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Palatal Expanders

Recent orthodontic and anthropomorphic research has shown that the size and width of human jaws has decreased significantly in the last 400-500 years. So much so, that remains from that time period often exhibited perfectly straight teeth, all the wisdom in place and very little need for orthodontia. Much of this change has been associated with a change in our diets - a transition from tough, coarse food to processed, softer foods. There are many theories about how to restore proper jaw size in human, but one tool that has risen to the forefront of orthopedic treatment is the palatal expander. Learn how the palatal expander works and what health benefits it may have for you or your child.

How Does It Work?

Concerns over narrow and constricted palates has been growing in recent years but has been the topic of research for over 100 years. The first case of palatal (or maxillary) expansion was in 1860 by E.H Angell, but did not become a topic of extensive research until the 1960s*. Today, overwhelming evidence demonstrates the dental and system health benefits of this procedure. So, what happens when someone is given an expander?

Our upper jaw, called the maxilla, has a line that runs down the center called the midpalatal suture. In children, this suture is still open, meaning that the two halves of the maxilla are not fully fused together, much like a soft spot on a baby's skull. As the child matures and reaches puberty, this suture begins to close and the bones begin to fuse together. However, if we apply outward pressure to the maxilla before these bones fuse we can actually widen the palate itself and allow new bone to fill in the empty space.

An expander is a metal device with metal bands that fit around the back molars and a small screw in the center. At home, you will be instructed to turn this small screw one or two times a day. As the screw opens the bones are pushed apart and you can expect to see a small gap open between the front teeth. And that's it! Once you have finished turning, per Dr. Bloom's instructions, the expander will remain in place until Dr. Bloom feels the expansion will be stable and the expander can be removed. This is usually around 6 months.

*Bishara, Samir E., and Robert N. Staley. "Maxillary expansion: clinical implications." American journal of orthodontics and dentofacial orthopedics 91.1 (1987): 3-14.


Expander Before

After 2 weeks

Expander After

How to Turn Your Expander (Video)

How to Use Your Expander

Step-by-step Instructions

RPE rapid palatal expander

Step 1: Locate the key hole

In the center of the expander you will see a small hole. The hole should be near the front of the expander.

expander key positioning
expander key

Step 2: Place the tip of the key into the hole

The key tip is attached to the handle by a swiveling hinge. Most people find it useful to straighten the tip first so that it is in line with the handle.

palatal expander with key inserted

Step 3: Insert the key until it fully seats into the hole

This sometimes requires a little pressure. The key should feel like it will stay in place if you let go of the handle. If it does not feel secure, simple remove the key and try again.

palatal expander turning

Step 4: Push the key toward the back of the expander (toward the throat) until it will not go any further.

If you do not turn the screw all the way you may have a difficult time time finding the hole next time.

palatal expander after turning

Step 5: Pull straight down to remove the key

Do NOT undo the turn you just completed. Simply wiggle the key loose and remove it with gentle pressure.

RPE expander holes

Old hole

New hole

Step 6: Check that a new hole has appeared in the front of the expander.

This will ensure that you can locate the hole again when you are ready for another turn.

That's it! Easier than you thought, isn't it? If you have trouble locating the hole please contact our office and we will get you back on track. The most common problem we see with expanders is when patients/parents do not FULLY turn the screw and then cannot find the hole again. Please do not hesitate to call us if you have any questions!

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