Palate Expanders: Your Guide to Straight Teeth

palate expander

If your child or teenager needs to wear a palate expander, it might surprise you, but it’s actually quite common. Palatal expanders widen the upper jaw and are usually recommended for patients who are still growing. This is because it’s easier to adjust jaw and facial development during this time. Using a palate expander can often lead to significant benefits, such as achieving a broad, beautiful smile without needing tooth extractions, lengthy treatments, or corrective jaw surgery later on. To give you a better understanding of palate expander treatment, this article will cover all the details you need to know about this appliance. 

What is a Palate Expander?

As discussed earlier, a palatal expander is a tool used in orthodontics to widen the upper jaw. It helps create enough space for all the permanent teeth and fixes any differences between the upper and lower jaw alignments, making sure the top and bottom teeth fit together properly. Besides fixing these practical issues, using a palate expander can also improve the appearance of the smile by making it wider and more balanced.

Why Does My Child Need a Palate Expander?

The three most common reasons why a child or teen requires a palate expander are:

1. Crossbite:

In some cases, a child’s upper jaw may not match up well with the lower jaw, causing the back top teeth to bite inside the lower teeth. Expanding the upper jaw can help fix this.

2. Crowding:

Even before all of a child’s permanent teeth have grown in, we can see if there won’t be enough room for them. Expanding the upper jaw can make space for the teeth without needing to remove any.

3. Impacted Teeth:

Occasionally, a tooth may be blocked from coming in properly. By widening the upper jaw, it can help the tooth find its place naturally. This often occurs with canine or eye teeth.

How Does a Palatal Expander Work?

Different types of orthodontic expanders may vary in design, but they all operate similarly. One commonly used expander for younger patients is the rapid palatal expander. It’s a custom-made, stainless-steel device that fits around a few back upper teeth, consisting of two halves connected by a center screw.

To activate the expander, you or your child simply turns the screw using a special key. This creates gentle pressure on the upper molars and the junction of the two maxillary bones, causing them to gradually move apart and widen the jaw. After achieving the desired expansion, the expander remains in place for some time to allow new bone to form and stabilize the widened jaw.

Types of Palate Expanders

There are various palate expanders available, each serving different purposes. Some are removable, while others remain fixed within the mouth for extended periods. Your orthodontist will help determine which type suits you best based on your specific correction needs.

1. Removable Palate Expander

If minor jaw widening is required, your orthodontist might suggest a removable palate expander. These come in various brands and are meant to be worn throughout the day, except during meals, physical activities, and oral hygiene routines. Unlike some fixed expanders, the screw in removable ones typically needs turning only a few times per week, making maintenance easier.

2. Hyrax Rapid Palatal Expander

This fixed palate expander features bands that fit securely around individual molars. Cemented in place, these bands anchor the expander within the mouth. A centrally located screw, positioned beneath the palate, requires periodic adjustment using a provided key, with instructions from your orthodontist.

3. Quad Helix Appliance

Similar to the Hyrax, the Quad Helix is a fixed expander attached to the back molars. However, it operates differently—it starts in a compressed state and gradually expands on its own over time. Unlike other expanders, no manual adjustments are needed at home.

4. Implant-Supported Palate Expander

Primarily recommended for older patients, this expander type relies on four mini dental implants instead of dental structures for force application. Working closely with an oral surgeon or periodontist, your orthodontist oversees the placement of these implants, offering direct pressure to the upper jaw.

Selecting the appropriate palate expander involves careful consideration of individual needs and treatment goals, a decision best made in consultation with your orthodontist.

What is the Best Age to Get a Palate Expander

The timing of palatal expansion varies based on its intended purpose. If the goal is to widen the upper jaw by separating its bones, this procedure is typically best done before growth is complete.

During a child’s growth phase, the palatal bones of the upper jaw remain unfused. This allows orthodontists to safely use a palate expander to widen the jaw.

Once a child’s jaw has fully grown, using a standard palate expander to separate the palatal bones becomes more difficult. Instead, it may primarily shift teeth, resulting in temporary rather than permanent separation.

In general, palatal expansion is most effective in younger children. Some may undergo this procedure as early as seven years old. While expansion might still be possible in older teenagers, its effectiveness and stability may be reduced. By the time individuals reach their twenties, conventional palate expanders may not be as effective, leading to consideration of alternative options like MARPE or SARPE.

This highlights the importance of early orthodontic assessment, ideally by age seven. Early evaluation allows orthodontists to identify candidates who could benefit from palate expansion and recommend appropriate treatment during the most opportune developmental stage.

How to Adjust an Expander?

To make sure the palate expander does its job well, it needs to be activated properly. We usually suggest activating it at bedtime, so by the time your child wakes up, the pressure from the turn has eased off.

We always make sure our patients know how to adjust their expander confidently. While the specifics might vary depending on the expander type, the basic steps stay the same for most patients.

Here’s a simple guide on how to adjust an expander:

  1. Tilt your head or your child’s head backward.
  2. Use the key provided to turn the expander in the hole.
  3. Push the key all the way to the back of the mouth until it stops, showing the next hole.
  4. Carefully take out the key by pressing it backward and downward toward the tongue. This will reveal the new hole for the next adjustment.

Do Palate Expanders Hurt? 

Palate expanders usually don’t cause discomfort while wearing them, and adjusting them shouldn’t be painful either. When you adjust your expander, you might feel a bit of pressure on the roof of your mouth or a tingling in your teeth. Sometimes, this sensation might even reach up towards your nose or eyes. But don’t worry—it typically goes away after about 5 minutes.

Caring for Your Teeth and Gums with a Palate Expander

Taking care of your teeth, gums, and palate expander is really important to prevent problems like bacteria buildup and plaque. If plaque builds up, it can make your gums swollen and inflamed, which might make your expander uncomfortable.

Make sure to brush and floss your teeth regularly, especially after meals. You can use either an electric or manual toothbrush, just like your dentist suggests.

You can also use a mouth rinse to clean the nooks and crannies of the expander.

Try to avoid eating foods that are sticky, chewy, or hard. These kinds of foods can cause problems with your expander. Also, stay away from foods like nuts and carrots that create small particles that can get stuck.

Tell your child not to chew on hard things like pencils because it might damage the expander.

Advantages of a Palate Expander

When used correctly, a palate expander offers several benefits:

  • Correcting various dental issues like misalignment and crowding.
  • In children, potentially reducing the need for future oral surgeries.
  • Compatibility with other orthodontic devices such as braces and headgear.

Risks and Complications

Although age isn’t necessarily a risk factor, it’s essential to note that palate expanders for adults may require a longer treatment duration. Due to the fully developed nature of adult bones, the process of adjusting them takes more time.

Moreover, adapting to a new palate expander may involve temporary side effects, including:

  • Mild discomfort or pain.
  • Occasional headaches.
  • Increased salivation.
  • Difficulty in pronunciation (lisping).

Additionally, some individuals undergoing palate expansion may notice spacing between their front teeth, which can subsequently be addressed through orthodontic interventions. These anterior teeth, totaling 12 in number, occupy the front region of the mouth.

Lastly, inadequate cleaning of the palate expander can lead to the accumulation of food particles, debris, and plaque, resulting in an unpleasant taste or odor. It’s crucial to maintain proper oral hygiene by thoroughly cleaning the expander daily to mitigate this issue.

Alternatives to Palate Expanders

During your consultation with the orthodontist, you’ll work together to decide if using an expander or another treatment is the best option for you.

1. Braces

Braces might be suggested for both kids and adults to help with crowded teeth and crossbites.

2. Tooth Removal

Sometimes, your dentist might recommend removing certain teeth, like impacted eye teeth, to prevent overcrowding or overlapping. They might also suggest removing molars if there isn’t enough space for them to come through properly.

3. Jaw Surgery

For young adults with serious dental issues that braces can’t fix, jaw surgery might be considered to improve their dental health.

Closing Thoughts

Palate expanders may seem like a small device, but they can have a big impact on your smile and overall oral health. By creating more space in the upper jaw, they pave the way for straighter teeth, a wider smile, and potentially even prevent the need for future procedures. While wearing a palate expander might involve some initial adjustments, the long-term benefits make it a worthwhile journey towards a healthier, more confident you.

Concerned About Your Child’s Smile? Take Their Smile Assessment at Brite Orthodontics and Book a Consultation to Discuss Treatment Options. 

Dr. Satish Pai, M.D.S

Dr. Satish Pai is an orthodontist and Ivy League trained dentist who has served as a faculty at Columbia University. He believes a perfect smile not only makes a person look great but feel great. As the founder of Putnam Orthodontics and a Partner at Brite Orthodontics, he is dedicated to providing the best orthodontic treatments to his patients. He also writes to educate people about everything orthodontics and the importance of correctly aligned teeth along with good oral health. In his free time, you can find him golfing, doing yoga or surfing, and spending time with his family.

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