Palate widening is an orthodontic procedure designed to expand the upper jaw, also known as the maxilla. This process creates more space within the mouth, addressing various dental and functional issues. It aims to achieve proper alignment between the upper and lower teeth, crucial for overall oral health and function. Widening the palate can also contribute to improved breathing and is often part of comprehensive orthodontic treatment.
Understanding Palate Widening
The palate, or roof of the mouth, consists of two bones joined by the palatine or maxillary suture. A narrow palate, where the upper jaw is proportionally smaller than the lower, can lead to various problems. These often include crowded or misaligned teeth due to insufficient space.
A narrow palate can also result in crossbites, where upper teeth bite inside the lower teeth. Beyond dental issues, a constricted upper jaw can impact breathing, potentially leading to mouth breathing or obstructive sleep apnea due to reduced nasal airflow. Speech impediments may also arise, as limited space affects tongue movement and position. These anatomical limitations can stem from genetics, certain habits like thumb-sucking, or medical conditions.
Methods of Palate Expansion
Palate expansion involves gently separating the two halves of the upper jaw along the mid-palatal suture to create new bone and widen the arch. Various custom-made appliances apply controlled pressure for this process.
One common method is the Rapid Palatal Expander (RPE). RPEs are fixed appliances typically attached to the upper molars with a central screw. This screw is turned daily, widening the jaw by about 0.25 to 0.5 millimeters per turn. The rapid application of force helps separate the median palatal suture. Once expansion is complete, the appliance remains in place for several months, typically 3 to 6 months, to allow new bone to fill the gap and stabilize the widened palate.
Slow palatal expanders (SPEs) work by gradually stretching the palate with a spring-like action or through less frequent activations of a screw mechanism. These devices apply lighter, continuous forces, with activations typically occurring every few weeks or even months. This slower rate of expansion may cause less discomfort. Removable palatal expanders are also available for cases requiring minimal expansion, offering flexibility as they can be taken out for meals and cleaning.
For more complex or severe cases, surgically assisted rapid palatal expansion (SARPE) may be necessary. SARPE combines orthodontic treatment with a minor surgical procedure. During the surgery, a maxillofacial surgeon makes precise cuts in the bone to facilitate the separation of the palatal suture. An expander is placed before the surgery and activated after a few days, allowing for widening not possible with non-surgical methods.
Palate Widening for Different Age Groups
The process of palate widening varies significantly between children and adults due to differences in skeletal development. In children and adolescents, the mid-palatal suture has not yet fully fused. This flexibility allows for effective and often quicker expansion through orthodontic appliances alone. Orthodontists frequently recommend palatal expansion for children as young as 6 or 7, as their bones are still growing and are more pliable. Early intervention in childhood can prevent more complex issues later, such as tooth extractions or more invasive procedures.
For adults, the mid-palatal suture is fully fused, making non-surgical expansion more challenging. In these cases, traditional expanders may primarily tilt the teeth rather than achieving true skeletal expansion. Therefore, adults often require surgically assisted rapid palatal expansion (SARPE) to achieve significant and stable widening of the jaw. While adult palate expansion is possible, it typically involves more advanced techniques and may have longer treatment timelines compared to children.
What to Expect During Treatment
Patients undergoing palate widening can expect an adjustment period as they adjust to the expander. Initially, there may be some discomfort or a feeling of pressure in the roof of the mouth, behind the nose, or between the eyes. This sensation is typically mild to moderate and usually subsides within a few days after each activation. Over-the-counter pain relievers can help manage any discomfort.
Speech adjustments are common, as the tongue adapts to the appliance. Patients might experience a temporary lisp or difficulty pronouncing certain words, which generally improves with practice. Increased saliva production is also a common initial response. Maintaining good oral hygiene is important; patients must brush and clean around the expander regularly to prevent food impaction and gum irritation. Eating softer foods during the initial phase and after activations can also help with comfort.
Treatment duration varies depending on individual factors, including age and the severity of the condition, but typically ranges from several months to a year. After the active expansion phase, the expander is often kept in place for an additional few months to allow new bone to solidify the widened palate. Regular follow-up appointments with the orthodontist or oral surgeon are essential to monitor progress.