crowded teeth

So your orthodontist said your child needs a palatal expander?  Here is some helpful information to become familiar with what to expect moving forward.

How does it work?

Palatal expanders are a commonly used appliance in orthodontics to make room for crowded teeth, correct crossbites, increase the size of the airway and/or widen a narrow upper jaw. Many of us have held a newborn baby and felt the “soft spots” on their tender little heads. Those “soft spots” are cartilage sutures that have not yet closed in their developing skulls. In much the same way, each of us has a cartilage suture in our upper jaw that splits the upper jaw into two halves. At the onset of puberty, that suture starts to fuse together into one bone. However, prior to the fusion of the bone the upper jaw can be expanded significantly using a palatal expander. As the palate expands, the cartilage is stretched and stimulates bone to fill into the space created by the expander. If given enough time to stabilize, the jaw will then fill in with bone at the new “corrected” width. Pretty amazing!

Interestingly, the lower jaw does not have a suture to match the upper jaw, which limits the amount of expansion you can achieve on your bottom teeth.

What does it look like?

 

The expander connects to your top molar teeth with little metal rings called “bands”. Wires connected to these bands rest gently on the teeth. There is an activating mechanism in the center of the expander that can easily be turned with a “key” that is given to each patient. Your orthodontist will show you how to use the key – it is really easy! The key will slowly and gently widen the jaw with each activation about 0.25 mm. In our office, one activation is recommended each night before bedtime. Over the course of each 4 day period, the jaw widens just 1 millimeter. While this may not seem like much, within just a few weeks you will have created much more space for the teeth to fit into. You may experience some slight discomfort as the suture starts to open, but this process is relatively pain-free.

As the suture opens, you will often see a space open up between the two front teeth. This is normal and is evidence that the expander is doing its job. After your expansion is complete, the space will naturally start to close as the crowded teeth unravel. Any residual space will be closed with your braces.

How do you maintain the expander?

Keeping your teeth healthy while going through treatment with a palatal expander is pretty easy – it just takes a little extra time and effort when you are brushing and flossing your teeth. Your orthodontist will likely give you some extra little brushes to help you clean well around your expander and show some spots that are commonly missed. A Waterpik or similar device is also a helpful tool to clean around the expander. You should brush your expander the same way you would brush your teeth - until it looks clean and shiny with no white “fuzzies” (plaque) sitting on it.

Before you know it, you will have the stunning smile you have always wanted. Good luck! If you have any questions regarding expanders or orthodontic treatment, give our office a call.

There are basically three ways an orthodontist can create the space needed to straighten crowded, crooked teeth.  The most common is to widen and expand the smile to create a little more room for big teeth in a small jaw.  Thankfully, this option will work for most patients. The second way is to “slenderize” the teeth by polishing them to make them a tiny bit smaller.  As long as the reduction is minimal, there are generally no long-term negative consequences to this approach – and for people with really big teeth it can be a great option.

Occasionally, there is so much crowding that even a combination of widening and “slenderizing” just does not create enough room to fit in all the teeth with braces.  In these few cases, it is better to have fewer teeth that fit in your mouth then it is to try and jam all the teeth into a small jaw.  Trying to jam teeth into the bone when there isn't enough space can cause periodontal disease over the long term. If some teeth are removed (extracted), the remaining teeth and gums end up being healthier and they look better too.  We can discuss all the available options with you to find out what is going to give you the smile you want and deserve. Please call our Scottsdale orthodontic office or our Phoenix orthodontic office location for a free consultation.