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.
The connection to tooth decay and sippy cups is logical but yet it seems pacifiers and bottles get more of a bad wrap. Sippy cups were developed to transition from bottles to regular cups. When toddlers drink from these cups, they immerse the six front upper teeth in a drink that contains some sort of sugars. The convenience of these sippy cups leads children to sip on them throughout the day and all day long. This means sugars on the teeth for long periods of time which leads to the breakdown of enamel and cavities.
Even healthy juices and milks contain natural sugars that can decay these teeth. It is recommended that you give your child water throughout the day and only give other beverages at meal time. Like bottles, sippy cups should not be given when a child goes down for a nap or for the night. Sippy cups should be used as a transitional step for children, not as a long term solution for convenience.
This topic brings up a further point of getting young children to the dentist by 1 year of age. Pediatric dentists provide information on all topics for oral health care. Teaching parents important habits for their children and going over growth and development, an extremely important part of long term oral health. Dentists assess diet and feeding patterns that may contribute to tooth decay. Baby teeth are very important because they hold the place for permanent teeth and help guide them into correct position, so keeping these baby teeth healthy is very important.
We offer a free happy visit for children under the age of 3 years old if the child does not have dental insurance that covers regular check ups. Our pediatric dentists want to establish early care and prevention.
Click HERE for a link to Delta Dental and why they recommend your child see a pediatric dentist by the age of one!
A child may need a space maintainer due to the early loss of a tooth or teeth.
- Trauma has caused the early loss of a tooth
- Severe decay that has made the tooth nonrestorable
- an abscess has formed and the tooth must be extracted
- severe crowding is present and an orthodontist recommends an extraction(s)
Regardless of how a primary tooth has gone missing, it is important for the pediatric dentist or orthodontist to evaluate for a space maintainer. Teeth that are left without one will start to drift and possibly block out the permanent tooth below the gum.
There are both removable and fixed space maintainers. Our doctors prefer the fixed ones, so that they know they are placed securely for as long as needed. The location of the missing tooth and how many teeth are missing are the deciding factor in what type of space maintainer is needed. The patient is fitted and the appliance is sent to a lab to be made custom.
Space maintainers are cemented into proper position and children adjust quickly within a few days. Extra oral hygiene care is needed around the bands and your dental provider will go over these instructions. Space maintainers are checked at regular 6 month dental cleanings or at regular evaluations from your orthodontist. The doctors will let you know when the proper time to remove the space maintainer will be.
Careful manipulation of force that is used to guide the teeth into a new and improved position is what allows orthodontics to move teeth. Together, the cells of the ligament, cementum and bone continually form and reform in response to the normal forces of the bite. Compression causes resorption (melting away or dissolving) of bone and cementum. Tension causes the cells to respond by depositing bone and cementum. Teeth have ligaments made from fibers. These fibers join to the root surfaces that are inserted into the cementum and on the other side of the ligament, the fibers insert into the bone. The total ligament is like a hammock that allows teeth to move in their sockets and to respond to stresses of biting forces.
Wires provide a force as it interacts with each specific bracket. Each of your teeth has a different size and shape, and so do the brackets. Each bracket is custom made for the particular tooth on which it’s supposed to fit. Brackets have small slots where we insert the wire and small elastic ties fit around the bracket to hold the wire in place.Pressure at the bracket produces pressure and tension at the root of the tooth, causing remodeling of bone and tooth movement. Elastics are worn at some point during orthodontic treatment, connecting from upper jaw to the lower jaw and creating force as well. Brackets, wires, and elastics work together to move teeth over time to achieve an optimal bite and beautiful smile.
We often get calls to our office with worried parents about their child’s permanent teeth coming in behind their baby teeth. Shark teeth (compared to a sharks two rows of teeth) are most common with lower incisors. This happens much more then you think and is nothing to be worried about.
As children grow in their permanent teeth, they dissolve the roots of the baby teeth. Once the root is close to being dissolved, the baby tooth becomes loose. These loose teeth eventually fall out and the adult tooth grows in its place.
With shark teeth, the root of the baby tooth doesn’t dissolve quickly enough or the permanent tooth forms behind the baby tooth. Most of the time the baby teeth will eventually become loose and fall out on their own. With this space now open, chances are great for the teeth to self correct and move forward.
Sometimes these baby teeth do not become loose and need to be extracted. An x ray may be needed to determine if any treatment is necessary. If your child’s regular check up is close, just wait and bring it up to the dentist at this visit. If your child’s dental check up is a ways away and you have given the baby teeth time to become loose and they haven’t, call us for a quick check.
Have your child give this area extra attention while brushing. Two rows of teeth leave even more places for plaque to accumulate and gingivitis can easily start. Having regular check ups with your child’s pediatric dentist is always important for prevention and overall oral health.