A palatal expander is a custom-made orthodontic appliance designed to widen the upper jaw (maxilla). It's typically recommended for growing patients because the mid-palatal suture, the cartilage joint connecting the two halves of the upper jaw, is still flexible in children and young teens.
The device consists of a metal framework attached to the upper back teeth (usually molars) with bands or bonds, and a central screw mechanism that gradually applies gentle pressure. When activated (by turning the screw with a special key), the expander pushes the two halves of the palate apart, stimulating new bone growth in the gap. This process is known as maxillary expansion and can correct issues like:
- Crossbites, where upper teeth sit inside lower teeth instead of outside.
- Narrow upper arches leading to crowding or impacted teeth.
- Breathing problems related to a constricted nasal airway (expansion can increase nasal volume and improve airflow).
- Asymmetric jaw development that could worsen over time.
According to the American Association of Orthodontists (AAO), early intervention with a palatal expander during childhood can prevent more complex problems later, such as the need for tooth extractions, prolonged braces, or even jaw surgery in adulthood. Dr. Basil specializes in orthodontics and dentofacial orthopedics, allowing him to integrate expanders seamlessly into comprehensive treatment plans that guide both tooth alignment and facial growth.
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The best time for expansion is typically between ages 7 and 14, when the suture is most responsive. In High Point, NC families often bring their children in for early evaluations around age 7, as recommended by the AAO, to catch these issues early.
How Does the Turning Process Work?
During the active phase, parents or patients turn the expander using a small key inserted into the central screw. Instructions are always customized. Some require one turn per day, others every other day, for a set number of weeks.
Each turn applies controlled pressure, creating a small gap (diastema) between the front teeth, which is normal and temporary. This space closes naturally once turning stops and the bone stabilizes.
Important note: Never turn the expander without specific instructions from your orthodontist. Over-turning can cause discomfort, uneven expansion, or other issues. If a turn is missed, do not "catch up" by doing extra. Resume the normal schedule and inform your provider.
At Basil Orthodontics, we provide clear demonstrations, written instructions, and support to make the process smooth for families in High Point and beyond.
Should I Keep Turning the Expander?
No, at this time, if you have not been instructed to continue your turns, you should stop and wait until your next appointment with Dr. Basil.
Many patients reach the end of their prescribed turning phase but aren't sure what to do next. Perhaps the scheduled turns are complete, or an appointment was delayed. Continuing without guidance risks over-expansion or complications.
Dr. Basil and our team at Basil Orthodontics monitor progress closely with regular check-ups. We assess expansion via exams, photos, and imaging to ensure the jaw has widened appropriately and stabilized. Stopping turns when instructed prevents unnecessary pressure and allows the new bone to form solidly.
If you're unsure about your child's specific instructions, call our High Point office right away, we're here to clarify and schedule if needed.
Is It OK to Leave the Expander in Place?
Yes. The expander is usually in for 9-10 months.
After the active expansion phase ends, the appliance stays in place for several months (often 6-12, averaging 9-10) as a retainer. This "holding" period lets the new bone mature and prevents relapse, where the palate might narrow again.
During this time, the expander remains fixed with no more turning required. Patients adapt well, and speech/eating normalize. Good oral hygiene is key: brush around the appliance thoroughly, use a water flosser or proxy brush for hard-to-reach areas, and avoid sticky/hard foods that could damage it.
At Basil Orthodontics, we see many High Point patients thrive during this phase, transitioning smoothly to braces or other treatments afterward.
What If My Child Was Due to Have It Removed During an Office Closure?
Please be patient and sit tight. A few extra weeks will not cause any harm.
Office closures, holidays, or unexpected delays happen. A short extension with the expander in place is safe and common. The holding period is designed to be flexible, and brief delays won't undo progress or cause issues.
Dr. Basil will evaluate at the next visit and determine the best time for removal. In the meantime, maintain excellent hygiene and monitor for any concerns.
What If It Is Causing Pain or Discomfort?
Please call our office and we will be happy to help you out.
Some mild discomfort is normal during active turning with pressure in the palate, nose, or teeth, temporary speech changes, excess saliva, or a small gap between front teeth. These usually subside within a few days.
However, if pain is severe, persistent, or accompanied by swelling, loose bands, broken parts, or difficulty turning, contact Basil Orthodontics immediately. We prioritize quick responses for High Point families to keep treatment on track.
Over-the-counter pain relief (like children's acetaminophen or ibuprofen, per dosing guidelines) can help mild soreness, along with soft foods and warm salt water rinses.
Additional Tips for Palatal Expander Success
- Hygiene: Clean the expander daily to prevent plaque buildup and irritation.
- Diet: Stick to soft foods during active turning; avoid gum, caramels, popcorn, and ice.
- Follow-ups: Attend all appointments, progress checks ensure optimal results.
- Signs of issues: Watch for loose appliances, persistent pain, or unusual gaps.
Palatal expanders are a proven tool for creating lasting, healthy smiles. When used correctly under professional care, they can transform bites, improve breathing, and set the stage for beautiful alignment.
At Basil Orthodontics in High Point, NC, Dr. Basil and our team are committed to making your orthodontic journey comfortable and successful. We serve patients from High Point, Greensboro, Winston-Salem, and nearby communities with personalized care, including braces, Invisalign, and advanced appliances like palatal expanders.
If your child has a palatal expander or you're considering orthodontic treatment, don't hesitate to reach out. Schedule a complimentary consultation today by calling (336) 882-111. We're here to answer questions, provide guidance, and help create the confident smile your family deserves.