A palate expander is a dental appliance designed to widen the upper jaw, also known as the maxilla. This device fits in the roof of the mouth and gradually separates the two halves of the jawbone. While palate expanders are most commonly used in children, adults can benefit from this treatment. The process for adults differs significantly from that in children because the bones of the upper jaw are fully developed and fused, unlike the more flexible, still-growing bones found in younger patients.
Reasons Adults Consider Palate Expansion
Adults often seek palate expansion to address various dental and health concerns. Dental crowding, where insufficient space in the upper jaw leads to crooked or overlapping teeth, is a common reason. Widening the palate creates room for proper tooth alignment, potentially reducing the need for extractions.
Another frequent issue is a crossbite, occurring when upper teeth bite inside lower teeth. Palate expansion corrects this misalignment, improving how upper and lower teeth fit together. A narrow upper jaw can also contribute to breathing difficulties, including snoring and obstructive sleep apnea, by restricting nasal airflow. Expanding the palate can enlarge the airway, potentially improving breathing and sleep quality. Some individuals also consider palate expansion for aesthetic reasons, aiming for a broader smile or improved facial symmetry.
How Adult Palate Expansion Works
The fundamental difference in palate expansion between children and adults lies in the maturity of the upper jaw. In adults, the bones of the upper jaw, particularly the mid-palatal suture, are completely fused. This contrasts with children, whose palatal suture remains flexible and still developing, allowing for easier, non-surgical expansion.
Because of this fusion, traditional rapid palatal expanders (RPEs), effective in children, are generally insufficient for achieving true skeletal widening in adults. Such devices would primarily result in dental tipping, where teeth are merely pushed outwards, rather than true bone expansion. To overcome the resistance of the fused adult bone structure, specialized interventions are necessary. These typically involve either surgical procedures to loosen the bone or the use of skeletal anchorage, employing micro-implants to apply direct force to the bone. This targeted approach separates the fused maxilla, facilitating genuine skeletal expansion.
Types of Adult Palate Expanders
Effective palate expansion in adults relies on methods designed to address the fused nature of the upper jaw. One primary approach is Surgically Assisted Rapid Palatal Expansion (SARPE). This procedure involves a minor surgical intervention where strategic cuts, known as osteotomies, are made in the maxilla to weaken the bone and facilitate its separation. Following this surgical step, a conventional palate expander is then used to gradually widen the upper jaw over several weeks. SARPE is often recommended for cases requiring significant skeletal expansion.
Another advanced technique is Micro-Implant Assisted Rapid Palatal Expansion (MARPE), sometimes referred to as a Maxillary Skeletal Expander (MSE). This method utilizes small, temporary orthodontic implants, also known as temporary anchorage devices (TADs), which are placed directly into the palatal bone. These implants provide direct skeletal anchorage for the expander, allowing forces to be applied precisely to the bone, often bypassing the need for major surgery to achieve skeletal changes. MARPE and MSE are generally considered less invasive than SARPE and are suitable for moderate to significant expansion, demonstrating high success rates in separating the mid-palatal suture in adults.
The Adult Expansion Journey
The process of adult palate expansion begins with a thorough initial consultation and diagnosis. This includes a comprehensive examination, often utilizing 3D imaging such as CBCT scans, to accurately assess the patient’s bone structure and determine the most suitable expansion method. Once a treatment plan is established, the chosen expander is custom-made and then placed in the patient’s mouth. If Surgically Assisted Rapid Palatal Expansion (SARPE) is selected, a brief outpatient surgical procedure precedes the expander placement.
Following placement, the active expansion phase begins, during which the expander is activated, typically by turning a small key on a daily or every-other-day schedule. Patients commonly experience a sensation of pressure or mild discomfort, particularly after each activation. Temporary side effects, which usually subside as the mouth adjusts, may include mild discomfort, difficulty with speaking or eating, increased drooling, or a temporary lisp. A noticeable gap appearing between the front teeth is a normal and expected sign that the expansion is successfully widening the palate.
The active expansion phase typically lasts from a few weeks to several months, generally ranging from two to six months, though it can extend up to a year depending on the required expansion. After the desired width is achieved, the expander remains in place for a retention phase, usually an additional four to six months. This retention period allows new bone to solidify in the expanded space, stabilizing the results. Further orthodontic treatment, such as braces or aligners, is often necessary after expansion to finalize tooth positioning and achieve optimal bite relationships.