To Expand or Not to Expand

A palatal expander is a frequently used orthopedic appliance used in children and adults. There are many different types of expanders but it all boils down to doing the same thing- making your upper jaw wider. Your upper jaw is made up of two boney halves with a soft cartilage in between. The expander stretches the cartilage in the center allowing the jaw to widen. The prime time to use one is prior to age 14 before the cartilage is no longer soft and stretchy and instead turns into bone. When the expander is activated or turned, a gap will form temporarily between the front teeth. This is normal and a good sign it is working!

There are several reasons why you would need an expander. One is to avoid extracting permanent teeth in a really crowded mouth. If you don’t have enough room for all your teeth, an expander would be prescribed to widen the upper jaw and hence increase the circumference area of your upper jaw to make the room for your teeth.

Secondly, it can be used for a narrow upper jaw. This could be caused by a thumb sucking habit or genetics. Frequently, narrow jaws will have high arched palates and can be restored to a more normal shape via expansion. Also, patients with narrow jaws tend to have crossbites which cause the jaw to shift to the side and leaving it uncorrected can lead to asymmetrical growth of the jaw or TMJ problems.

Finally, expanders can be used to improve a patient’s airway. Although more research is needed to confirm the long term benefit of this, patients with sleep apnea and narrow airways can breathe better from having a wider upper jaw.

For adults or teenagers who have passed the prime time for expansion, there is still hope and it will require adjunct therapies. These include mini- implants that are placed in the roof of the mouth to which the expander is attached, or the use of an expander along with surgery to widen the jaw of a patient who is no longer growing.

As you can see there are many benefits to expansion and if it is prescribed for your child, don’t delay as the prime time may pass you by.