In young children, one of the most common appliances used in orthodontics today is the palatal expander, also known as an “orthodontic expander”. These appliances provide an important and innovative solution to the problem of crowding teeth. They work by expanding the arch in the mouth, but the work that they do isn’t entirely passive and there is a small learning curve for parents.
If your child has an orthodontic expander or is scheduled to get one, you’ll need to “do the turns” every day to make sure arch expansion proceeds on schedule. Successful expansion of the arch is only possible in young children whose growth plate in the roof of the mouth (the midpalatal suture) has not yet calcified or fused yet. Typically, the fusion of the midpalatal suture takes place between 14 and 16 years of age, so if your child is younger than this, arch expansion is still a possible treatment option.
The palatal expander is put into the mouth and attached to the upper arch via bands that are placed around the teeth and then cemented in place. Though there are removable expanders on the market, fixed expanders have some important advantages, particularly for kids. In particular, the fixed orthodontic expanders are unlikely to get lost or forgotten.
Initially, kids feel some discomfort when the expander is put in place, but the discomfort eventually goes away and afterward, is practically painless. Patients often say that they feel pressure on the roof of the mouth as the expander pushes outward on the arch.
It’s important for parents to be prepared for the treatment process that their child is going to go through during the arch expansion. Often, kids speak differently for a few days following the initial placement of the device. They may make a slurping sound sometimes as the mouth makes extra saliva after the expander is cemented in place. And parents will also notice that, as the milkshakes suture starts to open, the two upper incisors in the center of the arch will develop a gap. This gap is caused when the arch expander pushes the palate in opposite directions. If the expander stops being activated, however, the space will close on its own as the elastic fibers in the gums pull the teeth back into their original positions. Despite the closing of the gap between the teeth, the bone tissues remains expanded.
It’s normal for the teeth to feel a little loose in the mouth during treatment and they may feel sore too. It would be wise to feed your child foods that are fun, but that don’t require a lot of chewing. For example, mashed potatoes, yogurt, ice cream, soup, milkshakes, or pudding would be excellent choices. Within only a couple of days, your child will be able to eat normally again and the soreness will go away.
Often, the orthodontist will opt to over-expand the arch just a bit to allow plenty of room for the teeth to move. There is always some relapse of the arch back to its original size, so the dentist will make sure that the arch expansion is expanded just a little bit beyond the ideal size to allow for a small amount of relapse. After the orthodontist feels that the target size has been reached, they instruct you on how long the palatal expander needs to stay put to solidify the results. In some cases, the orthodontist may recommend that the expander stay in place throughout the remainder of the treatment, while in other cases, it may be possible to remove the device as soon as two months after the ideal arch expansion has been achieved.