Palatal expander

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Palatal Expander

A palatal expander, also known as a maxillary expander, is an orthodontic device used to widen the upper jaw (maxilla) so that the upper and lower teeth will fit together better. This is a common orthodontic procedure, often employed to correct a condition known as a crossbite, or to provide more space for teeth in a crowded mouth. The use of a palatal expander is most effective in children and adolescents, whose jaw bones are still developing.

Indications[edit | edit source]

The primary indication for the use of a palatal expander is to increase the width of the upper jaw. This is often necessary when there is a discrepancy between the width of the upper and lower jaws, leading to a crossbite, or when the upper jaw is not wide enough to accommodate all of the teeth, resulting in crowding. Other indications may include the correction of certain types of malocclusions and to aid in the treatment of obstructive sleep apnea in children, by widening the airway.

Types of Palatal Expanders[edit | edit source]

There are several types of palatal expanders, including:

  • Removable Expanders: These are similar to a retainer and can be taken out of the mouth by the patient. They are used in cases where only a slight adjustment is needed.
  • Fixed Expanders: These devices are cemented to the upper molars using dental bands. They are more commonly used because they can exert a greater force and achieve more significant expansion.
  • Rapid Palatal Expanders (RPE): A type of fixed expander that is used to achieve rapid expansion of the upper jaw over a short period, typically a few months.
  • Slow Palatal Expanders: These apply a gentler force over a longer period, which some believe may reduce discomfort and the risk of relapse.

Procedure[edit | edit source]

The procedure for installing a palatal expander varies depending on the type of expander. Fixed expanders are attached to the upper molars by bands placed around the teeth. Once in place, the expander is gradually widened by turning a screw in the center of the device with a special key. This process gradually increases the width of the upper jaw by applying pressure to the palatal bones, encouraging them to grow apart.

The adjustment period for a palatal expander typically involves a feeling of pressure and discomfort immediately after adjustments are made, but this usually subsides quickly. The total duration of treatment with a palatal expander varies depending on the individual case but generally ranges from several months to a year.

Risks and Complications[edit | edit source]

While the use of a palatal expander is generally safe, there are potential risks and complications, including:

  • Discomfort and pain
  • Speech difficulties
  • Difficulty eating
  • Increased salivation
  • Possible injury to the tongue or cheeks from the appliance
  • Rarely, improper use can lead to damage to the teeth or jaw

Aftercare[edit | edit source]

After the desired expansion has been achieved, the palatal expander may be left in place for several months to stabilize the expansion and prevent relapse. Good oral hygiene is essential during this period, as the appliance can trap food and make cleaning the teeth more challenging. Regular follow-up visits with the orthodontist are necessary to monitor progress and make any necessary adjustments.

Conclusion[edit | edit source]

Palatal expanders are a valuable tool in orthodontics, offering a solution for certain types of jaw and teeth alignment issues. While the process can be uncomfortable at times, the benefits of a properly aligned bite and improved oral health can be significant. As with any medical treatment, consultation with a qualified orthodontist is essential to determine the best approach for each individual case.


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Contributors: Prab R. Tumpati, MD