How Palatal Expander Works

Expander for Crossbite

A palatal expander is a dental appliance used to widen the upper jaw. It is typically used in children and teenagers whose upper jaws are still growing and developing. The expander works by applying gentle pressure on the palate, which is the roof of the mouth, and gradually widening it over time.

Palatal expanders are often used as part of a comprehensive orthodontic treatment plan to address issues such as crowding, crossbite, or impacted teeth. They can also address breathing problems or sleep apnea, which a narrow palate may cause.

Why would you need a Palatal Expander?

The palatal expander “expands” (or widens) your upper jaw by putting gentle pressure on your upper molars each time an adjustment is made. The animation below will instruct you when and how to adjust your expander. When you achieve the desired expansion, wear the appliance for several months to solidify the expansion and prevent regression.

Did you know that about 3.5 million children and teenagers start orthodontic treatments yearly? Braces are the most common form of orthodontics, but many other treatments are used to correct the alignment of teeth.

What Is a Palatal Expander?

A palatal expander is a device used to expand the width of the palate or the upper jaw. Usually, this device is used in early orthodontic work as part of a plan to prepare for a complete alignment of the teeth. Expanders are typically used before braces are installed, especially for children. You can think of these devices as the first step to the realignment of permanent teeth.

A palatal expander is a custom-made appliance that fits the individual’s mouth. It consists of a metal framework that attaches to the upper teeth on either side of the mouth and a screw or other expansion device in the center. The patient or their parent can turn the screw daily to widen the palate gradually.

Orthodontists put an orthodontic device on the roof of your mouth that pushes your jaw further apart! Don’t worry; this expander is a gentle treatment that produces life-long results.

Following the orthodontist’s instructions for using the palatal expander and maintaining good oral hygiene during treatment is essential. Regular dental checkups and cleanings are also needed to monitor the treatment progress and ensure that the teeth and gums remain healthy.

Why Is a Palatal Expander Used?

Why is there a need to expand the roof of the mouth? That’s a good question! Generally speaking, misaligned teeth are caused by overcrowding. We might use braces to fix crooked teeth, but braces cannot fix overcrowding. The solution is then to create room in the mouth for teeth to grow and be aligned. When we use devices like this expander, we can create room in the upper jaw that will allow braces to make the most effective improvements.

Palatal Expander Cost

The cost of a palatal expander can vary depending on the individual case, the dentist or orthodontist, and the location. In the US, the cost of a palatal expander can range from $1,500 to $3,500. In other countries, the cost can also vary widely. It is best to consult with a dental or orthodontic professional to get a more accurate estimate of the cost for your specific case.

Crossbites

A crossbite is a dental condition where the upper teeth sit inside the lower teeth when the jaws are closed rather than slightly overlapping them as they should. Crossbites can affect only one side of the mouth (unilateral) or both (bilateral). Crossbites can cause problems with dental function, facial symmetry, and jaw development and may require orthodontic treatment to correct.

What Are Crossbites?

When we examine your mouth and devise a plan to fix the alignment of your teeth, you might hear a few unfamiliar terms. The most important one that relates directly to expanders is the word crossbite. Crossbite refers to how the molars – or the bite – of your jaws do not match up.

Usually, crossbites happen when the upper jaw is more narrow than the lower jaw. While some people find that living with smaller crossbites is perfectly comfortable, there are times when more extreme crossbites make it difficult to chew food. Fixing a crossbite will allow for better chewing, make room for permanent teeth to continue to grow, and ultimately help perfect your smile.

What Causes Crossbites?

The cause of crossbites has been a subject of research. After all, not everyone is born with a crossbite! Several research studies indicate that crossbites are usually caused by genetics. Like many other things in your health, the state of your mouth is also often the result of a heredity lottery. Another cause for crossbites might be delayed tooth growth or teeth that have grown abnormally.

What Is the Best Age to Get a Palatal Expander?

Expanders can be an undertaking since adjusting their needs to be done by another person, and they must remain in the mouth for several months. But is there an age where expanding the roof of the mouth is most effective?

It is generally recommended that these devices be used before permanent adult teeth have finished growing, which means that the best age to use one is between the ages of 5 and 16. Most orthodontists use expanding devices after adult molars have grown in but before the other adult teeth in the upper jaw have finished growing.

How To Use

Using this device is gentle, effective, and very easy. After installation, your dentist will give you specific instructions on how often to use the device. Here we will break down the basic steps to give you an idea of how this device works. It is important to note that adjusting this device can either be done at home or at the dental office, depending on the child’s age and the amount of adjustment needed.

Step 1: The Position

It is easiest to use this device while lying flat with the head tilted back, just like at the dental office. A quick way to achieve the ideal position is to lay back on a bed with your head tilted back over the edge so that the crown of your head is facing the floor. Be sure to have good lighting and to keep the mouth open but relaxed.

Step 2: The Key

Every device comes with a key that helps turn the fender, which allows the arms of the device to expand. The key is a short metal rod that fits into the holes of the fender in the expander. To adjust the expander, place the key into the hole and push the key toward the back of the mouth so that the holes go toward the back of the throat.

Remove the key once the next hole is visible or after completing the correct number of turns. Your orthodontist will tell you how many turns to make each time you expand the device if you perform the task at home.

Step 3: The Time

Most of the expansion of the palate is done over six weeks or more. After the expansion of the upper jaw has reached the ideal width, an expander will remain in the mouth for 4 to 6 months to stabilize the upper jaw. After that, your orthodontist will remove the expander and continue your treatment plan.

Resources

Here are some scientific articles about palatal expanders:

• Bishara, S. E. (2001). Palatal expansion: the keys to success. American Journal of Orthodontics and Dentofacial Orthopedics, 119(1), 31-37. doi: 10.1067/mod.2001.109711
• Lagravere, M. O., Major, P. W., Flores-Mir, C. (2005). Long-term skeletal changes with rapid maxillary expansion: a systematic review. Angle Orthodontist, 75(6), 1046-1052. doi: 10.1043/0003-3219(2005)75[1046:LSCWRM]2.0.CO;2
• Lagravere, M. O., Heo, G., Major, P. W., Flores-Mir, C. (2010). Meta-analysis of immediate changes with rapid maxillary expansion treatment. Journal of the American Dental Association, 141(7), 716-726. doi: 10.14219/jada.archive.2010.0269
• McNamara Jr, J. A., Baccetti, T., Franchi, L., Herberger, T. A. (2003). Rapid maxillary expansion followed by fixed appliances: a long-term evaluation of changes in arch dimensions. Angle Orthodontist, 73(4), 344-353. doi: 10.1043/0003-3219(2003)073<0344:RMEFBA>2.0.CO;2
• Vardimon, A. D., Graber, T. M., Voss, L. R. (1984). Experimental and postexperimental responses to rapid maxillary expansion. American Journal of Orthodontics, 85(4), 345-352. doi: 10.1016/0002-9416(84)90057-2