Palatal Expander

What is a Palatal Expander?

A palatal expander is a specialized orthodontic appliance used to widen the upper jaw (palate). The device is custom-fitted to the patient's mouth and typically attaches to the back of the upper teeth. It gently applies pressure to the two halves of the upper jaw, causing them to gradually move apart. This expansion process allows for more space for the teeth, potentially improving bite alignment, creating room for adult teeth, and addressing issues like crowding or crossbite.

Palatal expanders are used in both children and adults, though they are generally more effective in growing children whose bones are still developing. In these younger patients, the bones of the upper jaw can be more easily moved, which accelerates the expansion process. However, in some cases, adults can also benefit from this appliance, though the process may take longer.

Why Would a Palatal Expander Be Needed?

A palatal expander is often used to address several common orthodontic concerns. The most frequent reasons for recommending this appliance include:

• Crossbite: A crossbite occurs when the upper teeth bite inside the lower teeth. This misalignment can cause uneven wear on the teeth, jaw pain, and even gum recession. By expanding the upper jaw, a palatal expander can help correct this misalignment, ensuring the teeth meet properly.
• Crowding: Crowding happens when there is not enough space for all the teeth to fit comfortably in the mouth. A palatal expander creates more space in the upper jaw, allowing for the proper alignment of teeth.
• Narrow Palate: Some individuals are born with a naturally narrow palate, which can lead to problems with speech, breathing, or chewing. Expanding the palate can improve these functions and contribute to overall oral health.
• Impacted Teeth: In some cases, teeth may fail to erupt properly because there isn’t enough room in the upper jaw. A palatal expander can help create space for these teeth to come in, preventing the need for more invasive treatments such as extractions.
• Bite Issues: A narrow upper jaw can contribute to bite problems, such as overbite, underbite, or open bite. Expanding the upper palate can help create a more even bite, improving the patient’s ability to chew and speak comfortably.

How Does a Palatal Expander Work?

The palatal expander consists of a metal framework that is securely attached to the upper molars using bands or brackets. The appliance contains a central screw that is activated periodically to slowly widen the palate.

Activation and Adjustment

The expander works by applying gentle, consistent pressure to the upper jaw. The patient or their caregiver will typically use a special key to turn the screw in the expander once or twice a day, as directed by Dr. Markham. Each turn of the screw gradually pushes the two halves of the upper jaw apart, leading to the desired expansion.

Biological Process

As the expander is used, it creates a small gap between the two halves of the upper jaw. Over time, new bone will fill in the space where the gap was created, solidifying the expanded position of the jaw. This process is known as sutural separation. The expansion generally takes a few weeks, but the total treatment time with the appliance can last from several months to over a year, depending on the patient’s specific needs.

Types of Palatal Expanders

There are several variations of palatal expanders, and Dr. Ceceilia M. Markham will select the most suitable option for each patient based on their unique dental needs. The two main types are:

• Rapid Palatal Expander (RPE): The most common type of expander, the rapid palatal expander (RPE), is typically used in growing children. This type of expander is designed to widen the upper jaw more quickly, often within a few months. RPEs are attached to the molars with metal bands and include a screw mechanism that the patient turns daily to facilitate expansion.
• Slow Palatal Expander (SPE): For adult patients or those with more severe dental issues, a slow palatal expander (SPE) may be used. These expanders work more gradually than the rapid variety, applying a slower force over a longer period. Although the process takes more time, slow palatal expanders can be effective for patients whose bone growth has slowed.
• Hyrax Expander: The Hyrax expander is another common choice for patients who require a significant amount of expansion. It features a metal framework and is also activated by a key. The Hyrax expander is often used when more precision is needed in the widening of the palate.
• Fixed vs. Removable Expanders: While fixed palatal expanders are commonly used, some patients may be candidates for removable expanders. These devices can be removed for cleaning and eating, but they may not be as effective in patients who need significant expansion.

Who Can Benefit from a Palatal Expander?

Palatal expanders are primarily recommended for children and teenagers because their jawbones are still developing. In younger patients, the bones of the upper jaw are not yet fully fused, so expansion can occur more quickly and with fewer complications. However, adults with a narrow upper jaw or a misaligned bite may also benefit from this appliance, although the treatment may take longer and require more intervention.

Dr. Markham carefully evaluates each patient's specific case to determine if a palatal expander is the best solution. The decision will depend on the patient’s age, the severity of their dental issues, and the treatment goals.

What to Expect During Treatment

If you or your child has been prescribed a palatal expander by Dr. Ceceilia M. Markham, here's what you can expect during the treatment process:

• Fitting the Expander: The initial appointment will involve placing the expander in the mouth and ensuring that it fits comfortably around the upper molars. The device will be cemented in place, and you will receive instructions on how to use the activation key to gradually expand the appliance.
• Regular Adjustments: Throughout the course of treatment, patients will return to Dr. Markham’s office for regular follow-up visits. These appointments will allow Dr. Markham to monitor progress and make adjustments if necessary. If you are using an RPE, the key will be used to turn the expander and gradually increase its width.
• Time Commitment: Treatment time with a palatal expander typically lasts between several months to a year, depending on the individual’s age, the severity of the misalignment, and the amount of expansion needed. During this time, patients are encouraged to maintain good oral hygiene to avoid complications such as plaque buildup or gum irritation around the appliance.
• Potential Side Effects: Some discomfort is normal when using a palatal expander, especially during the initial stages of treatment. Mild pain or pressure may occur as the device gradually widens the upper jaw. It’s also common for patients to experience a slight gap between the front teeth as the palate is expanded. This gap will close once the expansion process is complete.

Conclusion: Achieving a Healthier Smile with a Palatal Expander

The palatal expander is a versatile and effective orthodontic tool that can address a range of dental issues, including crossbite, crowding, and narrow palates. By gradually widening the upper jaw,it helps create more space for the teeth, improves bite alignment, and promotes better oral health overall. If you or your child are struggling with one of these dental issues, Dr. Ceceilia M. Markham, DMD, in Warrington, PA, can evaluate your needs and determine if a palatal expander is right for you.

If you’re ready to take the next step toward a healthier, more comfortable smile, contact Dr. Markham’s office today to schedule a consultation. With her expertise in orthodontics and personalized care, she will help guide you through the treatment process, ensuring that you achieve the best possible outcome for your smile.