A Rapid Palatal Expander (RPE) is an orthodontic device designed to correct a narrow upper jaw, known as the maxilla. This fixed appliance works by applying gentle, controlled pressure to widen the two halves of the jawbone, which are joined by the mid-palatal suture. By widening the arch, the RPE creates necessary space for permanent teeth to emerge correctly and helps to improve the alignment of the upper and lower jaws. Careful preparation is required to ensure the procedure is efficient and effective.
Preparing for the Expander Appointment
The process of receiving a fixed expander begins with several preparatory steps. After the orthodontist diagnoses a need for widening the upper jaw, precise records of the mouth are required to custom-fabricate the device. This involves taking impressions, either using a traditional putty material or a modern intraoral scanner, to capture the exact contours of the teeth and palate.
These impressions are then sent to a specialized laboratory where the custom appliance is built. The time required for this fabrication is separate from the chair time and can often take around ten business days. Ensuring the device is well-crafted is important for the subsequent placement appointment to go smoothly.
A few days before the expander is cemented, separators or spacers may need to be placed between the back molars. These devices gently push the teeth apart, creating a gap. This brief separation allows the metal bands of the expander to be seated securely around the molars during the final fitting.
Detailed Timeline of the Placement Procedure
Placement of a Rapid Palatal Expander typically takes 30 to 60 minutes. This duration ensures the appliance is bonded correctly and that the patient understands the activation process. The first step involves cleaning and preparing the upper molars that will anchor the device. This usually takes about five to ten minutes, ensuring the tooth surfaces are ready for optimal adhesion.
Once the teeth are prepared, the orthodontist fits the expander to ensure it rests against the palate and around the molars. Adjustments to the metal bands may be made during this fitting stage, which can take between ten and fifteen minutes. A perfect fit is necessary to distribute the expansion force evenly across the jaw structure.
After the fit is confirmed, dental cement is applied to the bands, and the expander is seated onto the molars, taking another ten to fifteen minutes. The cement is then cured, often using a special light, to create a secure bond that will withstand the forces of chewing and the expansion itself. The majority of the appointment time is dedicated to ensuring this secure and accurate placement.
The final segment of the appointment, lasting about ten minutes, is dedicated to instructing the patient or parent on the activation of the expander. The orthodontist demonstrates how to insert the key into the central screw mechanism and push it toward the back of the mouth until the next hole is visible. This confirms the patient is ready to begin the expansion phase at home.
Adjusting to the Newly Placed Expander
The experience immediately following the placement of the expander focuses on the body’s reaction to the new appliance. Patients often report a sensation of pressure and fullness in the mouth, which may extend to areas like the teeth, cheekbones, or the bridge of the nose. This discomfort is a normal response as the body registers the presence of the fixed device.
Soreness can be managed with common over-the-counter pain relievers, such as ibuprofen or acetaminophen. These medications help alleviate tenderness felt in the first 24 to 48 hours after the placement. A temporary change in speech, often presenting as a slight lisp, is also common because the tongue must learn to articulate sounds around the appliance occupying the roof of the mouth.
Reading aloud for a few minutes each day helps the tongue adapt quickly, often resolving speech changes within one to three days. A temporary diet of soft foods is recommended for the first few days, as chewing may feel awkward and hard foods risk damaging the device. The first turn of the expander, often done the same day or the next, may cause tightness, signaling the start of the widening process.