EXPANSION 101: Palatal Expansion vs. Dental Expansion – Fixing, Not Masking, The Issue

Hi, Bucks County! I’m Dr. Todd Welsh – your LOCAL Board-Certified Digital Orthodontist. Palatal expansion is a hot topic these days for multiple reasons. While expansion can improve airway function, make more room for teeth to erupt and aesthetically provide a wider smile, it should not be done solely for these reasons. Why? We don’t want to cause jaw issues to fix tooth issues.

Palatal expansion is an orthodontic procedure that widens the upper jaw (maxilla) to make jaw bones fit each other properly. As a byproduct, it often creates adequate space for teeth alignment and also improve oral function. However, not all palatal expansion methods are equal.

True Skeletal Expansion

True palatal expansion involves the use of a fixed expander that features plastic sides (see photo), which allows for more effective and controlled widening of the maxilla. This method applies force to the underlying skeletal structures as the plastic palatal pads exert forces on the actual palate to provide true expansion. When the expander is activated, it creates pressure on the mid-palatal suture, the joint between the two halves of the upper jaw. After a certain age, the joint starts to fuse making expansion more invasive, which is why expansion is recommended when children are younger, typically between ages 7-12, prior to the onset of puberty. This process facilitates an increase in the arch width and can lead to more harmonious facial development in patients where expansion is indicated.

Stability of Skeletal Expansion

One of the primary advantages of true skeletal expansion is its stability. Once the skeletal structures are expanded, the expander remains in the child’s mouth so the two halves of the upper jawbone can regenerate forming a larger palate. The upper jaw maintains its new width as new bone has formed and thus the jaw & teeth maintain their new positions more effectively than those achieved through dental expansion methods. This is particularly important for long-term treatment success, as stable skeletal changes reduce the likelihood of relapse, a common concern in orthodontics.

Alternative Methods

In contrast to true skeletal expansion, dental expansion primarily involves pushing the teeth towards the outer edges of the existing jawbone structure. This approach, often facilitated by braces or clear aligners, typically results in minimal changes to the width of the upper jaw. As a result, this alignment is often less stable and can lead to post-treatment relapse. Additionally, significant gum recession can occur.

Metal-only expanders and removeable expanders, though similar in design to fixed plastic and metal expanders, do not offer the same degree of skeletal expansion. They tend to exert forces that primarily affect the teeth, leading to a situation where the expansion is largely dental rather than skeletal. Without fully addressing the skeletal structure, the changes may revert after the removal of the appliance.

At BCO, we aim to fix the issue at hand. If palate expansion is indicated, we use a fixed expander with plastic pads, because it is a superior method for achieving significant stable skeletal changes in the width of the upper jaw. It is also more comfortable as the forces are distributed and not solely placed on the teeth.

Call or text our BCO Office to schedule your Free Consult with Dr. Welsh to find out if palate expansion is needed for your child. If it is not, your child will go into our complimentary BCO Kids Club where we will monitor their growth and tooth eruption & make going to the Orthodontist FUN!

 

Bucks County Orthodontics/ Todd M. Welsh, DMD

Board Certified Digital Orthodontic Specialist