Palatal Expander For Kids

About Palatal Expander For Kids

A palatal expander, also known as an orthodontic expander, is used to widen the upper jaw in children.

The expander helps to create more space in the mouth and correct issues such as posterior crossbite and some types of anterior crossbites before permanent teeth erupt.

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The Importance of Early Orthodontic Treatment

Regular dental checkups play a vital role in monitoring the development of the jaw and teeth, ensuring timely detection of any orthodontic issues.

These checkups allow us to assess the growth and alignment of the jaws, monitor the eruption of permanent teeth, and identify any potential problems with their bite early on.

Pediatric dentists are specialists in the dental growth and development of young children. We evaluate their growth and development at each check up exam. This includes orthodontic evaluations to monitor their developing bite and tooth alignment. Early detection of a developing issue can avoid potential problems with interceptive treatment or timely referral for orthodontic treatment. 

Why Is Palate Expansion Needed?

In some cases, a child’s upper jaw (palate) may be too narrow, causing crowded or crooked teeth. This can also lead to issues with proper breathing, speaking, and chewing.

A palatal expander works by gradually widening the upper jaw bones to make room for proper alignment of the teeth and improve overall oral function.

Types of Palate Expanders

There are various types of palatal expanders used in orthodontic treatment, including:

1. Quad Helix Fixed Appliance: This type of expander consists of a custom-made wire that is cemented to the molars in the upper jaw. The appliance applies gentle pressure to gradually widen the palate. This appliance does not require manual adjustment.
2. Rapid Palatal Expander (RPE): This type of expander is often used in older children whose plates have fused but are still growing. It consists of a screw that is turned daily to apply gentle pressure and separate the two halves of the upper jaw. When the RPE expands, it will create a gap between the two front teeth. This is temporary as they will be shifted back together with braces. 

We are usually able to identify the need for palate expansion at a younger age, which allows us to correct it sooner with the quad helix expander. Early expansion will not cause the sudden gap to form between the front teeth because the palate bones are not fused yet.

What Does a Palatal Expander Do?

A palatal expander is an effective orthodontic tool designed to address issues like posterior crossbite, anterior crossbite, a narrow upper arch and crowded teeth.

Posterior Crossbite

When the upper jaw is narrower than the lower jaw, the upper teeth may sit inside the lower teeth when biting down. 

This is known as a posterior crossbite and can often lead to shifting your jaw to one side every time you bite down, possibly leading to TMJ issue or uneven growth. 

A palatal expander helps to widen the upper jaw, allowing the upper teeth to properly align with the lower teeth.

Anterior Crossbite

Anterior crossbite, also known as an underbite, occurs when one or more of the front teeth in the upper jaw are positioned behind those in the lower jaw when biting down.

This misalignment can cause issues with proper tooth development and facial appearance. A palatal expander can help correct this by widening the upper jaw and bringing the front teeth into their proper position.

Narrow Palate (Upper Arch)

A narrow palate can cause both functional and cosmetic problems. 

A narrow arch can lead to airway problems because there is less room for the tongue in the mouth. This could lead to breathing difficulties and increased risk of sleep-disordered breathing.

A palatal expander can help to expand the upper jaw and create more space for proper tongue placement, improving breathing and overall oral function.

Crowded Teeth

When there is not enough room in the mouth for teeth to properly align, they can become crowded or crooked. This not only affects appearance but also makes it difficult to properly clean and maintain oral health.

A palatal expander can help create more space in the mouth, allowing for proper alignment of permanent teeth and preventing potential oral health issues.

Placing the Quad Helix Palatal Expander

The process of placing a palatal expander takes place over three appointments.  The first and third appointment will cause movement of the teeth and may cause some discomfort.  It is recommended to give your child OTC pain medication (if they can take it) about an hour before these appointments, for the rest of that day, and the following day if needed. 

First appointment (10 minutes): The separator/spacers are placed in between the back teeth. The purpose of these spacers is to create space around the molar tooth for the placement of the orthodontic bands at the next appointment. It is important that you not floss where the separators are as it may dislodge them. 

Second appointment (30 minutes): the separators are removed, orthodontic bands are fit around the molar teeth, and an impression or mould is taken of the upper mouth. The orthodontic bands are removed, and the separators are placed back between the teeth to keep the space open while the custom appliance is being made using the orthodontic bands fitted at this appointment.  

Third appointment (30 minutes): The separators are removed, the custom made quad helix is tried in and adjusted as needed.  It is then “activated” by the dentist before being cemented in place. 

Once the expander is in place, there is no need for daily adjustments. Your child will return about once a month for monitoring or any adjustments that may be necessary. The device will remain in the mouth for about 6 months. 

What to Expect After Placement

It will feel a bit strange for your child to have a new appliance in their mouth, but they will quickly get used to it. Most patients take 3 to 5 days to get used to the QH expander.. 

The expander may cause some mild discomfort or pressure when first placed and after each adjustment appointment. This is normal and can be managed with over-the-counter pain relievers such as ibuprofen, Tylenol, or similar analgesics. 

Your child may also experience an increase in saliva production and slight changes in speech while adjusting to the appliance. These are all temporary side effects that should resolve within a few days.

Another common problem after placement is a sore or inflamed tongue. Many patients acquire a habit of pushing against the QH wire with their tongue. While this is not harmful, it will make a groove in their tongue that can make the tongue sore. 

Dietary Adjustments While Wearing an Expander

To ensure that the expander stays in place and functions properly, there are certain dietary adjustments your child will need to make.

• Eat soft foods for the first few days to allow time to adjust to the appliance.
• Avoid hard, chewy or sticky foods that can damage the appliance, ie. Jolly Ranchers, Gummy Bears, Starburst, Skittles, taffy, suckers, or ice. 
• Cut up food into smaller pieces to make it easier to chew.
• Avoid chewing gum while wearing the expander.

Oral Hygiene

Good oral hygiene is important while wearing a palatal expander to prevent tooth decay and gum inflammation. Encourage your child to:

• Rinse their mouth after meals to remove food particles that may be stuck in the expander.
• Brush their teeth and the expander regularly to prevent plaque buildup.
• Use a floss threader or water flosser to clean between the teeth and under the expander wire.

What to Expect After Treatment

Once the desired expansion is achieved, the appliance will be removed. There is usually no need for a retainer in younger children to maintain the expansion.

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