Much Confusion on Adult Palate Expansion

[Hendrickx]

Hi all,

I am curious to hear if anyone on this board has had a palate expander as part of their ortho treatment WITHOUT having the sarpe surgery?

I had braces as a teenager but never had a palate expander, even though I definitely should have since I have always had a narrow palate.

I recently signed up for ortho treatment again in May at the tender age of 26 and as part of the treatment I just had a palate expander placed three weeks ago. The orthodontist told me my teeth would need to be expanded 4-6mm to correct the narrow bite and a crossbite. For the first week with the expander I turned the screw once per day, and for the past two weeks I have turned it once ever other day.

I am confused because I have read conflicting information regarding this palate expansion in adults. Some research states that the palate expansion can be successful if the treatment is done slowly(which mine has been at only once every other day), and some research states that it is very risky and can result in the teeth being uprooted/bone being damaged.

Can anyone bestow your wisdom on my regarding this subject? I have definitely noticed my upper teeth have widened, but I have no gap between the front teeth like many others have stated, so apparently my teeth are shifting, rather than the palate; however, I have not experienced any extreme pain that would be indicative of teeth/bone being damaged.

Thanks again for anyone who can help.



**I moved this topic from the "orthognathic surgery" category as I realized it probably wasn't as relevant in that folder, hence the lack of replies or views.

[invisagirl]

Well I can just tell you what my ortho told me about palate expanders when I asked. I was told that they don't widen the palate in adults but they do move teeth that were toward the tongue like this "\" and get them like this "|"

[cbraces]

Hi all,

I am curious to hear if anyone on this board has had a palate expander as part of their ortho treatment WITHOUT having the sarpe surgery?

I had braces as a teenager but never had a palate expander, even though I definitely should have since I have always had a narrow palate.

I recently signed up for ortho treatment again in May at the tender age of 26 and as part of the treatment I just had a palate expander placed three weeks ago. The orthodontist told me my teeth would need to be expanded 4-6mm to correct the narrow bite and a crossbite. For the first week with the expander I turned the screw once per day, and for the past two weeks I have turned it once ever other day.

I am confused because I have read conflicting information regarding this palate expansion in adults. Some research states that the palate expansion can be successful if the treatment is done slowly(which mine has been at only once every other day), and some research states that it is very risky and can result in the teeth being uprooted/bone being damaged.

Can anyone bestow your wisdom on my regarding this subject? I have definitely noticed my upper teeth have widened, but I have no gap between the front teeth like many others have stated, so apparently my teeth are shifting, rather than the palate; however, I have not experienced any extreme pain that would be indicative of teeth/bone being damaged.

Thanks again for anyone who can help.



**I moved this topic from the "orthognathic surgery" category as I realized it probably wasn't as relevant in that folder, hence the lack of replies or views.

Hi there, I do have eight years experiance in the ortho/surgery field. I will give you some of my knowledge.

My boss has been an orthodontist for 31 years. He is very well know for his finished cases. When an adult comes into our office with a norrow palate and crossbites they are required to have surgery becaue the upper jaw is made of 2 bones when your growth has been completed the 2 jaws bones fuse and become one. (when a teenager develops facial hair that is our cut off for expansion with a screw) and they become a surgery case. The surgery case will be a more stable result.

But remember your palate is narrow for a reason. At night you probibly breath through your mouth at night time, and your mouth probibly is wide open. Therefore if you do not wear a retainer at night time once your treatment has been completed that you are at a high chance of your palate relapsing and becoming narrow again.

If you have any further question please ask. Hope I was of some help!!

[jaws]

Yes, I have also heard that it is not possible to actually expand the palate as an adult. Instead, expansion devices 'tip' the teeth outwards to create a wider arch. (someone correct me if I'm wrong!).

I am also the 'tender' age of 26, and I have had an upper palate expander for 4 months now (without SARPE surgery), and my arch has definitely widened. Here are some pics:

BEGINNING OF TREATMENT:



3 MONTHS LATER:



(click on the images to make them bigger)

[jaws]

Ha ha! Thanks Meryaten! My ortho is surprised at how quickly my top arch has expanded...now if I could just get the bottom arch to catch up...

[Hendrickx]

My boss has been an orthodontist for 31 years. He is very well know for his finished cases. When an adult comes into our office with a norrow palate and crossbites they are required to have surgery becaue the upper jaw is made of 2 bones when your growth has been completed the 2 jaws bones fuse and become one. (when a teenager develops facial hair that is our cut off for expansion with a screw) and they become a surgery case. The surgery case will be a more stable result.

But remember your palate is narrow for a reason. At night you probibly breath through your mouth at night time, and your mouth probibly is wide open. Therefore if you do not wear a retainer at night time once your treatment has been completed that you are at a high chance of your palate relapsing and becoming narrow again.

If you have any further question please ask. Hope I was of some help!!

Thanks for the info, Cbraces. It seems like the prevailing opinion is that adults should have the sarpe surgery before or instead of the rapid palate expansion.

I have already had this rapid palate expander for about one month now, having turned the screw once a day for a week and every two days for the last three weeks(not nearly as fast as the 1-2 times per day for kids). I have another week or two of turning before I am done, and I will have had about 4-6mm of space opened up.

My concern is what I have read about an increased chance of tooth loss from having this expansion done in adults. However, I have also read that if this procedure is done slowly, which mine has been, then the risk is small.

This seems to be an area where a lot of orthodontists can't seem to agree.

[shinyam]

I was also very concerned about this issue, and did a lot of researching. The reports are conflicting. Some say that it shouldn't be done at all in adults without surgery, others say it's fine.

I have been wearing an expander for almost a year now, with no pain or other side effects. I can only hope that things work out.

[Chaim9778]

Check the 'Ask the Doc' forum. I'm sure one of the orthos who help with this site addressed this question a while back. I think he said that your jaw does not expand as an adult, only the teeth can be moved not the bone structure. I had to wear expanders for 9 months on top and bottom but I didn't have the key, they had a spring in the middle that spread them apart slowly. It worked a bit, my palate is still narrow, just not as prounounced as before.

[CelestialVoices]

I will be getting an expander and my ortho said nothing about surgery (athough I didn't ask him either because I didn't think about it)

[decisionmade]

I had very successful surgically assisted rapid palate expansion surgery (SARPE) and am 34. The expander has done its job and I am happy with the results! From all my research I would not have even attempted expansion without it for all the reasons already stated.....I've documented my journey in "my stories"..Best wishess to all!

[airxjordan24]

so what's the verdict on this? I am 21 years old and have had the RPE in my mouth for about 4 days now. I turn the key once a day. I did not have the surgery and my doc did not mention anything about it.
So can the expander be used without the surgery? This thread wasnt really clear on it

[Raspberry]

My Orthodontist told me that Palate expanders are "Not for adults" when i asked him about the differing treatment plan from the other Dentist/Orthodontist that I had a consultation with.

This may just be his opinion. The orthodontist that wanted to use a lower palate expander as part of my treatment told me that there are two different schools of orthodontia, one who believe in pulling teeth to make room in adults, and ones who believe in preserving the teeth with the use of expanders. Surgery was never mentioned in regards to the expander.

i'm not really sure what to think about this issue. I picked my current orthodontist because he was very highly recommended by everyone I'd asked.

[jaws]

I agree that orthodontists just seem to differ on this issue. I do think that it's pretty much agreed upon that you can't actually expand the palate in adults without surgery. However, some orthos like to pull teeth to make room, while others like to 'expand' things dentally, by tipping the teeth outwards. I think the 'correct' option really varies from case to case.

My ortho is using a procedure on me called 'Controled Arch', which involves top and bottom 'expanders' (more like lingual arches). I have not had any extractions. The orthos on this site have said that I might have problems with retention once the braces are off, due to my ortho 'expanding' my arches by tipping my teeth outwards. However, my ortho seems to think that things will be fine. I guess only time will tell.

Here are some updated pictures:

Before Top:



Top After 10 Months:



Before Bottom:



Bottom After 10 Months:

[toothsday]

Hi I'm doing my research looking into lingual braces and Palatal expansion without surgery assistance. I see this thread is years old- would be so interested to hear how successful anyone's been with their palate expansion- or any issues that have been had? I would be willing to wear retainers at night til the end of time. I'm 21. Thank you for any responses!! Extremely grateful.

[Jborders12]

Hi toothsday,

I had extreme top crowding, to the point where both of my lateral incisors was pushed completely behind my front teeth and canines. I was 22 when I went to the ortho for first time and during my consultation told me that they were uncertain if using the rapid palatal expander will work due to my age. I wasn't fond of the idea of surgery, so I agreed to the process if it needed to be done.

The RPE was placed on and began the treatment. I had it on (without braces) for 4 months and expanded it once or a twice a week depending on my progress. At the 4 month mark, I had all four bicuspids extracted (top + bottom) and braces put on (all on the same day!). I had the expander on for another year after that, although I stopped cranking it about 6 months after the braces were on. I've had the expander off now for about 8 months and my braces come off altogether in 2 weeks.

Hope my story helps a bit!