Sometimes a patient’s upper jaw needs to be enlarged to create a wider more attractive smile and relieve the crowding. Left untreated, a narrow palate can lead to excessive wear of the teeth or the need for extensive dental work as an adult. Patients who have completed growth may require surgically assisted rapid palatal expansion. Ideally a patient should still be growing when the expansion is used. This can be done with a custom made expander that is attached to the upper back teeth and spreads the suture or the two halves of the upper jaw apart. New bone fills in between the two halves and the upper jaw remains permanently wider. The process can take a few weeks to a few months. There are several designs for these expanders (bonded, banded, removable), but all have a center screw that can be activated with a special key or a wrench. This is done by placing the key into the key hole in the center screw and gently pushing the key clockwise toward the back of the appliance. Different appliances require different activation techniques. Follow our instructions on how to expand and how often.

It may take a few days to get used to a new appliance. The expander should be brushed whenever the teeth are brushed. Chewing, swallowing and speech may be a bit awkward at first. The mouth and the base of your nose may tingle. Over-the-counter analgesics will help to relieve the initial discomfort.

After a few days of expanding you may notice a space between the front teeth. This is a sign of victory, it means that the appliance is working, and the palate is being expanded. Do not panic, it is temporary and will close most of the time on itself once the expansion is completed. Most patients will require braces following palatal expansion and retainers thereafter.


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