If a kid's orthodontist finds that lack of room in the mouth for all the permanent teeth is causing problems, they may recommend a palatal expander. This appliance attaches to the top row of teeth and spans the roof of the mouth. A mechanism allows a parent to insert a tiny key and turn the fender. This serves to gradually, and with minimal discomfort, spread the two sides of the child's upper jaw farther apart.
A palatal expander is useful for addressing three main orthodontic problems.
If the upper jaw is too narrow, the top teeth come down along the inner edge of the bottom row instead of the outer edge. The term for this phenomenon is a crossbite. A palatal expander works to correct the crossbite by expanding the upper jaw so that it extends beyond the edge of the lower jaw like it is supposed to.
An impacted tooth occurs when the other teeth block it and it is unable to erupt the way it is supposed to. A palatal expander can create enough space so that the other teeth move out of the way and the impacted tooth can come in.
When the jaw is narrow, there may not be enough room for all the permanent teeth to come in. A kid's orthodontist can gauge whether crowding will take place and recommend a palatal expander as an alternative to extracting teeth to create enough room.
There is a window of opportunity in which a palatal expander may be effective. The appliance serves to move the two bones of the hard palate apart. This is possible in childhood because the bones do not permanently fuse together until adolescence. Once the fusion takes place, surgery may be required.
A kid's orthodontist will provide the necessary tool and explain to the parent how to use it, as well as the schedule by which the adjustments should take place. The adjustment is a relatively simple matter, but it can take practice to get it right.
Tilt the kid's head back, open-mouthed, in a well-lit area and look into the mouth. The movable fender with the hole in it should be visible.
The key provided fits the hole in the appliance. However, both are very tiny, so it may take time to make the connection.
While pushing the key toward the back of the mouth, the parent should be able to see and feel the fender rotating, until the new hole becomes visible. It is impossible to push the key too far, so the parent should not become nervous and stop rotating prematurely. That can cause problems when it comes time to do the next adjustment.
This is accomplished by pushing the key down towards the tongue, then pushing it back. Double-check that the next hole is visible first.
The kid's orthodontist will inform the parent how often to perform the adjustment. Adjustments may occur more often at the beginning of treatment. The orthodontist will also advise the parent of the treatment's duration.
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