Many of our patients ask us about expanders. Often an orthodontist will recommend that your child get expanders if your child has misaligned teeth, significant crowding, or a crossbite. Each of these issues can present as a developmental anomaly that is severe enough that, if it isn’t treated early or on time, could lead to extractions, facial asymmetry that is permanent, or ectopically erupting teeth that could require surgery to rescue in the future. That is the reason that expanders are often needed before adolescence or braces are even applied to the teeth. So, what exactly are expanders?
There are both upper jaw expanders and lower jaw expanders. An upper expander is basically an appliance that is custom made to fit the roof of the mouth or the upper dental arches and is often referred to as a Palatal Expander. It is designed to widen the jaw to make room for crowded teeth or make the upper jaw wider when it is narrower than the lower jaw (which it should never be). Depending upon the situation, expanders can be used while baby teeth are still present or after they have all fallen out. The key thing is that the expansion is done before growth is completed when the jaws are highly resistant to simple widening.
Lower expanders are removable devices that are taken in and out of the mouth as permanent solutions tend to fight the presence of the tongue. Lower expanders to not push apart at a suture as the lower jaw is just one, boomerang shaped bone but the presence of the expander with slow turning to make it widen can assure the lower teeth are upright over the bone and help to guide new teeth into a slightly wider eruption perimeter.
Upper expanders are usually attached by metal rings around the molars that are called bands. Expanders work by applying pressure at the mid-palatal suture which responds to that pressure by first moving apart and then laying down new bone to create a new, wider palate. It usually takes between several weeks or several months to do its job. After the expander is put into place, your child may feel discomfort and even some soreness. It’s a good idea to serve him/her soft foods that don’t require a lot of chewing until the expander feels more normal in the mouth and they re-acclimate themselves with swallowing with the new device in place. You will be instructed to turn your expander on a doctor prescribed regimen in order to achieve the goal of expanding the palate. Your orthodontist will go over instructions for just what the expectations are.
Just like braces, it is important to avoid sticky foods such as sticky candy that can get caught on the appliance or pull it loose. It is also just as important to take good care of the teeth while the expander is in place. Good oral care and hygiene are a must at this time. It may be a bit more challenging, but there are cleaning aides that can help. Your orthodontist will be happy to tell you the best way to care for them. Remember to reinforce the importance of flossing and brushing.
About Pediatric Dentistry and Orthodontic Specialists of Michigan, the offices of Drs. Delaney, Plunkett, Ralstrom, Makowski, Thanasas, Ker, and Associates
Pediatric Dentistry and Orthodontic Specialists of Michigan have specialized in pediatric dentistry and orthodontics since 1968. Our family-friendly office gives patients and families a more comfortable and consistent experience with dentistry from the very beginning. The pediatric dentists treat children from newborn to 18 years of age while our orthodontists provide care for both children and adults, including being an Invisalign preferred provider. The ability to treat all special needs patients reaches beyond our facility, which has treatment rooms available for children who require additional privacy. Valued hospital affiliations allow dental services to be performed at DMC Children’s Hospital and St. John Providence Health System when needed. Our specialists are also on staff at Henry Ford and Beaumont hospitals.
