An orthodontic expander is one of the most commonly used and useful appliances in orthodontics. It is commonly referred to as a palatal expander. The bone that covers the roof of our mouth is referred to as the palate and is comprised of two halves. There is a suture, or soft connective tissue, that connects the two halves together. The expander connects to the top molars and goes across the roof of the mouth but does not touch the roof of the mouth. The expander places a small, gentle force on the palate which causes the suture to stretch and expand which in turn widens the palate. 

As children age that suture hardens and the palate becomes more difficult to expand. A palatal expander is most effective in younger children typically between ages 7 and 11 because the suture is more responsive to the forces the expander places. In some cases an expander can be used for older patients, but typically an expander is most effective for younger patients.

Main reasons an expander is used:

• The upper jaw is too narrow to properly fit with the lower jaw.
• Expanding the upper jaw can create more room for teeth that would otherwise be crowded.
• There is an impacted tooth that won’t come in because it is blocked by another tooth. Widening the jaw can create more space to help the impacted tooth come in.

Main things to be aware of:

• A palatal expander is quite easily tolerated even if it may sound intimidating to some people. 
• During the first couple days, some people may need to adjust to speaking with the expander in their mouth (not all people do). We recommend talking as much as possible the first couple days to allow the tongue to adjust to the expander. This can be done by reading a book out loud or singing in front of the mirror, whatever works for you!
• There may be some initial discomfort, but the expansion is relatively painless. For the first few days, eating soft foods that don’t require too much chewing is helpful as your child adjusts to having the expander.
• As the suture widens, a gap between the front teeth may develop. This gap is only there temporarily. The elastic fibers in the gums will pull the teeth back to their original positions after the expansion is complete.
• After the proper amount of expansion has been achieved, the expander is held in place for a few months while new bone forms where the suture stretched and widened.