Metal Mouth Message Board

My 14 year old daughter is supposed to be getting an expander on tomorrow, and she has been on line finding all kind of terrible stuff out! I need to know what is true, but don't have much time!
She is reading that a girls bones fuse on her upper palate by 13, and the dentist writing this page said he wouldn't use an expander on a girl over 13. If this is true and they put an expander in what can happen? Then, of course, there is the space that is going to appear between the two front teeth.
The appliance she is having put in isn't the rapid one, but the gentler one, will this make a difference? She is basically telling me to cancel the appointment, she would rather live with crooked teeth. UGH!!!! Please someone help me figure this out, tell me it worked great on you and your old(er than she is.)
I read the site she was on and it definatly looked like an expander was not the way to go in a 14 year old girl. WHY is it so hard to figure out what is TRUE???

One frantic mom

This is really something you should address with your ortho. If you are really uncomfotable with the treatment your daughter might be receiving, you need to speak up! I'm not a professional, so I can't speak about if an expander is supposed to be used on a 14 year old, but I know many people on this site have had expanders (myself included). It's been my understanding expanders are used most often on children because their bones don't fuse until late teens, but I could be wrong. Could you perhaps call the orthos office in the morning and see if he/she would be able to meet with you prior to the appointment?

Hi,

As an orthodontist I will tell you that the midpalatal suture can be fused by 14, but there are plenty of patients who will still nicely expand at that age. We use primarily rapid palatal expanders, but turn them more slowly in an older patient (ex 1 turn every other day) and keep a close eye on things. Observing the angle of the molars attached to the expander and a radiograph of the upper jaw (called an occlusal radiograph) can help determine whether a true palatal split is occuring.

You may also want to talk about why he's expanding. If a skeletal crossbite is present, I'd go along with your orthodontists advice. If it's simply to gain room for teeth, you may have other options.

I would certainly discuss your concerns with your orthodontist; I'm sure he'd be happy to discuss this to help you feel more comfortable with treatment.

My daughter had a palate expander at 13, and it worked great for her--she's got a nice broad palate now, and didn't need any teeth pulled with the braces. She was afraid of it at first, too, and definitely didn't enjoy it, but it was worth the hassle. Another kid we know had one about 13-14 and did fine as well. I would much rather use it than have teeth pulled...

I had a rapid palatal expander at 26, wore it for six months and we turned it maybe once a week - just very slowly. We didn't want a great deal of expansion, just enough to bring me gently out of crossbite.
I had no problems with my RPE, in fact, I actually missed it once it was removed - my tongue kept looking for it!

I think you need to feel comfortable with your daughters treatment, as does she - but if I could do this as a teenager and finish growing into my new smile (plus have Mom & Dad pick up the $$$), I'd go for it!

Good luck!

I agree with what everyone has said here. I have heard the same regarding the use of the expander, however, my ortho told us that he did not recommend them on kids older than 18, however, they can still be very effective on those who are older. There are many on this board who have had them and had great success. I know a 26 year old who has one right now and things are working great for her. If your ortho thinks it will be fine then I would trust him and go with it. Expansion is usually done very slowly (not rapid like mine) and kids adapt to the appliance far quicker and with less difficulty than adults.

I would say go for it! She will not regret it. My son has had a lingual arch, a pendulum appliance (which is very similar to the expander) and is now in full braces. This has all been done since he started at about age 12. He will be 14 in June and will be getting his braces off in May. His teeth look amazing and I can tell you he has handled the whole journey far better than I have (we were both braced the same day) He has said on numerous occasions that it really is not that big of a deal and that time has gone by very quickly. Tell her to relax, it will all be fine.

Brandy

I am 34 and have had my expander for 6 months. It has done its job beautifully and I will be bidding it a gleeful farewell next week. They can be anoying and a little painful at times, but overall they are not a really big deal.

I am not sure why some orthos insist that you can't use expanders on people over a certain age. There are plenty of us on here that have had success with them as adults.

Hey Gunter,
As I understand it (and actually I think there are mixed reviews on this) but supposedly the results from SARPE (surgically assisted rapid palate expansion) in adults are supposed to be more stable (less relapse) due to the fact that it actually forces new bone to grow and fill in the space. Thus it cannot go back to its previous state. Also in non surgical adult expansion, there is a tendency for the teeth to tip outwards as opposed to expanding/moving straight out, which does not happen when SARPE is performed. It also takes a lot longer to achieve the space with non surgical expansion as keying of the appliance must be done very slowly to avoid discomfort. Personally I'm glad I had SARPE. I was done expanding in 17 days, and my space closed up in about 8 weeks. All in all the whole surgery/expansion process only lasted for 3 months total. A friend of mine is having the exact same procedures as I only she chose the non surgical route. Her teeth are not attractive, they look tipped, and it makes her mouth look like she has horse teeth. She has even commented on how much nicer my teeth look then hers. She was afraid of the SARPE surgery but now she say she wishes she would've done it.
I have seen adults who have achieved great results without surgery though so who knows!

In kids though, since the palatal suture as not fused yet, it is my understanding that new bone also grows in this area. This is why most dentists like to get expanders in when kids are relatively young as its the least invasive for them.

Brandy,

Well said.

Dr. S

Thanks!

Brandy

Wondering if you went for the expander? If so how is she doing?

Interesting article on palatal suture here

http://ejo.oxfordjournals.org/cgi/reprint/23/2/105.pdf