Palatal Expansion
Making the upper jaw wider
A palatal expansion appliance can markedly increase the width
of the upper jaw. A wider jaw allows upper and lower teeth to fit
together. This permits teeth and jaws to function well and contributes
to a broader, more attractive smile. For some patients,
expansion may prevent the need for extraction of permanent
teeth because space is created for permanent teeth.
Dr. Yoon has determined that palatal expansion is necessary for
your child. A narrow upper jaw may interfere with the fit of upper
and lower teeth. With expansion, nasal airway becomes wider,
nasal obstruction may get improved, often your child feels
easier breathing thru nose.
Palatal expansion is a combination of tooth movement and jaw
expansion. It works by widening the two halves of the upper jaw,
called the palate. The two halves are joined together by a ‘suture’
in the middle of the roof of the mouth. The orthodontist custom
makes an expander for each patient. An expander can be fixed
or removable. The expander is attached to the upper back teeth
and eases the suture apart, which makes the upper jaw wider.
As the jaw expands, new bone fills in between the two halves
of the palate. This process is called distraction osteogenesis.
Expansion can take a few weeks to a few months, depending
on the amount of expansion required for an individual patient.
A rapid palatal expander (RPE), also known as a rapid maxillary
expander (RME), is generally worn for three to six months. During
the first few weeks of wear it is necessary to expand (activate)
the appliance. Dr. Yoon will provide detailed instructions on how
to activate the appliance and operate it properly to achieve the
desired results.
Questions and Answers
How do I know palatal expansion is right for my child?
Palatal expansion improves the way the upper and lower jaws and the
upper
and lower teeth work. It widens the jaw so there is sufficient room for
permanent upper and lower teeth to come in. Expansion can make the
nasal
floor wider so nasal breathing becomes easier.
Without expansion, and depending on the problem, permanent teeth
may not
have enough space to come in; or the lower jaw could grow out of
proportion,
which could require corrective surgery as an adult.
Left untreated, a narrow palate can lead to excessive wearing of the
teeth or
the need for extensive dental work as an adult.
Dr. Audrey Yoon will explain how to activate your child’s palatal
expander.
What is the best age for palatal expansion?
Age alone is not the best predictor as to when a palatal expansion
appliance should be used. Ideally a patient should still be
growing.
An orthodontist can estimate skeletal maturation and
determine whether a patient is still growing by analyzing the
X-rays. Patients who have completed growth may require
miniscrew-assisted rapid palatal expansion or surgically-assisted
rapid palatal expansion.
How is the appliance activated?
Dr. Audrey Yoon will recommend the type of expansion appliance
necessary. Different appliances require different activation
techniques. Depending on the appliance, the palatal expander
may require activation with a special key or wrench.
Follow Dr. Yoon’s orthodontist’s instructions on how to expand
your child’s appliance and how often to expand it.
What can I expect?
It may take a few days to get used to a palatal expander. Chewing,
swallowing and talking may be awkward at first. The mouth and
nose may be sore or may tingle. Some patients report a slight
headache. Talk with your Dr. Yoon and team about over-the-counter
analgesics to relieve discomfort.
After only a few days of expanding, you may notice space between
the front teeth. This is a sign the appliance is working and the
palate is being expanded.
Most patients require full orthodontic treatment (braces) or
aligner therapy (Invisalign) following palatal expansion.
How is the appliance cared for?
The expander should be brushed whenever teeth are brushed.
Patients should rinse the mouth with water after eating or after
drinking a beverage with sugar. Removable expanders should
be brushed and rinsed each time the appliance is taken out of
the mouth.
Placement of expander
Two weeks later, half of expansion complete
Four weeks later, expansion complete
Braces close the spacing and align the bite creating a healthy, beautiful
smile.
