A palatal expander is an orthodontic appliance designed to widen the upper jaw (maxilla) to create more space for crowded teeth and correct bite issues like a crossbite. This device works by applying gentle, controlled pressure to the mid-palatal suture, the connection between the two halves of the upper jaw. The process of gradually tightening the device, known as activation, encourages the bone structure to widen over weeks or months, following a specific schedule prescribed by your orthodontist.
Essential Preparation and Tools
Before beginning the activation process, proper preparation ensures both hygiene and clear visibility of the device’s mechanism. Always start by thoroughly washing your hands to prevent the introduction of bacteria into the mouth. You will need the small, specialized metal key provided by your orthodontic office.
You also need a strong, focused light source, such as a flashlight or a headlamp, since the expander is located on the roof of the mouth. Positioning is important for a clear view, so the patient should be seated comfortably with their head tilted backward. A small mirror can also be helpful for the person performing the turn to ensure the key is inserted and turned correctly into the central screw mechanism.
Step-by-Step Activation Instructions
The activation process involves turning the central screw mechanism a precise, small amount. Locate the hole in the screw that is currently facing toward the front teeth or the nose, as this is the starting point for the turn. Gently slide the wire tip of the specialized key into this hole until it is fully seated; the bend in the key’s wire will stop it from going in too far.
Once the key is firmly in place, push it steadily and slowly toward the back of the mouth. This action rotates the internal screw, which separates the two halves of the expander. Continue pushing the key until it can no longer move and the next hole in the screw mechanism becomes fully visible at the front.
The final step is carefully removing the key without reversing the turn. To do this, press the key down and back, toward the tongue, as you slide it out of the hole. This ensures that the newly exposed hole remains facing forward, confirming the turn is complete and ready for the next scheduled activation. Each full turn typically widens the expander by a fraction of a millimeter, requiring adherence to the exact schedule provided by your orthodontist.
Monitoring Comfort and Troubleshooting
Following an activation, it is common to feel a sensation of pressure or tightness across the roof of the mouth or near the bridge of the nose. This is a normal reaction and indicates that the device is working to gently separate the jawbone structure. Minor, temporary side effects like increased saliva production, slight lisping, or mild tenderness in the teeth are also expected as the mouth adjusts to the change.
If minor discomfort occurs, over-the-counter pain relievers, such as ibuprofen, can be taken about an hour before the scheduled turn to help manage the pressure. It is also beneficial to stick to a diet of soft foods for the first few days after an activation to avoid putting excessive force on the teeth and appliance. You may also notice a temporary gap appearing between the two front teeth, which is a common sign that the expansion is successful.
If the key feels stuck or you cannot complete a full turn, do not force the movement. Instead, remove the key and re-insert it into the original starting hole to attempt the turn again. Should you experience sharp, severe pain that does not resolve with medication, or if any part of the expander becomes loose, bent, or broken, contact your orthodontist immediately. It is important to continue the prescribed turning schedule precisely; if you miss an activation, simply continue with the next scheduled turn without trying to make up for the missed one.