EXPANDER THERAPY

The doctor can widen the patient's smile using expander therapy before braces are applied. Due to the nature of the treatment, expander therapy is usually reserved for children (usually when they still have baby teeth present) and for teens or young adults in cases of very crowded teeth or cross-bites.
​Expander therapy uses expansion orthodontic appliances to widen the dental arch through sutural expansion of the upper jaw and by tipping the teeth of the lower jaw. This results in a broad, dynamic smile. It usually lasts 4 to 6 months per arch. The braces follow for additional fees, when all of the permanent teeth have erupted.

The process uses two kinds of expanders, the Upper Expander for upper teeth, and the Lower Expander for lower teeth. The results are obvious!

STEPS & APPOINTMENT SEQUENCE

a. First Visit: The doctor will size the back teeth, and then take a mold of the teeth in order to custom-make the expander.

b. Second Visit: The patient comes back a few weeks later to get the Upper and/or Lower Expander. At this appointment, the doctor will try it in the mouth of the patient and make some minor adjustments before cementing it with a special adhesive. The doctor will also show the patient how to turn the expander and give instructions on how to keep it clean.

c. Third Visit: If enough expansion has been achieved, the expander may be removed at this appointment. If more expansion or stabilization is required, the expander will be left in place until the next appointment.

FAQ’S

HOW LONG WILL IT TAKE THE PATIENT TO ADJUST TO THE EXPANDER?

The first couple of days, the patient may feel like food is stuck between the teeth, and the tongue may get sore from touching the expander while talking. The patient needs to keep it clean with a toothbrush and mouth rinses. During these first few days, the patient will experience discomfort because the teeth are moving for the first time. This will subside significantly as the treatment progresses. The patient may take ibuprofen (Advil) to relive the discomfort or Acetaminophen (Tylenol).

WHY DOESN’T IT WORK AS WELL FOR ADULTS?

The expander works by widening the midpalatal suture of the upper arch. This suture is in the roof of the mouth and it turns into bone after puberty. Once the bone is set, expansion may be painful and not stable. In the lower arch the teeth mostly tip once the permanent canines have erupted fully.

HOW LONG DO THE RESULTS LAST?

In children and adolescents the results are permanent. Retainers, of course, will have to be worn after the braces. In adults, the results are pretty stable as long as the expansion in minimal.

WHAT HAPPENS IF THE EXPANDER CANNOT BE TURNED ANYMORE?

When the patient has reached the end, the expansion screw will not turn any more. The patient should leave it alone until the next appointment.

WHAT IF THE EXPANDER COMES LOOSE AND ONLY ONE SIDE COMES OFF?

The patient should wiggle the other side out. If it does not come out, the patient should call the office to schedule an appointment to re-cement it. The patient should be careful chewing in the meantime.

WHAT IF THE EXPANDER COMES OFF?

The patient should remove it, and NOT throw it away. The patient should call the office to schedule an appointment to re-cement.