Palatal Expansion

The American Association of Orthodontists recommends that every child have an examination by an orthodontist around the age of 7. In the orthodontic offices of Dr.Allen Garai (Board Certified Orthodontist), there is no charge for that examination. Most children will not need any treatment at that age, but there are some problems with the development of the teeth or with the growth of the mouth and the face that benefit greatly from treatment at the proper age. A problem frequently seen is a posterior crossbite, in which some or all of the upper back teeth are biting inside of the lower back teeth. This improper bite should be corrected early so that the remaining adult teeth can erupt into their proper position and so that the jaws can continue to grow normally. Some things that can cause a crossbite are: a narrow upper jaw relative to the lower jaw, upper back teeth that are angled inward or a narrow, tapered upper jaw caused by a prolonged thumb-sucking habit.

Expansion of the palate at an early age, often 7-10, is ideal to correct these problems. At this age, the upper jaw can be easily expanded because the right and left sides have not yet fused together, i.e. the mid-palatal suture has not closed yet. At this time, the palate can be expanded easily and comfortably with minimal force, resulting in a more ideal size and shape of the palate and the bone that holds the developing teeth. Proper timing is critical. Increasing age brings increasing interdigitation of bone within the midpalatal suture. In the preadolescent, the suture opens easily using a variety of orthodontic appliances. By early adolesence, considerable force is required to open the suture.  With some patients, as early as age 14, it may not be possible to open the suture and expand the jaw without surgical assistance, because the suture has already fused. Girls tend to have earlier fusion of the midpalatal suture than boys. For these reasons, an early, complimentary examination is very important.

In addition to correcting a posterior crossbite, there are other benefits from palatal expansion. Expanding the palate increases the space that is available for the remaining upper adult teeth as they are developing and erupting into the mouth. In some children who do not have enough space in the upper arch for their teeth, the developing adult teeth will be forced into adjacent teeth, possibly damaging them by causing resorption, or dissolving of part of a tooth or its root. Sometimes, the front teeth will look crowded or rotated, indicating a lack of space, but other times the crowding and misplacement of the teeth is seen only in an x-ray which our office will take without charge in the initial examination. Palatal expansion at this critical time can provide more space for the developing teeth to erupt more ideally and avoid any misplacement or damage. Another benefit of palatal expansion may be the widening of the upper jaw which can lead to a more attractive smile in adolescence and adulthood in some patients who have an upper jaw that appears quite narrow relative to the width of their smile. In some patients with a very narrow appearance of the upper jaw when smiling, palatal expansion is indicated.

For all of these reasons, and many others related to growth, Dr Garai recommends an evaluation of your child by age seven. Our office is committed to giving the best possible treatment to growing children. If your child has any problems in growth and development that would be improved by palatal expansion or other orthodontic treatment, it is important for you to be aware of the issues so that you can make an informed decision about any possible treatment. Just call our Vienna or Great Falls,Va orthodontic office for an initial examination at no charge, so that you will have the option to have any developmental problems ideally treated at the proper time in your child’s growth.