When you think of orthodontics, one of the first appliances that might come to mind is a palate expander. A palate expander is a common appliance that is used to correct a width problem with your upper jaw, when it is too narrow in comparison to the lower jaw. Some of the most common issues that may require an expander are a crossbite (where the upper teeth fit inside of the lower teeth) or severe dental crowding. These types of bites require correction as early as possible in order to reduce long term problems, such as facial asymmetry and tooth wear. Expanders are typically recommended to younger patients who are growing but may also be used in adult patients in some cases.

Aside from crossbites and crowding, expanders may also be recommended for:

• Underbite
• Shifting of the lower jaw on closing
• Narrow smile
• Difficulty breathing
• Impacted teeth

By creating width in the upper arch, the use of an orthodontic expander can be the difference between needing to have permanent adult teeth extracted, and a non-extraction treatment in some cases.

How Does an Expander Work?

Expanders can be an appliance that is fixed in place or removable. These appliances can work as a spring or can require turns at home in order to gain width. The expander works by applying continuous gentle pressure to the maxillary bones. When patients are young, these bones are separate, and as we age, they fuse together. For this reason, expanders work best in early years before the bone connects. Watch this helpful video that shows what an expander can look like, and how it works.

When you begin expander treatment, your orthodontist will provide you with a key that you will need to make the turns in the expander at home. Turns are typically done by a parent or guardian at a prescribed rate. To turn, place your key into the key hole and move one time in the direction of the arrow indicated on the expander. If your key is lost or broken, you can use a paperclip until it is convenient to get another from your orthodontist.

How Long is an Expander Worn?

An expander will typically remain in the mouth for nearly 1 year, even if the appliance is not being actively expanded. Your orthodontist may recommend that the appliance stay in even longer, so that a relapse of expansion does not occur. Sometimes, the expander is replaced with a retainer or another appliance with the same goal of maintaining the width that the expander had created. It is very important to maintain the appliance as instructed by your orthodontist to ensure that the jaw does not return back to the original size. If an expander ever becomes loose or breaks, it is important to schedule a visit with your orthodontist to address the concern.

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