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Oral expansion

What is oral expansion?

Oral (or palate) expansion is an orthodontic procedure used to expand the upper bone arch when the palate is too small. The oral expander applies constant, safe pressure on teeth to gently stretch the palatine suture.

Oral expansion is done on children as a preliminary procedure. It can help prevent complex orthodontic procedures or reduce their duration.

When is a palate expander needed?

This procedure is recommended when the upper jaw is too narrow and disproportionate to the lower jaw. Widening the upper arch re-establishes balance and creates more space.

Oral expansion can also correct other problems, including:

  • Malocclusion
  • Insufficient space on the arch, which prevents teeth from aligning correctly
  • Overlapping teeth
  • Crossbite (upper teeth fall behind the bottom teeth when biting down)
  • Nasal cavity that restricts air passage
  • Cosmetic problems

Advantages of oral expansion

By treating malocclusion, palate expansion improves chewing and prevents premature wearing of teeth.

In addition, properly aligned teeth are easier to clean because they do not overlap. Better dental hygiene reduces the risk of developing cavities or gum disease.

Two types of palate expanders

Removable device:

  • Can be removed for cleaning (teeth are brushed as usual and the device is cleaned according to the dentist’s instructions)
  • Exerts slight pressure on posterior teeth, expanding the palate and creating additional space on the dental arch (transversal expansion)
  • Before bed, the device is removed, adjusted as directed and placed back into the mouth

Permanent device:

  • Secured to teeth until the treatment is complete; it can only be removed by the dentist
  • Attached to the posterior teeth and exerts constant pressure to achieve the desired expansion
  • Adjusted directly in the mouth every day

The procedure

1) Activation phase:

Every day, the child or their parent adjusts the device. Constant pressure gradually separates the bones of the palatine suture. A small key is inserted into the device and turned to activate the expansion. It’s important to follow the dentist’s activation instructions carefully. This phase lasts two to three weeks.

2) Immobilization phase:

Once the desired width has been achieved, the activation phase ends, but the device is worn for another three months or so. During this immobilization phase, the expansion stabilizes and the bone tissue in the middle of the palate recalcifies.

During the procedure, it is normal for an interdental space, or diastema, to form between the two upper incisors. It will slowly close a few weeks after the treatment ends. The palate, however, will retain its expanded width.

Treatment duration

In general, the treatment lasts four to six months. However, as with other orthodontic procedures, its duration can vary depending on the following:

  • Severity of the problem
  • Oral health
  • Age

When should this treatment begin?

Although palate expansions can be done at any age, it works best on younger patients aged between 6 and 9. In most cases, children and teenagers who are still growing are the best candidates.

For increased effectiveness:

  1. Practice proper oral hygiene to help prevent cavities and gum disease
  2. Clean the device thoroughly
  3. Follow the dentist’s instructions carefully
  4. Wear a retainer afterward to stabilize the expansion. Your dentist will let you know how often and how long you should wear the retainer. It may be for a specific time period or for life.

Is it painful?

Some mild pain will be felt during the activation phase. You’ll feel pressure on your palate and cheeks, and you may feel some tingling under the device and along your nasal bone. This discomfort generally goes away 15 to 30 minutes after the activation. Taking a painkiller like Advil should help.