Palatal expansion is simply widening the roof of your mouth, which is called your palate. It is a fairly common orthodontic treatment and there are quite a few reasons that an orthodontist would recommend it. This treatment is sometimes needed to correct the bite in ways that braces alone cannot do, and to allow more room for teeth to erupt. Like many orthodontic treatments, there is an optimal age for it, but anyone can get their palate widened if necessary.
Palatal expansion widens the roof of your child’s mouth, so their upper jaw is the optimal width. The most common dental situations that make palatal expansion necessary are a crossbite, underbite, cleft palate repair, crowded teeth, and impacted teeth. Any of these conditions may cause a malocclusion, which is the term for teeth that do not align properly, creating a poor fit when your jaw is closed.
A crossbite occurs when the lower jaw is wider than the upper jaw, so the upper teeth bite inside the lower teeth.
An underbite is seen when the front lower teeth stick out further than the front upper teeth.
A cleft palate occurs when the tissue of the roof of the mouth does not fuse, causing an opening or split in the palate. As this is repaired and heals, scar tissue forms which can prevent the palate from expanding as it usually would.
Crowded teeth can cause a host of problems. Dentists and orthodontists can see when there is not going to be enough room for all the permanent teeth to erupt. Early orthodontic treatment to expand the palate can minimize the time spent in braces and create a more optimal alignment than braces could do on their own.
Impacted teeth are usually blocked from erupting by the other teeth. This is often seen in the upper canine teeth, which are vital for biting into foods, guiding the other teeth into position when biting down, forming words, and supporting the upper lip. Palatal expansion can create enough room for these important teeth to grow in.
Why is a good fit important? A good bite helps the upper and lower jaw to function well together. When your bite is misaligned it can cause many health problems including difficulty biting and chewing, trouble speaking clearly, uneven wear on teeth (which harms your enamel), strain on your jaw muscles, TMJ disorder, headaches, tooth grinding, impacted teeth, and crowded teeth which can lead to cavities. It may also cause your smile or face to be asymmetrical, which could cause low self-esteem.
Another important reason for palatal expansion is breathing conditions, including mouth breathing and some types of sleep apnea. A narrow palate can cause both of the problems, which may lead to sleepiness, difficulty concentrating, and irritability. All of these side effects can contribute to social issues and lower grades. Once the palate is expanded, a child will benefit from better airflow and respiratory function.
Hilda Torre and Jose A. Alarcón studied a group of children with narrow palates who were treated with palatal expanders. They found that the grades of children who received treatment improved by an average of 5 percent in the year after treatment. How incredible is it that a treatment lasting around six months can have such an impact on a child’s learning abilities?
Palatal expansion may sound like a big ordeal, but when children are treated at the right age it can be simpler than braces. This is why. The palate is made up of two parts: the soft palate which is made of muscle and connective tissue covered in a mucosal lining, and the hard palate which is bone. A child’s hard palate develops in two halves which grow throughout childhood, and they do not fuse together until after puberty. If you look at the roof of your child’s mouth you can see something that looks like a line starting between the two front teeth and running toward the back of their mouth. This midline is where the palate eventually fuses together.
A palatal expander slowly pushes the two halves apart. This gradual widening takes advantage of a child’s natural bone growth and allows time for new bone and cartilage to form in between the two halves of the upper jaw. This makes palatal expansion in children much more simple than if they wait until after puberty when the upper jaw bones stop growing and fuse together.
Palatal expanders are custom-made for a patient. They fit over some of the upper molars and many expanders are connected by a screw in the middle. The child or their parents turn this screw a small amount every day, which slowly widens the upper jaw. Once the extra space is created, expanders are worn for a while longer to give the bone and cartilage enough time to grow strong and maintain the space that was gained. The average amount of time an expander is worn is 4 to 6 months, depending on the individual and the amount of expansion needed.
Every child is different, but the optimal time for palatal expansion is usually sometime after the permanent teeth begin to come in and before puberty begins. For many children, the best time is somewhere between the age of 7 and 12, since younger children will often need less pressure to achieve the best results. Another reason this is a good time is that younger children often adapt more easily to changing the way they eat and speak while the expander is in their mouth than older teens and adults do.
Can adults get their palate expanded? It is still possible to expand the palate after puberty. However, it will often involve surgery to separate the fused halves of the upper jaw in addition to wearing a palate expander.
Like any other orthodontic treatment, there is often an adjustment period. Since the device sits against the roof of the mouth, your child will probably produce more saliva, and eating and speaking may feel strange for a few days. Everyone responds differently, and it may be a simple adjustment for some. Others may feel more pressure or discomfort or take a while longer to adjust to eating and speaking normally. It is helpful for many patients to take ibuprofen half an hour before turning the expander, to minimize any feeling of pressure or discomfort.
As with braces, it is helpful to stick to a soft foods diet for a few days after getting the expander. Smoothies, yogurt, soup, and mashed potatoes are great choices during this time. Even after the discomfort fades away, it is important to avoid foods that can interfere with or stick to the expander. This includes any hard, crunchy, or sticky foods.
It is also important for your child to take great care of their mouth while the expander is in place. When they brush and floss, the expander also needs to be brushed. It is a great practice to have them rinse their mouth out anytime they eat something or drink anything other than water. This will minimize the buildup of harmful bacteria and help keep their mouth clean and healthy.
If you notice a gap forming between their top two front teeth, don’t worry. This is a good sign that the expander is doing its job. Many times, the gap will close naturally.
If your child needs early orthodontic treatment or palatal expansion, we would be privileged to schedule a complimentary consultation. We take a conservative approach to orthodontic care and will create a personalized orthodontic treatment plan for your child, designed with their best interest. Each person on our team will make every effort to keep your child’s dental and orthodontic treatment a positive experience where your child can feel relaxed, comfortable, and safe throughout their appointment. We hope to see you here!
At Jungle Roots Children’s Dentistry & Orthodontics, we strive to provide the highest comprehensive pediatric and orthodontic dental care in a unique, fun-filled environment staffed by a team of caring, energetic professionals. We believe the establishment of a “dental home” at an early age is the key to a lifetime of positive visits to the dentist.