Upper Jaw Expansion

Overview of Upper Jaw Expansion

Upper jaw expansion treatment, also known as palate expansion, is an orthodontic procedure designed to widen the upper jaw when it is too narrow. The goal is to correct dental issues such as crossbite, crowding, or impacted teeth by creating more space for teeth and improving the alignment of the upper and lower jaws. The treatment is highly effective in children, although it can be used in teens and adults with more specialized techniques, such as surgical assistance.

What is Upper Jaw Expansion Treatment?

Upper jaw expansion treatment is done with palate expander, is an oral device used to gradually widen a narrow upper jaw. It is placed in the roof of the mouth, and through controlled tension, it separates the two halves of the upper jaw over time. This process is essential for aligning the upper and lower teeth properly and can even aid in improving breathing by widening the nasal cavity.

Expanders are commonly used in children, as their jawbones are still developing. In teens and adults, the same treatment can be applied, though in adults, it often requires surgical support since their bones have already fused.

For detailed information about maxillary expansion treatment, I recommend you to read the article Maxillary expansion: a meta analysis published in Clinical Orthodontics and Research.

Benefits of Upper Jaw Expansion in Children

One of the key advantages of performing orthodontic treatment, particularly upper jaw expansion, during childhood is the ability to leverage natural growth processes. The upper jaw, made of two separate bones, doesn’t fully fuse until after puberty. Early treatment can prevent future complications, such as severe crowding, misalignment, or even the need for more invasive surgical procedures.

Upper jaw expanders, such as palate expanders, are often recommended at early ages, when the bones are still flexible. This early intervention can shorten treatment time and reduce the need for complex orthodontics later on.

For more detailed information about orthodontic treatments at an early age, I recommend you to read my article Early Orthodontic Treatments.

Conditions Treated by Upper Jaw Expansion

Upper jaw expansion is recommended for a range of dental conditions, including:

• Crossbite (Narrow Upper Jaw): If the upper jaw is too narrow compared to the lower jaw, it can result in a crossbite, where the upper back teeth close inside the lower teeth instead of covering them like a lid.
• Crowding: When there isn’t enough space for permanent teeth to erupt properly, upper jaw expansion can create additional room, allowing teeth to align naturally.
• Impacted Teeth: In cases where a tooth is blocked from erupting by neighboring teeth, palate expansion can help create space for it to emerge on its own. This is often required for canines, which tend to be impacted.
• Breathing: Upper jaw expansion can also improve airflow in individuals by widening the nasal passages, facilitating easier breathing.

Types of Palate Expanders

There are several types of palate expanders, depending on the patient’s age, needs, and jaw condition:

• Removable Palate Expander: This type looks like a space maintainer and is used for mild cases where only slight expansion is required.
• Rapid Palate Expander (RPE): This fixed appliance attaches to the upper back teeth and uses a central screw to widen the palate quickly by 0.5 millimeters per day. It’s commonly used in children and adolescents, taking between three to six months to complete the expansion.
• Surgically Assisted Rapid Palate Expander (SARPE): In cases where the bones are already fused (typically in adults), a surgically assisted fixed expander is used. First, the palate expander is cemented in the mouth and then a surgical procedure called corticotomy is performed. This treatment is no different from a fixed palate expander (rapid palate expander) at an earlier age, except for the surgical operation.
• Implant-Supported Expander: This type is reserved for teens and adults. It applies force directly to four dental implants rather than teeth, which allows for more precise and controlled expansion in cases of fully developed bones. It can be combined with corticotomy surgery in patients with complete bone development.

How Upper Jaw Expanders Work

Palate expanders work by applying force to the upper jaw’s two halves, separating them gradually. As the palate widens, new bone forms in the space created by the expansion. This process usually takes between two to three months for children, though it can take up to a year for adults.

In children, the two halves of the upper jaw are not fully fused, making expansion easier. For adults, whose bones are fully developed, the process is more complex and often requires longer treatment times.

What to Expect During Upper Jaw Expansion

When using a palate expander, you or your child may experience mild discomfort for the first few days, particularly after turning the expansion key. Common side effects include:

• Temporary tooth or head discomfort.
• Increased saliva production.
• Difficulty speaking.
• Spacing between the front teeth, which will correct itself over time.

As the device remains in place after the expansion, this helps to stabilize the newly formed bone and ensure that the jaw does not shrink back to its original position.

Risks and Complications

While upper jaw expansion is generally safe, it comes with some risks and complications, especially in adults. These include:

• Longer treatment times for adults: Since adult bones are fully formed, it takes longer to achieve the desired expansion.
• Temporary side effects: Including mild pain, lisping, drooling, and headaches. These effects typically subside as the mouth adjusts to the appliance.
• Spacing between anterior teeth: Palate expansion can temporarily create gaps between the front teeth. This can be corrected with orthodontics.

Patients are also advised to clean their expanders daily to avoid plaque buildup, which can lead to a bad taste or odor.

The Importance of Early Treatment

Early treatment with palate expanders is important to avoid complex interventions, usually later in life. In children, upper jaw expansion can reduce the likelihood of tooth extractions and severe overcrowding. Additionally, expanding the upper jaw improves aesthetics, broadening the smile and contributing to better facial harmony.

Breathing is also improved as upper jaw expansion widens the nasal passages, making it easier for patients to breathe through their nose.

Conclusion

Upper jaw expansion is a versatile orthodontic treatment that can resolve many dental and skeletal issues. While the treatment is most effective in children, teens and adults can also benefit from advanced techniques like SARPE and implant-supported expanders. With the ability to correct misaligned bites, relieve crowding, solve cross-bite and even improve breathing, palate expansion plays a crucial role in orthodontic treatment.