Palatal Expansion

What Is Palatal Expansion?

Orthodontics, the branch of dentistry that focuses on correcting dental and facial irregularities, offers a range of treatment options to address malocclusions or misalignments of teeth and jaws. Palatal expansion, also known as rapid maxillary expansion or maxillary expansion, is a common orthodontic procedure used to widen the palate, which is the roof of the mouth. The palate consists of two halves, known as the maxilla, which are located on the upper jaw and are fused together at the midline.

Palatal expansion can be an effective treatment for a variety of conditions related to a narrow upper jaw, including crossbites, crowding of teeth, and other bite issues.

How does it work?

Palatal expansion is achieved using orthodontic appliances called palatal expanders, which are designed to apply controlled, gentle pressure on the maxillary bones to gradually separate them and create additional space. This allows for the expansion of the maxilla and the correction of the dental and facial irregularities associated with a narrow upper jaw. Palatal expansion is most commonly performed during childhood or adolescence when the jaw is still growing and more amenable to modification. However, it can also be performed in adults, although it may require additional steps and careful consideration of individual patient factors.

What is a Palate Expander?

A palate expander is an orthodontic appliance used to widen the maxilla or the roof of the mouth. Palate expanders are custom-made devices that are typically attached to the upper teeth and are used to apply controlled, gentle pressure on the maxillary bones to gradually separate them and create additional space. Palate expanders can address various dental and facial issues associated with a narrow upper jaw, including crossbites, crowding of teeth, impacted teeth, and aesthetic concerns.

What is a palatal expander made of?

Palate expanders can come in various designs and types, depending on the specific needs of the patient and the treatment goals. They are typically made of metal or acrylic material and may have different activation mechanisms, such as screw-based or spring-based systems, to allow for gradual expansion. Palate expanders are typically fixed appliances, meaning they are bonded to the teeth and cannot be removed by the patient. They are adjusted periodically by the orthodontist to achieve the desired amount of expansion and treatment outcomes.

Types of Palatal Expanders

There are several types of palatal expanders that can be used to achieve palatal expansion. The choice of palatal expander depends on various factors, including the age of the patient, the severity of the malocclusion, the desired amount of expansion, and the treatment goals. Some of the common types of palatal expanders include:

• Rapid Palatal Expander (RPE)

  This is the most commonly used type of palatal expander and is typically used in children and adolescents. It consists of a metal framework that is bonded to the upper teeth and a screw in the middle that can be activated to gradually expand the maxilla. RPEs are typically activated by turning the screw with a special key, usually once or twice a day, to achieve the desired amount of expansion.

• Haas Expander

  This is a type of RPE that has an acrylic plate covering the entire palate, making it more comfortable for the patient. The Haas expander is usually used in younger patients or those with a sensitive gag reflex.

• Hyrax Expander

  This is another type of RPE that has a wider screw and is activated using a special key. The Hyrax expander is typically used in cases that require a more rapid or greater amount of expansion.

• Quad Helix Expander

  This is a spring-based expander that uses a series of coils and helices to apply continuous pressure on the maxilla for gradual expansion. The Quad Helix expander does not require activation with a key and is typically used in cases that require minimal expansion.

• Removable Palatal Expander

  This is a removable appliance that can be taken in and out by the patient and is typically used in cases that require minor expansion or in patients who may not tolerate a fixed appliance.

• Implant-supported Palate Expander

  This type of palatal expander is anchored to dental implants placed in the palate, providing additional stability and control during the expansion process. Implant-supported palate expanders are typically used in cases where traditional palatal expanders may not be suitable due to anatomical limitations or other factors.

Who needs palatal expansion?

Palatal expansion may be recommended for individuals who have a narrow maxilla, or a narrow upper jaw, which can result in a variety of dental and facial issues. Some of the common conditions that may necessitate palatal expansion include:

It is important to note that not everyone with a narrow maxilla requires palatal expansion. Orthodontic treatment, including palatal expansion, is typically recommended based on a comprehensive evaluation by an orthodontist, taking into consideration the individual’s specific dental and facial characteristics, treatment goals, and overall oral health.

How much does a palatal expander cost?

The cost of palatal expansion in Ontario can vary depending on various factors, such as the type of expander used, the complexity of the case, the duration of treatment, and the experience and expertise of the orthodontist. Generally, the cost of palatal expansion can range from $ 2,000 to $ 5,000 in Ontario. It is essential to note that these estimates are just a general range, and the actual cost can be significantly different depending on individual cases and specific orthodontic practices. It is recommended to consult with a qualified orthodontist to determine the exact cost of palatal expansion and to discuss the available payment options and insurance coverage.

Advantages of Palatal Expansion

Palatal expansion has several advantages for patients who require orthodontic treatment. Some of the main advantages of palatal expansion include:

• Wider dental arches: Palatal expansion can help widen the dental arches, creating more space for crowded teeth to properly align. This can result in better overall dental alignment, improved occlusion (bite), and enhanced facial aesthetics.
• Better breathing and sleep quality: Palatal expansion can also help improve breathing and sleep quality in patients with breathing issues, such as sleep apnea or narrow nasal passages. By widening the maxilla, palatal expansion can increase the nasal airway space and reduce airway resistance, leading to improved breathing and better sleep quality.
• Reduced need for extractions: Palatal expansion can often help create enough space for the teeth to properly align without the need for extractions. This can be particularly beneficial in cases where there is crowding or overlapping of teeth and can help preserve natural teeth.
• Improved orthodontic outcomes: Palatal expansion can improve the outcomes of other orthodontic treatments, such as braces or Invisalign. By creating more space for the teeth to align, palatal expansion can facilitate smoother and more efficient orthodontic treatment.
• Enhanced facial aesthetics: Palatal expansion can also have positive effects on facial aesthetics. A wider dental arch can contribute to a broader smile, a more harmonious facial profile, and improved facial balance.

Disadvantages of Palatal Expansion

While palatal expansion can offer many benefits, there are also some potential disadvantages and limitations to consider. These include:

• Discomfort and soreness: Palatal expansion can cause discomfort and soreness, particularly during the initial stages of activation. This can be managed with pain medications or other remedies recommended by the orthodontist, but it may still be uncomfortable for some patients.
• Speech changes: Palatal expansion may temporarily affect speech, particularly in younger children who are still developing their speech skills. However, most patients adapt to the expander within a short period of time, and speech returns to normal.
• Compliance and maintenance: Palatal expanders require regular adjustments and maintenance by the orthodontist and compliance with the treatment plan is crucial for successful outcomes. Patients need to be committed to following the orthodontist’s instructions and attending regular appointments for adjustments.
• Potential risks and complications: Palatal expansion, like any orthodontic treatment, carries some risks and potential complications, such as discomfort, gingival recession, tooth tipping or tilting, relapse, and soft tissue irritation. However, these risks are generally low and can be managed by an experienced orthodontist.
• Anatomical limitations: Palatal expansion may not be suitable for all patients due to anatomical limitations, such as a thin palate or other factors. In such cases, alternative treatment options may need to be considered.