Looking for information on the Palate expander or palatal expander?
Palate expander or palatal expander is a device that an orthodontist uses to widen the upper jaw. We have a lot more information on palatal expanders and their impact on airway and sleep apnea on the link.
What is a palate expander or palatal expander?
A palate expander is a device we place on the roof of the mouth to “expand” or widen the palate, or upper jaw. In growing children, the upper jaw has 2 bones, the right half & the left half and there is a separation we call the “suture.” Remember the “soft spot” on a baby’s head? That is the suture of all the skull bones that eventually fuse together. The palate is just like that – 2 bones that eventually fuse together! While using a palatal expander, we are simply “pushing” the 2 bones apart at the suture with very little to no discomfort. Many children receive a palatal expander to correct bite issues, such as a crossbite, underbite, severe crowding in the developing teeth (not enough space for permanent teeth), and also, AIRWAY issues.
More on airway issue and the expander.
The floor of the nose is the same bone as the roof of the mouth, therefore you will notice less restriction in airflow through the nose. This helps reduce or eliminate MOUTH BREATHING or open mouth posture at rest. Many children have sleep disordered breathing due to narrow airways. In our office, we do a full airway assessment with 3D imaging and a comprehensive oral & physical examination to determine if airway issues are present. Symptoms of sleep disordered breathing or sleep apnea are: not sleeping well through the night, trouble focusing during the day, tired/dark circles under the eyes, and forward tongue posture (Dr. Danielle will help determine if the tongue is postured forward or downward & work with you on these aspects).
How does a palatal expander work?
An expander works by pushing the 2 bones of the upper jaw apart while it is very soft & malleable. By widening the upper jaw, we create a lot of room for new developing teeth, correcting bites, and increasing airways.
How do we insert a palate expander?
It is easier to show you than to tell you so we are sharing our palatal expander insertion video.
What does an expander look like?
An expander is a metal appliance that sits on the roof of the mouth, so when smiling, you cannot see the appliance! Here is what it looks like:
What is the palatal expander key?
The palate expander key is simply the tool you will use to activate or turn the expander. You will do 1 turn per day for approximately 28 days, or as prescribed by the orthodontist.
Does a palate expander change face shape?
While a palate expander does not change the face shape, it is widening the upper jaw, so the smile appears wider. Also rarely the alar base can widen, following the palate widening. The facial changes you see are part of the growing face, plus a little extra width in the upper jaw, which is a very favorable change!
Does a palatal expander break your jaw?
The palatal expander does NOT break the jaw. When we use an expander at the correct age there still is not a fusion of the bones. Therefore, all the expander is doing is pushing the two bones apart with little to no discomfort. If the patient feels anything it is just pressure in the nasal area while doing the turn.
Does an expander give you a gap?
The expander does create a gap or space between the 2 front teeth. For us orthodontists, we celebrate this space! This means we have done our job of pushing those bones apart!
Does an expander give you a lisp or affect your speech?
When we first place the palatal expander, there will be extra saliva in the mouth (the brain is thinking there is food in there!) so speech may be affected for a few days. Also, the space where the tongue usually sits now has a bar siting there. Therefore, the tongue needs to re-learn where to put itself during speech. The speech resumes to normal after 3-5 days once the tongue “learns” what to do!
Does a palatal expander cause pain?
Most children have no problems with it at all. If anything it causes parents more issues worrying about it than it causes the children. For some kids it is uncomfortable when we first put it in, but as you can see in the video above that is not always the case. There may be a little soreness as it expands the palate but kids typically never complain or mention it to parents. Two of our kids have had them and they never said anything about them hurting and very rarely do moms mention it to us.
What does the palate expander cost?
We use expanders for many reasons in orthodontics. Therefore the cost depends on what your total plan is. Typically this fee is given on the day of your examination with the orthodontist. In general, the palatal expander costs between $2000-3,400, depending on where you live & what the treatment plan will be utilizing the expander.
What are the palate expander alternatives?
There are some alternatives to expanders when we do not need full opening of the suture. We can use braces on the top teeth for some expansion, but not always. There are times, such as in airway issues or very narrow palates where braces will not be enough to separate things. With the addition of 3D imaging, Dr. Danielle can evaluate & MEASURE the actual palatal distance in comparison to the mandible (lower jaw). It is NOT a cookbook answer for everyone! Therefore, the orthodontist MUST properly evaluate, diagnose, and plan according to the needs of the specific patient. If we can use braces instead of an expander, then by all means, no need for an expander!!
What is the palatal expander adult version?
In adults the two bones of the palate are fused together, therefore you need either a surgical intervention or a more complex design that involves TAD. This is more complex and varies from person to person. Therefore, we need a consultation to review exactly what your options are.
Palatal expander research
For those that care about the research we have a couple of the meta-analysis studies below
Lagravere 2005 review shows expanders work better in adolescents than young adults and a few other things. Zhou’s 2014 analysis shows rapid expander use is effective in both the mandible and maxilla.