Palatal Expansion

Making the upper jaw wider

A palatal expansion appliance can markedly increase the width of the upper jaw. A wider jaw allows upper and lower teeth to fit together. This permits teeth and jaws to function well and contributes to a broader, more attractive smile. For some patients, expansion may prevent the need for extraction of permanent teeth because space is created for permanent teeth.

Dr. Yoon has determined that palatal expansion is necessary for your child. A narrow upper jaw may interfere with the fit of upper and lower teeth. With expansion, nasal airway becomes wider, nasal obstruction may get improved, often your child feels easier breathing thru nose.

Palatal expansion is a combination of tooth movement and jaw expansion. It works by widening the two halves of the upper jaw, called the palate. The two halves are joined together by a ‘suture’ in the middle of the roof of the mouth. The orthodontist custom makes an expander for each patient. An expander can be fixed or removable. The expander is attached to the upper back teeth and eases the suture apart, which makes the upper jaw wider. As the jaw expands, new bone fills in between the two halves of the palate. This process is called distraction osteogenesis.

Expansion can take a few weeks to a few months, depending on the amount of expansion required for an individual patient. A rapid palatal expander (RPE), also known as a rapid maxillary expander (RME), is generally worn for three to six months. During the first few weeks of wear it is necessary to expand (activate) the appliance. Dr. Yoon will provide detailed instructions on how to activate the appliance and operate it properly to achieve the desired results.


Questions and Answers

How do I know palatal expansion is right for my child?
Palatal expansion improves the way the upper and lower jaws and the upper and lower teeth work. It widens the jaw so there is sufficient room for permanent upper and lower teeth to come in. Expansion can make the nasal floor wider so nasal breathing becomes easier. Without expansion, and depending on the problem, permanent teeth may not have enough space to come in; or the lower jaw could grow out of proportion, which could require corrective surgery as an adult.

Left untreated, a narrow palate can lead to excessive wearing of the teeth or the need for extensive dental work as an adult. Dr. Audrey Yoon will explain how to activate your child’s palatal expander.

What is the best age for palatal expansion?
Age alone is not the best predictor as to when a palatal expansion appliance should be used. Ideally a patient should still be growing.

An orthodontist can estimate skeletal maturation and determine whether a patient is still growing by analyzing the X-rays. Patients who have completed growth may require miniscrew-assisted rapid palatal expansion or surgically-assisted rapid palatal expansion.

How is the appliance activated?
Dr. Audrey Yoon will recommend the type of expansion appliance necessary. Different appliances require different activation techniques. Depending on the appliance, the palatal expander may require activation with a special key or wrench.

Follow Dr. Yoon’s orthodontist’s instructions on how to expand your child’s appliance and how often to expand it.

What can I expect?
It may take a few days to get used to a palatal expander. Chewing, swallowing and talking may be awkward at first. The mouth and nose may be sore or may tingle. Some patients report a slight headache. Talk with your Dr. Yoon and team about over-the-counter analgesics to relieve discomfort.

After only a few days of expanding, you may notice space between the front teeth. This is a sign the appliance is working and the palate is being expanded.

Most patients require full orthodontic treatment (braces) or aligner therapy (Invisalign) following palatal expansion.

How is the appliance cared for?
The expander should be brushed whenever teeth are brushed. Patients should rinse the mouth with water after eating or after drinking a beverage with sugar. Removable expanders should be brushed and rinsed each time the appliance is taken out of the mouth. Placement of expander
Two weeks later, half of expansion complete

Four weeks later, expansion complete

Braces close the spacing and align the bite creating a healthy, beautiful smile.