Some children and occasionally even some adults need to widen their upper jaw. When an orthodontist decides on this type of procedure, an orthodontic expander is called into place. Dr. Menachem Roth of Carvalho and Roth Orthodontics in Newton Centre, Marlborough, and Northborough, Massachusetts explains here how it all works.
The purpose of the orthodontic expander is to widen the upper jaw. That has two goals: The first is to create space for teeth, the second — and the most common — is to correct the crossbite, where the upper teeth are inside the lower teeth.
In growing children, the palate is made of two bones that are split in the center. As we age and reach puberty, those bones begin to fuse together. Up until that point, using this type of appliance, we can widen the upper jaw and separate those two bones without really any pain at all, and thus create a wider and a broader arch.
The appliance itself can come in two forms: It can either be a removable one that looks similar to a retainer, or a fixed one. The first is something the patient will wear all the time but they can take it in and out of the mouth when needed. The second type is much more commonly used. Fixed expanders are appliances that are glued into the mouth and remain there; the child cannot take it in and out.
Turned By a Screw
Both types are fairly intricate. A left and right portion fits around the molars and is held together in the middle by a screw. Turing that screw widens the appliance and puts pressure on the teeth to increase or widen the jaw and the palate. The device is typically turned by the patient or his parent one to two times per day for a few weeks. Usually there is a small amount of pressure while the run is done but it dissipates quickly, and doesn’t really hurt.
Once the active expansion is completed, the appliance is generally left in place for four to eight months to allow new bones to develop in the center of the palate and heal and stabilize. During the process, many patients will develop a space between the upper front teeth. While this may be unsightly, it does indicate the process is working well. The space closes on its own in the weeks following the completion of the expansion.
Expansion for Adults
Adult expansion, which is much more rare, is accompanied by a surgical procedure. In patients where growth is already completed and the bone is already fused, some orthodontists will recommend a surgically-assisted rapid palatal expansion where the same type of appliance will be used. But prior to beginning to turn it, the oral surgeon makes a small cut through the palatal bone to allow the two sides to spread.
The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.
