Orthodontic procedures such as braces are used to correct problems with the alignment – the way the top and bottom teeth fit together. They also help fill in gaps when teeth aren't close enough together. In some cases, though, teeth produce crowding and there's simply not enough room for all of them to fit properly. This is where upper jaw expansion might be necessary.
Why Palate Expansion?
When teeth are crowded, they can overlap one another, sit crookedly or even grow in sideways. Often, the jaw of a growing child is too small to accommodate a full mouth of teeth. Originally, to make more room, orthodontists would extract teeth, but this meant the patient would lose some of his or her permanent teeth. Now, palate expansion – sometimes called Rapid Palatal Expansion (RPE) – is more common. This procedure uses a device that gradually widens the roof of the mouth (the palate) to make more room for permanent teeth to emerge, and the effect occurs over a few weeks or months. In some cases, expansion is the only treatment necessary to correct the bite. Usually, however, the orthodontist will also use braces to be sure all the teeth are correctly positioned.
How Does it Work?
The roof of the mouth consists of two pieces that do not completely join until adulthood. This place where they join can be gradually eased apart to create more room. This technique is more effective with younger patients; in adults, the area has closed and the separate halves of the palate don't shift as easily.
Palate expansion is often accomplished with a special appliance called a palatal expander, which attaches to both sides of the upper molars. According to the British Journal of Orthodontics, it consists of two separate pieces that move apart gradually with an expansion screw. Because it's usually used to treat children or young adolescents, a parent is trusted with the use of this tool, which turns a key in the center joint of the device to stretch the two portions away from each other. Each turn widens the spreader a very small distance, but over time, the palate becomes wide enough to make room for the patient's adult teeth. While you're wearing the appliance, it's important to keep your mouth as clean as possible using a fluoride toothpaste like Colgate® Triple Action, which should be brushed against the expander itself as well.
Though this process sounds daunting, it is relatively simple, and only feels less noticeable with wear. Nonetheless, your dentist might prescribe medication to ease the initial pain – the American Academy of Pediatric Dentistry (AAPD) reports patients often experience the most discomfort at the beginning of treatment. There is also a higher likelihood of discomfort if the expansion is conducted quickly. For example, if the orthodontist prescribes two full turns of the key per day, you're more likely to experience soreness than if the key is turned only once per day.
Is Surgery Necessary to Expand the Upper Jaw?
In most cases, the palate expander is sufficient to create enough room for the permanent teeth. Sometimes, it's even enough to make braces unnecessary. However, it's more common for an orthodontist to recommend traditional braces to move the teeth into proper position after the palatal expander has done its work.
Because expanders are most effective with younger patients, surgery is more often necessary with adults who require orthodontic work. Your orthodontist will evaluate your individual needs to determine if this is an appropriate approach. If surgery is necessary to expand the upper jaw, explains the Journal of Dental & Allied Sciences, it's usually used to separate the halves of the palate so they can then be moved into position with an expander.
Upper jaw expansion is a way to prepare the mouth for the arrival of permanent teeth that otherwise might not have had sufficient room. It can also be used in adults to make room for existing teeth if there are severe problems with the bite. Expanding the upper jaw can reduce the amount of time spent in braces and give you a properly aligned smile.