A palatal expander is a fixed orthodontic appliance designed to widen the upper jaw, known as the maxilla. It works by applying gentle, controlled pressure to the two halves of the upper jawbone, gradually separating them at the midline palatal suture. This separation corrects discrepancies between the width of the upper and lower dental arches. Achieving the desired skeletal expansion requires regular, minute activations of the device over several weeks or months, performed at home to maintain the prescribed, gradual rate of expansion.
Essential Supplies and Preparation
Before beginning the adjustment, gathering the correct materials and ensuring the patient is comfortable will help the process proceed smoothly. The specific adjustment tool, often a small metal rod or plastic device, is provided by the orthodontist and is precisely shaped to fit into the expansion screw mechanism. A reliable light source, such as a flashlight or a headlamp, is necessary to clearly illuminate the small mechanism inside the mouth. A small, handheld mirror can also be helpful for the person assisting with the turn to confirm the key is inserted correctly and the adjustment is complete.
The patient should be positioned comfortably, perhaps sitting in a chair with their head tilted slightly back to give the adjuster a clear view of the palate. The patient should remain relaxed and breathe normally through their nose during the brief procedure. Clear visibility of the expander’s center screw mechanism is paramount to ensure the key is inserted into the correct hole and that the full rotation is achieved.
Step-by-Step Guide to Turning the Expander
The mechanical process of activating the expander requires precision and a steady hand to ensure the device is advanced correctly. First, locate the small hole in the center of the expander mechanism, which is the opening currently facing toward the front of the mouth. The specialized activation key must be slid completely into this opening until the tip is fully engaged within the internal mechanism of the screw. Ensuring the key is fully inserted is important to prevent slipping and to guarantee a complete turn.
Once the key is securely in place, gently push the key toward the back of the throat or the roof of the mouth. This rotational movement activates the screw, causing the expansion mechanism to move slightly and create the desired pressure. Continue pushing until the next hole on the expansion screw becomes visible and the key physically stops against the device’s housing. This stopping point confirms that one full activation cycle has been completed.
The adjuster must then carefully remove the key by pulling it straight down or out without reversing the rotation. If the key is pulled out incorrectly, there is a risk of partially undoing the turn, which compromises the precise expansion schedule. The appearance of the newly exposed hole, now facing forward, confirms the activation is complete and the device is ready for the next turning cycle. Orthodontists typically prescribe only one full turn per cycle, often once or twice daily, depending on the patient’s treatment plan.
What to Expect After the Adjustment
Immediately following the adjustment, patients often report a sensation of pressure or tightness across the roof of the mouth and sometimes in the upper teeth. This feeling is a direct result of the gentle force being applied to the midline palatal suture and is a sign that the device is working as intended. Mild soreness in the teeth or even a feeling of pressure at the bridge of the nose may occur temporarily as the skeletal structures respond to the expansion force. These sensations typically subside within a few minutes or hours after the activation.
It is common for patients to experience temporary changes in speech, such as a slight lisp or difficulty pronouncing certain sounds, because of the appliance taking up space in the mouth. Patients should also plan to eat softer foods for the first day or two after an adjustment to minimize discomfort while chewing. If the adjustment causes severe, unmanageable pain that persists beyond a few hours, or if a band securing the device comes loose, the orthodontist should be contacted immediately. Similarly, if the adjustment key is lost or the main body of the appliance appears broken, professional guidance is necessary to avoid compromising the treatment progress.