing it on your own.  Even though the exact specifics vary depending on type of expander you choose, basic instructions remain the same for most patients.

Tips for adjusting a palatal expander step by step:

• Tip the head back
• Place the key you were given into the hole of the appliance
• Push the key completely towards the back of the mouth until it stops, and you can fully see the next hole in your appliance
• Carefully remove the key by pressing back and down towards the tongue
• The new hole for the next activation should be visible

Does a palatal expander hurt?

A palatal expander is not painful. However, there will be some soreness and pressure after the appliance has been fitted and the key is turned, particularly during the first few days. Discomfort will be mild at most, and sticking to light and soft foods that do not require biting and chewing for a week will definitely help.

Palate expanders should not cause severe pain. If you develop any concerning side effects or unbearable pain, call your orthodontist right away.

An orthodontic expander may be the right treatment option to help your child successfully navigate early orthodontic treatment and get the best care to correct crossbite and dental crowding due to a lack of space in the mouth. An experienced and board-certified orthodontist, Dr. Gibbs understands how a palatal expander widens the roof or palate of the mouth and provides crucial space needed to align the teeth and bite in children as well as adults. He answer a all your questions and cater to your individual needs to ensure you enjoy the best oral care and desired outcomes.