By Deborah Jeanne Sergeant
It’s not uncommon to see a young child with a palatial expander. The orthodontic device isn’t traditional orthodontic braces. However, it can help children with a functional problem such as crossbite. An expander may also reduce the need for orthodontic braces later.
Dentist P. Emile Rossouw, doctor of medicine and surgery and chairwoman of orthodontics at Eastman Institute for Oral Health, said that starting children with expanders at a young age is important. “The younger the better, because an interference with the position of the upper and lower jaws can eventually create other problems that can become more permanent,” she said.
In younger children, the mid-palatial structure in the roof of the mouth is comprised of two bony parts that begin to fuse by puberty. An expander helps by gradually moving those two bony parts away from each other so bone will fill in the area to widen the palate. Providers wait until the first molars are in place so they have a place to anchor the expander.
Widening the palate can help the jaw function better.
“A narrow upper jaw can lead to deviation of the lower jaw,” Rossouw said. “If you close your mouth and if the jaws don’t fit well, it can move to one side and ultimately if left alone, it can create a more severe malocclusion. If there’s crossbite and there’s a deviation, it’s an indication to do something earlier.”
Some people may think waiting for orthodontic treatment until their children are teens, the traditional age for a “tin grin.” But Rossouw said that expanders can help fix and repair crowding issues. It can be difficult to predict if they will need braces. However, with a functional, widened palate, the chances are better that the patient won’t need braces. It may also improve issues with breathing, tongue position and speech.
Dentist Cynthia Wong, chairwoman of pediatric dentistry at Eastman Institute for Oral Health, encourages parents to seek screening for their children at a pediatric dentist’s office or an orthodontist’s office. Most orthodontists will evaluate potential patients for free without further obligation.
“Per the American Academy of Orthodontists and the American Academy of Pediatric Dentists, we recommend children are screened for jaw problems at age 7 at the latest,” Wong said. “I don’t think an orthodontist will see a child younger than that unless there’s a big problem. I perform a jaw evaluation at every appointment every six months. I detect many problems early. Some would benefit from receiving palatal expansion. Most children will get it once they start losing baby teeth at about age 8. It depends on what the problem is and how urgently we need expansion to happen. Some kids get it earlier; some later.”
A little after puberty, the palate completes the fusing process and palatial expansion is not possible.
“Once corrected, because both pieces are fitting, the upper and lower jaw will grow harmoniously,” Wong said. “It’s much more stable after palatal expanders. Otherwise, we can move the teeth and make it work. But I always talk about the teeth and jawbone are like the flower in the flowerpot. Plant it in the middle. It won’t grow as well if you have to move it from the edge to the middle after it’s grown.”