The Importance of Early Expansion

Early expansion is a preventative orthodontic treatment aimed at widening the upper jaw (maxilla) to improve dental alignment, facial development, airway health, and overall oral health. This treatment is especially beneficial when started at a young age, as it takes advantage of the natural growth and development of a child’s jaw.

Different Types of Expanders

There are various types of expanders designed to address different orthodontic needs:

1. Fixed Palatal Expander: This appliance is used to widen the jaws by applying gentle pressure on the molars each time an adjustment is made. Parents are coached on how to make an adjustment using a key that turns the appliance. The number of turns and frequency of adjustments is dependent on each unique treatment plan.
2. Removable Expanders: These appliances function similarly to fixed palatal expanders, but can be taken out for cleaning and eating. It is important to note that progress may take longer and is not as predictable as the fixed palatal expanders.
3. Palatal Bars: In some clear aligner systems, a palatal bar widens throughout the course of treatment, which encourages palatal expansion in adjunct to teeth alignment.

Who is a Good Candidate for Early Expansion?

Early expansion is most effective in children whose jaws are still developing. Ideal candidates include:

• Children with Crossbites: When the upper teeth fit inside the lower teeth, indicating that the upper jaw is too narrow.
• Children with Crowded Teeth: Lack of space for all the teeth to fit properly in the dental arch.
• Children with Breathing Issues: Those who experience mouth breathing, snoring, or sleep apnea due to a narrow upper jaw. This often includes children who breathe primarily through the mouth.
• Children with Impacted Teeth: When teeth are blocked from emerging due to lack of space.
• Children with Narrow Palates: Measurements can be taken to check if your child’s palate is too narrow. 

The Expansion Process

The process of dental expansion is straightforward and involves several key steps:

1. Initial Consultation: Dr. Nora will assess your child’s dental and oral health to determine if they are a good candidate for expansion. If your child is a good candidate for expansion and you would like to move forward, records will be taken for the custom fabrication of the appliance. These records include a cone beam CT scan (CBCT scans are used to visualize the airway health of the patient and ensure that there are no concerns needed for further treatment), digital impressions, intraoral photographs, facial photographs, and posture photographs.
2. Placement of the Expander: Once the appropriate expander is selected, it will be custom-fitted and placed in your child’s mouth. Dr. Nora will provide detailed instructions on how to make adjustments and maintain the expanders.
3. Monitoring Progress: Regular follow-up visits will ensure the expansion is progressing as planned. Adjustments may be made during these visits to ensure optimal results.
4. Retention Phase: After the desired expansion is achieved, a retention device, such as a retainer, may be used to hold the new jaw width in place until the bone solidifies and stabilizes.

Benefits of Early Expansion

Early expansion offers numerous benefits that can significantly impact a child’s oral health and overall well-being:

1. Improved Dental Alignment

• Reduced Need for Extractions: Creating more space in the dental arch reduces the likelihood of needing tooth extractions in the future.
• Proper Tooth Eruption: Ensures that permanent teeth have enough space to emerge correctly, reducing the risk of impaction or misalignment.

2. Enhanced Facial Development

• Balanced Facial Structure: Proper jaw alignment contributes to a balanced and harmonious facial appearance.
• Correct Bite Function: Improves the bite, reducing the risk of long-term issues such as jaw pain and improper chewing. This is also important for optimal speech development.

3. Better Breathing and Sleep

• Improved Airway: Widening the upper jaw can enhance nasal breathing and reduce the likelihood of mouth breathing, snoring, and sleep apnea.
• Overall Health: Better sleep quality leads to improved overall health, cognitive function, and behavior in children.

4. Boosted Self-Esteem and Confidence

• Aesthetic Benefits: Early expansion can result in a more harmonious smile and facial profile, boosting your child’s self-esteem and confidence.

Important Things to Know About Expansion for Children

• Comfort and Adaptation: Initial discomfort or pressure is common but usually subsides as the child adapts to the expander.
• Compliance: Most expansion devices require patient compliance. Whether the appliance needs to be fitted, adjusted, or bonded to your child’s teeth, this can only be properly done if the patient can sit through the procedure.
• Oral Hygiene: Maintaining good oral hygiene is crucial. Special care should be taken to clean around the expander to prevent plaque buildup and cavities.
• Dietary Adjustments: Certain foods that are sticky, hard, or chewy should be avoided to prevent damage to the expander.