Lastly, expanders contribute to a broader, more attractive smile. Expansion is easiest and results are most stable when performed on a growing child or teen. Activation of an expander is usually done by a parent, guardian, or someone other than the patient.
On the day the expander is placed, we give you a key that inserts into an opening in the activation portion of the RPE. It is easiest to have the patient lie down on a bed or couch where there is good light. Then, the patient tilts their head back so that the RPE can be seen clearly with the arrows pointing in the direction of the turn. The key is inserted into the top hole visible until it is firmly in place. Note that when the key is fully inserted, the bend in center of the key is no longer visible.
Follow the arrows facing towards the back of the mouth to apply a small amount of pressure to swivel the key in their direction, completing a 90 degree turn on the key. As you turn, the fender rotates and a new hole becomes visible. The rotation stops when the key meets the back of the expander.
When the turn is complete, simply push down toward the tongue while you continue to lightly apply pressure toward the back of the mouth to remove the key. You should then see the next hole for insertion at the top. You will be given specific instructions as to how many turns to complete before the next appointment. The expansion of the palate is usually completed in weeks. However, the appliance remains in the mouth for a longer period, generally months to allow the new bone that has formed to mature.
If an RPE is removed too early, some of the width gained could be lost. Fortunately for our expander patients, the appliances are made purely of metal and do not require the colored rubber ties.
Furthermore, since the appliance sits on the roof of the mouth, it is seldom seen by anyone. If our only concern is the narrow upper jaw and the position of the teeth is satisfactory, we will commence with the expander treatment and once complete, we will end treatment. If the patient wants to avoid wearing braces and wants to use clear aligners Invisalign instead, we can coordinate the two treatments. Usually an expander is used first. We proceed with the expander treatment as normal.
Once we achieve the desired expansion with the upper jaw, the expander will remain in place for months depending on the condition. When our expander treatment is complete, we will remove the appliance and use a retainer to hold our correction until we are able to begin our clear aligner treatment. This is a great option for kids who want to correct their jaw alignment and straighten their crooked teeth without the use of traditional metal braces.
Learn More About Invisalign. Most patients have a small lisp when they first get an orthodontic expander. However, it is usually short lived and most patients go back to talking normally very soon. The tongue will quickly adapt to sharing the roof of the mouth with the expander and soon after nobody will be able to hear a difference.
To speed up the process, talking out loud as much as possible after the expander is in place can help. Many patients find it helpful to read out loud to practice. When we are able to do the expander at the correct age, it is usually a fairly painless procedure. The soft spot on the roof of the mouth easily separates and allows for effective, pain-free expansion.
It usually is felt for just a few seconds after turning and quickly dissipates. If we are not able to begin our expander at the correct age, the soft spot in the roof of the mouth hardens into bone. Once the growth center closes, the expander can be a bit more uncomfortable for the patient. Furthermore, the expander is not nearly as effective because it is only moving the teeth and not the jaw bone.
In order to widen the upper jaw after the suture closes, the patient must go through a surgical procedure. This entails a consultation, diagnosis and treatment plan by both an orthodontist and an oral surgeon.
They will work together coordinate treatment to achieve the desired result. Surgery is easily avoidable by seeing an orthodontist at the correct stage of development, getting an early diagnosis and proceeding with the correct treatment.
See Orthodontics FAQs. The American Association of Orthodontics recommends children see an orthodontist by the age of 7. When it comes to expanders, we definitely want to take advantage of growth potential to avoid surgery and get the best result we can. Most pediatric dentists are well aware of expanders and the great work they do, and will advise when is the right time for an examination by an orthodontist. We offer complimentary orthodontic examination with our board certified orthodontist.
If you are interested in a consultation, please contact our Portland office today! Do you or your child need an orthodontic evaluation? Call us at to schedule your visit to our downtown Portland location! Schedule Now. This blog provides general information and discussion about dentistry and other health related topics.
The opinions and content expressed on this blog are for general conversational purposes only and should not be interpreted as dental or medical advice pertaining to any particular individual. If the reader or any other person has a dental or medical concern, he or she should consult with an appropriately-licensed dentist, physician or other health care provider.
All palate expanders are custom-made. They are either made from impression taken from the mouth, or digital scan taken from the mouth. Palatal expanders do not work as well for adults when compared to children or adolescents. This is because the sutures surrounding the upper jaw maxilla fuses and calcifies as a child grows older. Once the sutures are fused and completely calcified, the upper jaw can no longer be expanded.
Therefore, if there is an indication for upper jaw expansion, it is best to have palate expander treatment early. The most common age for palate expander treatment is from 8 to 15 years of age. For adult treatment, if the amount of expansion is small, then palatal expander may work. If the amount of expansion is significant such as correction of posterior crossbite , then palate expander combined with jaw surgery will be required.
If there is an upper and lower jaw size discrepancy, then palate expander treatment is necessary. Narrow upper jaw can cause lasting bite problems and can impact physical appearance. Because of this, school dentists, children dentists, and family dentists are trained to identify signs of narrow upper jaw early so a prompt referral can be made to an Orthodontist.
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