What is a palatal expander?
A palatal expander is an appliance that is attached to the upper molars through bonding or bands. The palatal expander is used to widen the upper jaw. It is typically used when the upper jaw is too narrow or the upper teeth are crowded. Activating the expander creates gradual outward pressure to cause an increased amount of bone to grow between the right and left halves of the jaw, resulting in increased width.
PALATAL EXPANDER QUESTIONS
When should I turn the palatal expander?
Dr. Hodges will provide a specific schedule for when you should activate the expander. If you are not sure of how many turns to make on the expander, please contact the office so that you do not turn the expander too many times.
When turning the expander, it does not matter what time of the day you do it. And it does not matter that you turn it the same time every day. Turn when it is most convenient.
How do I turn (or activate) the expander?
You have been given a special key for activating the expander. Activate in the following manner:
The patient should lie down or tilt their head back. A position that works well would be to lie on a couch with the patients head in the parent’s lap – or sit on the floor in front of a parent (parent seated in a chair) leaning head back into the lap. A source of light is helpful to illuminate the inside of the mouth (little brother with a flashlight is perfect!). Insert the key into the hole at the midline of the appliance. Rotate downward and backward as the key moves toward the throat. The key should be pushed until the next hole is completely visible. Stopping short is the most common mistake, creating an inability to insert the key next time. Remove the key by pushing downward (towards the tongue) and slightly inward (toward the throat) on the handle. Do not to reverse the turn as you remove the key from the appliance.
How will my expander feel? Will my expander feel sore or uncomfortable?
The first day or two is the most challenging. Initially, the patient may feel frustrated. With patience, encouragement and a positive attitude you will quickly adapt.
Some pressure may be experienced at the bridge of the nose, in the cheek area, or on the teeth. After about one week, a space may open between the two upper front teeth. Occasionally, the front teeth will become slightly mobile and sensitive. These are only temporary effects. Ibuprofen or Tylenol will help any soreness.
After turning of the appliance has been discontinued, there will be a gradual closure of the midline space spontaneously. This closure is to be expected and is not a problem.
How will my expander feel? Will it make me talk funny?
Speech difficulties are normal at first, but are usually are resolved within 24 to 72 hours. A helpful tip is to read out loud to practice your speech until this improves. Within a few days, this will not even be an issue.
How will my expander feel? How can I eat with the palatal expander?
Eating difficulties usually are resolved within 24 to 72 hours. Excess saliva is normal when the appliance is initially placed. Your mouth may water more than usual and this will stop after the first few days as your body adjusts. It is helpful to eat softer foods until you have grown accustomed to this new feeling. During meals, food may accumulate between the roof of the mouth and the appliance. It is best to finish the meal or snack first, then dislodge the food by swishing around a mouth full of your drink or water. If the food particles remain under the appliance, they may become a source of irritation to the roof of the mouth that will become uncomfortable for the patient.
How do I clean around my palatal expander?
Cleaning thoroughly is very important. Please pay particular attention to the margin where the appliance meets the gums on the cheek side and the tongue side. Improper brushing can leave heavy plaque buildup, which will cause gingivitis. If you notice the gums are bleeding, especially during brushing, this is a sign of gingivitis. This can be eliminated within two to four days with adequate plaque removal when brushing.
What if my expander appliance becomes loose?
If the appliance becomes loose (or you think it may be loose) or if there is pain or extreme breath odor, call the office. A loose appliance should not be activated (or turned) and no part of the appliance should be discarded or thrown away. Please contact the office and we will advise you on how to proceed.
What if I have an expander and missed my appointment?
During the time of activation of the appliance, it is my Important that you be seen at your scheduled appliance. If for some reason you miss an appointment, expanding the appliance should be discontinued until the patient is seen. In that case, please call the office promptly to reschedule.