Palatal Expansion
When the upper arch is too narrow to fit properly with the lower arch, expansion of the upper arch is often indicated. In many cases, the most stable way to accomplish the expansion is by applying orthodontic force to the upper arch to achieve skeletal rather than dental expansion. The upper jaw bone in growing patients has growth centers called sutures which are soft cartilage. The mid-palatal suture separates the roof of the mouth into left and right halves. When pressure is applied in a controlled manner, the mid-palatal suture can be significantly widened correcting crossbites and creating more room for the eruption and alignment of teeth.
The appliance used to expand the maxilla is called a Rapid Palatal Expander (RPE). This appliance is custom made for each patient. Usually the parents of the younger patients activate the appliance, or sometimes the older patients will activate the appliance themselves. Expansion of the upper arch is accomplished in approximately 6 weeks. This appliance remains in the mouth for approximately 3 to 4 months to hold the expansion while the new bone formation takes place.
WHAT TO EXPECT:
- The back teeth may be uncomfortable for 48 to 72 hours after placing the RPE.
- Swallowing may be awkward for several days because of the room that the appliance occupies in the roof of the mouth. Speech may also be affected for the same reason. Most children adapt and compensate within a day or two.
- A significant space may develop between the two upper front teeth. This is temporary and will usually begin to close automatically when the RPE is no longer being activated.
- After the initial adjustment period, when the RPE is activated, the patient may feel pressure for a short time but there should be little, if any, discomfort.
INSTRUCTIONS FOR ACTIVATING THE RPE:
- Have patient open his/her mouth as wide as possible while laying on a bed or couch, tilting head back.
- Locate the hole in the middle of the expander. Place key firmly in hole, until key is fully engaged.
- Swing the handle of the key toward the back of the mouth until you see the next hole appear, ensuring not to lose your turn.
- You will make one turn each day for 3 weeks. At the 3 week point we will check the progress and continue turning for an additional 3 weeks. After 6 weeks of turning, the appliance will sit in patient’s mouth inactive for another 6 weeks allowing bone to fill in and stabilize expansion.
- WE STRESS THE IMPORTANCE OF THE EXPANDER STAYING IN PLACE THE ENTIRE 12 WEEKS. With all of this being said: avoid eating hard or chewy candy, do not chew ice, and do not play with the RPE with your tongue or fingers, it will loosen.
- Please call our office at (814) 337-1313 if you have any problems or concerns.