Palatal Expanders

During childhood, Dr. Windhorst can take full advantage of a child's natural growth to effectively prevent or correct malocclusions (bad bites). This is one of the greatest benefits of initiating orthodontic treatment at an early age. One of the devices that Dr. Windhorst uses is a palatal expander.

A palatal expander gradually widens the upper jaw (maxillary expansion) to create more space in the mouth. This process may sound scary, but it's actually quite simple. Before puberty, the upper jaw develops as two separate halves that can be easily and gently separated within several months. The upper jaw fuses together completely after puberty.

Maxillary expansion is necessary if a child is experiencing:

  • Crossbite: The upper and lower jaw is misaligned, causing the back top teeth to bite inside the lower teeth. A crossbite can be corrected by widening the upper jaw.
  • Crowding: There is not enough space in the jaw for all the teeth to fit properly. If not treated, crowding can get worse, resulting in crooked teeth. We can generally identify crowding before all the permanent teeth erupt.
  • Impacted Tooth: A tooth that erupts partially or not at all, and is blocked by other teeth. This often happens with cuspids or canines – the pointier teeth under the eyes. Expansion of the upper jaw can create space in the mouth for the tooth to erupt in the correct position.

In addition to correcting malocclusions, maxillary expansion can improve breathing and enhance the smile. Expansion also limits the amount of teeth that need to be extracted to create space.

How Does the Palatal Expander Work?

A palatal expander is precisely customized for each patient. The appliance fits over several top teeth at the back of the mouth. It has two halves which are connected in the middle by a spring. Once the expander is placed in the mouth, the spring is activated and does not require any additional activation. We will monitor the patient to make sure the expansion is progressing, and remove the expander once a suitable amount of expansion has been achieved.

Occasionally, we have to use a screw-activated expander. A special key is used to turn the screw a small amount every day. This creates tension at the junction of the palatal bones, stimulating them to progressively move apart. After the upper jaw is widened, the appliance must be worn a few more months so new bone can form in the gap and stabilize the expansion. Expanders are typically worn for 3-6 months.

What to Expect During Treatment

Initially, speaking and eating will feel different. During treatment, a gap may develop between the front teeth. This is normal and indicates that the appliance is widening the jaw as desired. After expansion, the permanent teeth will be perfectly aligned with no spaces between them.