A palate expander is an orthodontic appliance designed to gradually widen the upper jaw, also known as the maxilla. This device fits in the roof of the mouth, applying gentle, continuous pressure to move the two halves of the jawbone apart. Used for children, adolescents, and sometimes adults, its primary goal is to ensure upper and lower teeth fit correctly, promoting better dental alignment and oral health.
Why Palate Expansion Is Necessary
Palate expansion becomes necessary when the upper jaw is too narrow, leading to various dental and anatomical issues. One common problem is a crossbite, where the upper teeth bite inside the lower teeth when the jaws are closed, rather than slightly overlapping them. This misalignment can cause uneven wear on teeth, gum recession, jaw discomfort, and potentially affect facial symmetry.
Another reason for palate expansion is dental crowding. A narrow upper jaw often lacks sufficient space for permanent teeth to erupt, resulting in crooked or overlapping teeth. Expanding the palate can create the necessary room, reducing or eliminating the need for tooth extractions. A constricted upper jaw can also restrict airflow, leading to breathing difficulties, such as mouth breathing or snoring. Addressing these issues early can improve chewing and speech.
The Science Behind Palate Expansion
The mechanism of a palate expander relies on applying gentle, consistent pressure to the upper jaw. This pressure is directed at the midpalatal suture, which is a flexible connective tissue or growth plate located in the roof of the mouth, running down the center. In growing children and adolescents, this suture has not yet fully fused, making it responsive to orthopedic forces.
When the expander is activated, it gradually separates the two halves of the palatine bone. This controlled separation stimulates osteogenesis, the formation of new bone tissue in the gap created along the midpalatal suture. As new bone is deposited, it permanently widens the palate.
This process is most effective in younger individuals because their sutures are still pliable and actively growing. While possible in adults, it is typically more uncomfortable and may require surgical assistance due to suture fusion. Expansion can occur at a rate of approximately 0.5 to 1 millimeter per day.
The Palate Expander Journey: From Placement to Retention
The journey with a palate expander begins with its initial placement, where the device is either bonded to the upper molars or uses an acrylic attachment. Patients might experience mild pressure or discomfort for a day or two as they adjust to the appliance. The active expansion phase involves regular adjustments, performed by turning a small screw in the center of the expander with a special key.
The frequency of these adjustments can vary, ranging from daily to twice weekly, as directed by the orthodontist. This consistent activation gradually widens the jaw over a period of several weeks to several months (three to six months), depending on the individual’s needs and the desired expansion. During this phase, a temporary gap may form between the front teeth, indicating progression. Patients might also notice temporary changes in speech, such as a slight lisp, or increased saliva production.
Once the desired expansion is achieved, the active turning stops, and the expander enters a retention phase. During this period, the appliance remains in place for several months (8 to 9 months) to allow the newly formed bone to solidify and stabilize the widened palate. After this retention period, the expander is removed, and further orthodontic treatment, such as braces or aligners, is used to fine-tune tooth alignment and ensure the stability of the results.