Why? How? When? to use a rapid palatal expander (RPE)

Why a palatal expander:

An RPE is a great appliance that can be used in youth to correct some common bite issues.

• Crowding – Not enough room for all of the permanent teeth to erupt in an ideal position. The upper jaw sometimes is very narrow, contributing to not enough space.
• Impacted teeth – When there is not enough space, permanent teeth can become trapped and will not erupt ( come in ) without orthodontic help. Widening the upper jaw can create more space, giving teeth some more room to move.
• Crossbites – Upper teeth should fit over the lower teeth, like a lid on a jar. A crossbite happens when one or more of the teeth in the upper jaw are on the inside or inward of the teeth in the lower jaw. Expansion of the upper jaw puts these teeth where they are suppose to be.

How does a palatal expander work?

Once bands are placed, a mold is taken and an the RPE appliance is made for the patient. Once glued into position, a key is given and instructions are given on how to turn and how many times to turn.

The upper jaw has a suture dividing it. Before puberty, it is possible to expand the upper jaw and push this suture apart. The RPE needs to stay in place for a good 4 to 6 months because new bone will grow into the space created. Each turn widens a very small distance, but over time, the palate becomes wider.

When is the best time to use a palatal expander?

The orthodontist likes to work with children’s natural growth. After an evaluation and a treatment plan are put together, the orthodontist will consider tooth and skeletal development along with growth spurts to determine the best treatment time for children. The majority of malocclusion’s ( bite problems ) are easiest to treat before a child hits puberty.