A palate expander is an orthodontic device that stimulates the mouth and jaws to grow larger. Mouth expanders can be used to create more space so the teeth can fit better. More space helps with mouth breathing during sleep and nasal stuffiness. A benefit of of receiving expanders during childhood is that we can take full advantage of a child’s natural growth to prevent problems such as mouth breathing, mouth breather face and bad bites. Jaw expanders are usually used for kids to create more space so all the teeth can be straightened. Adult expanders can be used to treat sleep apnea and TMJ problems. The most popular adult expanders are Vivos appliances and Homeoblock devices.
How Palate Expanders Work
Expanders come in many different shapes and sizes depending on the condition that needs to be corrected. Often, jaw expanders are used in combination with braces, but the purpose of expanders and braces is totally different. Expanders are custom made to put light pressure in the direction the jaws need to grow. The tension at the interface of the teeth and jaw bones gradually grows the jaws to the desired shape. The expanders are worn only at night and do not hurt. The appliances look like retainers and are comfortable.
Correct Cross Bite and Mouth Breathing Treatment
Can you imagine breathing through that crowded mouth? Palate expanders are appliances that should work in concert with muscle forces and naturally present growth factors to develop beautiful smiles, proper facial profiles, healthy breathing patterns during sleep, and overall health. Not all expanders are created equal and there are at least 20 different kinds in common use.
As parents we always want the best for our kids. Things near the top of the list are straight teeth and overall health. But did you know they are closely related. A critical part of child development is proper growth of the mouth, nasal passageways and healthy breathing patterns during sleep. Palatal expanders can be very helpful in this regard. Some produce just cosmetic results, while others can correct cross bites, deep bites and mouth breathing problems.
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In this article, we review the different palate expander alternatives used by Dr. Adams at Maryland Holistic Dentist in Burtonsville Maryland.
Palate Expanders Before and After
Palate Expander Cost
The cost of a palatal expander depends on the complexity of the situation and how long the treatment will last. On the average palate expanders cost $4000 – $7000. The fee usually includes all the necessary X-rays, visits and adjustments of the appliance. Usually palatal expansion takes 6 – 9 months. Dr. Adams usually prefers to do removable appliances that are only worn at night. The chile will need to come in for check ups every 6 – 8 weeks.
Orthodontic Expanders Compare to Braces Video
Palate Expander Appliances Video
Braces Compared to Palatal Expanders:
Braces are for straightening teeth and the goal of maxillary expansion is growing the jaws to be the right size and shape. The optimal treatment in every case is to grow the jaws to be the proper size and shape and then align the teeth and bite. Often times teeth will become naturally straighter after expanders. Creating enough room for teeth to fit can allow teeth to fit without crowding or being crooked. Often orthodontics is necessary after expansion therapy, but in some cases an acceptable cosmetic result can be obtained with expanders alone.
Schwarz Removable Orthodontic Expander
The Schwarz appliance is one of the most versatile facial growth appliances available. Dr. Adams loves the Schwarz because it is only worn at night and only takes 6-12 months to complete expansion therapy. The appliance is a removable appliance worn 10-12 hours per day. The palatal expander should be put in after dinner and worn through the night. The Schwarz can be designed to promote growth of upper and lower jaws more forward, taller and wider. As the jaw bones grow, so do the surrounding facial bones and surrounding soft tissues such as lips, cheeks. The result is growth of the entire facial structures and the lower 1/2 of the face in particular.
When Does a Child need a Palate Expander:
- mouth breathing especially at night
- dry lips and swollen tonsils
- crowded crooked teeth. This is the physical evidence that the mouth and nasal passageways are not growing optimally and something needs to be done or else.
Dental Expansion with Invisalign
The most popular expander is Invisalign but most dentist do not know it can be used for dental expansion. Infact there is Invisalign for mouth breathing and Invisalign for correcting reverse lower jaw position.
Video Nose Breathing Compared to Mouth Breathing
Schwarz is a Custom Designed Removable Expander
The Schwarz can be custom designed to stimulate bone growth where it is specifically needed. The picture above shows an upper appliance that can be adjusted for forward and lateral expansion. Additionally the back teeth have acrylic covering them. This is called a bite plane. The “bite plane” is shaped purposely to control how the lower jaw rests on it. The bite plane is usually shaped to create a more forward resting lower jaw position. A forward bite position stimulates the lower jaw to grow forward. The upper Schwarz is most often coupled with a lower complimentary device.
The lower Schwarz only stimulates wider growth of the mandible. Schwarz appliances are very easy to tolerate and can be taken out during the day and during eating. The Schwarz appliance is Dr. Adams’ favorite appliances to correct crooked crowded teeth and night time breathing issues in kids. The end result of the treatment is more room for the teeth to fit, improved facial profile, larger mouth and nasal passageways, improved breathing and airway, and a larger nicer looking smile.
How do Expanders Stimulate the Mouth to Grow:
Palatal expanders work by placing light pressure in the direction where bone needs to grow. The natural action of muscles such as tongue pressure, cheek and lip movement will do the rest in most cases. Occasionally tongue and lip ties need to be released and myotherapy (tongue exercises) may be completed.
When a Tongue Needs to be Untied Video
The DNA appliance is an FDA cleared treatment for sleep apnea. The DNA is very similar to the Schwarz appliance and it works for adults using the same growth patterns. The AGGA is an adult growth appliance.
ALF Appliance
ALF stands for advanced lightwire functional. The ALF is a springy wire that stays in the mouth 24 hours a day and puts a constant outward springy pressure. The tongue pushes up against the wire creating natural expansive pressure. The wire can be custom made to fit around teeth that are in narrow spaces and crowded up against one another. Most of the time, the ALF will need to be followed by another expansive appliance once it corrects the severe crowding.
Twin Block for Controlled Anterior Growth
so called “Twin Block appliance” because the growth technique depends upon upper and lower appliances that work together. The lower jaw is guided forward because the upper and lower appliances come together only when the patient bites more forward. Using a forward bite to correct retrognathia is called functional orthodontics for some reason. The Twin Block was Invented by Dr. William. The Twin Block technique is well tolerated and has a high rate of success as long as the appliance is worn after dinner and through the night. The Twin Block design like the Schwarz allows for width and forward growth of the upper arch and width growth of the lower arch. The Twin Block may be a better choice than the Schwarz when more forward growth of the lower jaw is needed.
Crozat Lightwire Appliance
The Crozat expander is the sister appliance of the ALF. Very similar design the the advanced lightwire except the Crozat crosses from one side of the palate to the other in additon to spanning the back surfaces of the teeth. The Crozat uses the forces of the tongue to aid in expansion or growth of the jaw bone. The Crozat has a tendency to use a thicker wire than the ALF and it is usually used in cased where more expansion in the back of the palate is needed as compared to the ALF. Neither the ALF or the Crozat use a bite plate and therefore are not capable of much forward growth of the lower jaw or so called “functional” growth.
Hyrax Fixed Maxillary Expander
The Hyrax expander is the go to for many orthodontists. It only expands the maxilla. It also expands the back part of the mouth the same as the front. The Hyrax does a good job of arbitrarily growing the maxilla wider. And it does so at a very fast rate. The Hyrax is an example of a “rapid palatal expander.” All the above appliances are slow palatal expanders that are capable of growing the mouth in several different directions outwards and forwards. The above appliances also grow the mouth in a shape that respects and mimics the natural shape of the mouth or the growth pattern is intentional. Dr. Adams does not use rapid palatal expanders because he believes slower expanders produce a better result.
Myobrace Expander System
Myobrace palatal expander is a popular system because it is easy for the doctor to deliver care to the patient. Unfortunately while the system does promote some growth, it is not calibrated or calculate for any specific growth. most people who are treated require more expansion and orthodontic treatment after use of the Myobrace.
Consequences of Not Using an Expander?
Ultimately when the mouth, upper airway and the bite are not developed and optimized overall Health will suffer. Usually sleep apnea and tmj problems are just the start of the problems. Additional health problems related to poor sleep and sleep apnea are:
- thyroid and metabolic problems
- weight gain
- heart and cardiovascular disease
- tmd problems and teeth clenching
- obstructive sleep apnea
Palate expanders can help correct conditions including:
Cross Bite – when the upper jaw is too small and the lower teeth sit outside of the upper teeth. Also called over bite.
Deep Bite – when the lower is in a reverse position and bite well behind the upper teeth and into the palate. Also called under bite.
Mouth Breathing
Sleep Problems
Teeth Crowding – Teeth become crooked long before adult teeth grow into the mouth. We recognize when there will not be enough room in the mouth and use expanders to create space for larger permanent teeth. Widening the jaws can create space for all the teeth to fit without the need for removing teeth.
Impacted Teeth – when there is not enough space for adult teeth to grow into the mouth. The teeth literally get stuck under the roots of other teeth. Impacted teeth get stuck due to jaw crowding. Expanders creates room for impacted teeth to grow properly into the mouth.
