"Turning" The Palatal Expander
Rapid Palatal Expander
We use "Rapid Palatal Expansion" to increase the width of a patient's upper jaw to match that of their lower jaw, to correct skeletal cross-bites of teeth and to create space in the upper jaw to allow for the straightening of teeth. We also use it to help correct mid-face skeletal deficiencies and to make breathing throught the nose easier. It's a common procedure that we use in about twenty percent of all the patients we treat.
First, the "Palatal Expander" is cemented onto several teeth. Then a "key" is used to turn a jackscrew in the appliance to carry out the widening. (The upper jaw is usually overexpanded to compensate for any relapse after the "Palatal Expander" is removed.) During the expansion, we keep close track of our patient's progress. When their upper jaw reaches the proper width, we "freeze" the "Palatal Expander". Then we check our patient once a month to make sure that everything is as it should be. And at the end of two or three months, our patient is ready for either a "retainer" or "braces" - while the new bone is given a chance to mature.
THE DOs AND DON'Ts OF "RAPID PALATAL EXPANSION"
Before "Turning" The "Palatal Expander"
It is necessary to check that the "Palatal Expander" has remained secure on all of the teeth it has been cemented onto - each time before "turning". If it is loose, it should not be "turned" until it is first re-cemented. Contact us as soon as possible.
We instruct our patient and whoever is "turning" the "Palatal Expander" in the correct and safe way to do "turns" when the "Palatal Expander" is first cemented in place. The "Palatal Expander" should be "turned" as directed - with the following exceptions:
*The "Palatal Expander" is loose. If it is loose and "turned", it may slide off of the anchoring teeth and we may not be able to re-cement it properly. Don't "turn" the "Palatal Expander" - call us
* A great deal of resistance is felt when "turning" the "Palatal Expander". We don't want the "key" to bend or break and get swallowed - skip a "turn". If the resistance has not let up by the time the next "turn" is due - notify us
* The patient is feeling too much pressure to feel comfortable with an additional "turn". Skip a "turn". If the patient should need to miss two "turns" in a row because of discomfort, we should be contacted so that we may see if everthing is okay
Patients usually feel pressure on their teeth and face for about one minute after each turn of the "Palatal Expander". When ten to fifteen "turns" have been completed, a space between their two upper middle teeth will develop. This space occurs when the palatal bones start to separate and will get larger with each "turn". After the bones have separated, very little pressure is felt with successive "turns". About three weeks after the turning has been completed, the teeth will start to move back together as new bone fills in between the separated palatal bones.
Loose and/or Broken "Palatal Expander"
Our patient or someone in the patient's family must check daily to see it anything has become loose or has broken parts (even after the turning has been completed). If something does become loose or broken, we should be notified immediately. This will allow us to fix it promptly - before anything gets swallowed or any other problems develop.
Speech and Chewing
It takes time for a patient to become accustomed to a "Palatal Expander". During the first few days that the "Palatal Expander" is in place, an increase in saliva is very likely and speech may become "sloppy". The patient may also find it difficult to eat. These problems ease with time.
Foods that are very sticky, hard or chewy such as gum, taffy, caramel, ice, bagels, etc... have to be avoided. They may loosen and damage the "Palatal Expander". Pizza and peanut butter are as sticky as allowed.
It is very important that the "Palatal Expander" and all teeth are kept clean. It's easy for food to become trapped and cause inflamed and painful gums that bleed easily. Brushing should be thorough but gentle. Warm rinses will help to keep things clean and stop swelling and bleeding.
As mentioned, good patient hygiene and warm rinses will help relieve any soreness and minor swelling that occurs. And soft foods make chewing more comfortable. From time to time, a mild analgesic may be necessary.
"Rapid Palatal Expansion"
THE ABCs OF "RAPID PALATAL EXPANSION"