Palatal Expansion at age 19

[Brutus]

I got braces at age 12 to fix an moderate overbite, ~6mm. I kind of wish I hadn't gotten them now, as they didn't really make my teeth look better. They removed the crowding, but I still have a 4mm overjet and my palate is somewhat narrow.

I have sleep apnea and have been mouthbreathing as long as I can remember. I understand that there's a lot of debate as to whether environment vs genetics causes crooked teeth, since people with a narrow palate are more likely to mouth breathe in the first place.

Doe anyone here have experience with palatal expansion as an adult? If so, did it help you breathe better?

[mrkdilkington]

Palatal expansion (e.g. SAPRE) will absolutely help reduce mouth breathing. The maxilla is the 'floor' of the nose, and widening it will directly widen your nasal passageways. In my case, my jaw surgery included a 3-piece segmented le-fort 1 osteotomy which widened my maxilla and eliminated the need for mouth breathing. You've made the right choices so far and you're in for a treat.

Regarding sleep-disordered breathing, obstructions and airway resistance can generally occur in three regions of the upper airway: nasal region, near the soft-palate, and behind the tongue. Your jaw surgeon will be able to determine which regions are 'problem areas' for you. It's likely for those with OSA to have issues in multiple regions. If you do have issues near the soft-palate and tongue, you may require maxillomandibular advancement surgery to address them, after your palatal expansion is completed. It's also worth seeing an otolaryngologist (ENT) that is specialized in sleep surgery who can diagnose airway issues as well. Otolaryngologists have a different set of procedures they use for sleep surgery, with pros and cons compared to corrective jaw surgery depending on your specific case. Let me know if you have any questions.

[Nozzelnut]

At 19 there's a decent chance you can get enough expansion with regular techniques; being more on the younger side of things. In some ways you're considered an adult, but for most medical issues you're still a "pediatric" patient. I'd ask your ortho about expanders; and I'd go that route before surgery, if at all possible. But, being young, there's less of a chance of permanent damage to nerves and a faster recovery if you did were a surgery candidate...

FWIW I wish my previous ortho (while growing up) had used expansion instead extractions. I might not be in the position I'm in right now.

PS wear your retainers! (It's a lifetime commitment.)

[DEV12345]

Look into the ALF appliance. It works wonders for adults. I would steer clear of any rapid palate expanders as they effect the cranial bones and breathing patterns in many negative ways. There are also options like Bioblock and other orthotropic appliances. Palatal expansion is absolutely a possibility after age 12.

[Metalmouth33]

I was a mouthbreather both before and after palatal expansion (had at age 23). I'm less of a mouthbreather now, but I still can't sleep without mouthbreathing. As far as I know I don't have sleep apnea, but I do require more sleep than most people I know.

I had a rapid surgical expansion, I'd have to agree with DEV12345. Try to avoid this route. There are negative side-effects, so you want to be sure before any surgery.