Today we will talk about Palate Expansion.

It is very important to know that we cannot expand the palate at any age in a simple way. The reason is because when we do an expansion of the palate we are moving the bones as well as the teeth. In adults, the bones cannot move easily because our growth has already finished and the bones are completely fused. In growing children we do not have these problems, so it will be much easier to carry out an expansion. The ideal age to do this type of treatment is around 7-8 years.

Contrary to what many parents think, it is better to start controlling bone growth and tooth replacement at an early age (Fig 1), since if an expansion had to be done, it would be easier than if we waited. To that the replacement of the teeth has finished or the growth of the bones is more advanced.

Narrow palate can lead to poor swallowing and / or chewing, deviation of the jaw to the closing of the mouth, poor speech or a very narrow passage of air through the nose favoring oral respiration. All of these examples of poor mouth function can lead to secondary problems such as tooth decay, abnormal growth of facial bones, increased tendency to snore or sleep apnea, and even severe pronunciation deficits.

Figure 1

Palate Expansion are short treatments, not at all annoying and are usually done with fixed appliances. When we place a fixed device we all live more quietly and avoid discussions at home.

If the appliance cannot be removed, the parents do not have to worry about the child putting the appliance on, and the children are calmer because they do not have to constantly think about putting on and taking off the appliance to eat. play sports or play with friends.

In addition, the fixed devices allow to make a more continuous force that results in a better expansion and a better quality in the final result of treatment.

Figure 2

The normal operation of this type of apparatus consists of the following steps:

• We took a scan of the patient’s mouth to send it to the laboratory (figure 2).
• A week later, Dr. Joan Rossell placed the appliance with a special cement so that it would resist the entire treatment time (figure 3).
• Activating the device must be done at home and is extremely simple. The usual schedule consists of 1 activation per day for approximately 28-35 days.
• Once all the activations have been carried out, the device MUST NOT BE ACTIVATED any more during the rest of the treatment. This must remain passive in the mouth, to settle the expansion achieved and not lose the changes. The retention period can last between 8-12 months. If we remove the device before we can see a loss of the expansion achieved.

Figura 3

The operation is so simple and works so well that many parents are surprised. Children tolerate it without problems and since the device does not have to apply practically force to carry out the expansion, they hardly notice any pressure. The first days it generates discomfort especially during chewing and swallowing. After 1 or 2 days, patients already begin to lead a more normal life and eat practically everything.

When the expansions are carried out in ages beyond 13 years of age we can find 2 different situations:

– The first situation would be very similar to the one we have explained, the operation is similar but the pressure felt by the patient is a little more intense. Normally it is a tolerable pressure that disappears in a few minutes

– The second situation would be one in which the device performs the expansion force but the bones do not yield to the pressure. This is when expanding in a conventional way can be counterproductive and we must look for alternative methods to achieve the proper expansion. The most common urgency in these cases is the sensation of pain when activating the expander. If this happens, it is important to contact the consultation to assess whether the treatment is working properly.

In summary, visiting children at the orthodontist from the age of 7 can help to detect if an expansion is necessary, which leads to better growth of the jaw bones.