If your child's orthodontist has recommended a palatal expander, you probably have questions. Expanders are common in orthodontic treatment for growing children. They widen the upper jaw to create space for teeth and correct the bite, often reducing the need for extractions later.
A narrow upper jaw can cause crossbites, crowding and breathing difficulties. In children, the two halves of the upper jaw are joined by a growth suture that has not fully fused, allowing them to be gently widened.
Most expanders are fixed to the upper back teeth and have a small screw in the centre. Turning the screw with a special key gradually widens the appliance, applying gentle pressure that separates the two halves of the jaw. New bone forms in the gap.
Parents are usually shown how to turn the expander at home, following a set schedule. Your orthodontist will tell you how many turns to make and for how long. Keep a chart to track turns, and contact the clinic if you are unsure.
Children may feel pressure in the teeth, nose or cheeks after turning. A gap may appear between the front teeth, which is a normal sign that the expander is working and usually closes over time. Speech and swallowing may feel different for a few days.
Choose soft foods for the first few days and avoid sticky or hard foods that could damage the appliance. Brush carefully around the expander and use a water flosser or rinse to remove trapped food.
When an expander is first fitted, children may notice changes in speech, especially with sounds such as s and t, as the tongue gets used to the appliance on the roof of the mouth. Swallowing may also feel different, and some children produce more saliva at first. These changes usually improve within a week. Encouraging your child to read aloud, sing and talk normally helps them adjust faster. If your child feels self-conscious, reassure them that the changes are temporary. Teachers can also be informed so they understand if speech sounds slightly different for a short time.
Palatal expansion works best in children because the growth suture in the upper jaw has not yet fused. In older teenagers and adults, the suture is more mature, making expansion more difficult. In some cases, special appliances supported by small anchors in the bone, or a surgical procedure, may be needed to expand the upper jaw in adults. Alternatively, some cases can be managed with orthodontic movement of the teeth alone. This is another reason why an early orthodontic check around age seven is recommended, as treating a narrow jaw is usually simpler during growth.
Once the desired width has been reached, you will stop turning the expander, but it usually stays in place for several months. This allows new bone to form and stabilise the expansion. Removing it too soon could allow the jaw to relapse. After the expander is removed, a retainer or other appliance may be used to maintain the width, and braces may follow to align the teeth. Your orthodontist will monitor progress with regular check-ups. Continuing good oral hygiene and avoiding hard or sticky foods during this time helps protect the appliance and keeps treatment on schedule.
Children may feel pressure after turning, but it usually fades within minutes to hours.
Active expansion takes a few weeks, followed by several months of keeping the appliance in place while bone forms.
Yes. It shows the expander is working and usually closes on its own or with braces.
Discuss whether an expander is right for your child. Learn more about metal braces in Al Ain.
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