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Orthodontist - Tell me about expanders


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My oldest had a dentist appt today, and he recommended an orthodontist for "early intervention." My son's baby teeth were a little crowded, so we fully expected that he would need some help once the adult teeth came in.

 

Can someone explain expanders to me? (We haven't consulted the orthodontist yet, but the dentist indicated that this would be the likely course of action.) When I was a kid, my teeth were crowded so they pulled some permanent teeth. Why isn't this still practiced?:confused: I'm started to wonder if this is a money scheme am tempted to find someone to pull some teeth instead. But I know nothing about expanders except the name. Can any of you enlighten me?

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Not sure exactly what type they will use, but some are placed on the roof of the mouth and then tightened every now and again. They are called Palate Expanders. It gives more room in the mouth.

Most orthos and dentists realize there are healthy advantages to not removing teeth, so they try to avoid it.

I don't find it a money scheme.

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Years ago, my daughter had an upper and lower expander. For the upper expander, I had to use a key to crank/turn it every night for a week and then the orthodontist glued that setting and it stayed in place.

 

My girlfriend drove her son to the orthodontist every day to have them use the key. I thought it was easy to do myself.

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There are different types of expanders. My ds has a "special" one, which is adjusted occasionally by the orthodontist. I forgot what it's called. He has always had a messed up mouth and we knew this time would come. He actually looks forward to getting braces, though that's a few years off (he's only 9). He'll have the palate expander for about 9 months and then a retainer for a year. Then there will be some time before he gets braces.

 

Ds is very sensitive to just about anything, so I've been pleasantly surprised that he hasn't complained a bit about the expander (knock on wood!!).

 

I'd much rather widen the mouth than pull teeth.

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I had permanent teeth pulled before my orthodontia. Both our dentist and DS's current orthodontist have told me they don't do that anymore because it tends to produce a less than optimal facial profile.

 

DS is 10 and has been in braces for about a year and a half now. He should be completely finished in another 6-12 months. He had the upper palate expander for about 8-10 weeks when he first started, and it was no big deal. The expander attached to two teeth and sat close to the roof of his mouth. I turned a crank with a key on a set schedule that they provided. He said after we turned the key it felt tight, but never really hurt. We've had very good results with his orthdontia so far. The hardest part of having the expander was (1) food got stuck between the expander and the roof of his mouth, so he had to brush with a special tool after each meal; and (2) it gave him a slight lisp while talking for the first couple of weeks.

 

I don't find it a money making scheme at all. I'd much rather do this than oral surgery, like what I went through.

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I think expanders are sort of a fad. It seems every kid who needs braces these days is starting with a palate expander. They are useful for some kids and not appropriate for others, but some orthodontists use them on every kid with crowding. We saw 1 Dr who wanted to put an expander in my son's mouth. It would have been a long and expensive process. We were not given any other options and assumed that we would proceed with that plan. We moved before it could be placed and saw another orthodontist (a much older guy) and he told us that we should just pull teeth. Our son's jaw was so small that he would need twice the maximum amount of space an expander could create. He said he tried it with his own son and ended up having to pull the teeth anyway after a lot of pain and hassle. If your son only needs a little space, then I think the expander may be the best route, but if he needs a lot of space, you might want a 2nd opinion. I trusted the 2nd opinion more because pulling teeth is cheaper and he looked at the teeth of my younger kids who just happened to be there waiting on their brother and he told me that they would not need any orthodontic work.

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We so far have had 3 kids get palate expanders. (We are a family of narrow-jaws, unfortunately for us, LOL.) My second son was the first. He had adult teeth coming in WAYYY above the gum line because there was just no room. We turned the expander key each night for several weeks, like a previous poster mentioned, and then that last setting was glued into place for awhile more. It was amazing to watch the high-up teeth just drop down into place!

 

I also had a bunch of teeth pulled as a child, so I had the same thoughts as you. And to some degree--I still wonder. I mean, I never have had any problems with my missing teeth . . . but anyhow, for whatever reasons, they just don't pull teeth to make room anymore, it seems, and the expanders do work tremendously well. The main annoying thing, other than the cost, is this vacuum-sucking noise the kids make to clear stuff that gets stuck up there. Blech! And they make more saliva and sometimes talk less distincively.

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DS7 has a cross bite, he will get an expander on in the next year. Afterwards they are discussing a some type of retainer until he gets braces when he is older. From experience with my other children it is easier to move things around when they are little, then they are in braces for a shorter period of time. I would prefer to move things around when possible over pulling teeth. Second and even third opinions can be helpful when evaluating course of treatment.

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We're in the middle of this right now. I did get two opinions and they both said the same thing. So, he had spacers put in first. Those were like rubber bands that stuck between his teeth. They stayed in for a week. Then he was fitted for the appliance. The spacers went back in once the appliance was ready and after a week of spacers again, the expander was attached. Like others have said, you will turn a key every day to create the expansion. To be honest, the first two days were AWFUL. He cried. I cried. It only hurt for a few minutes after I turned, but that turn was painful. Make sure you have someone to hold a flashlight for you and aim it right at the keyhole. It helps a bunch. After that it was a piece of cake. Now, it is glued in place until after Christmas. It does annoy him when food gets in there, but good brushing habits will help fix that.

I was skeptical at first also. My DS was 7 when we started. However, we had dinner with a good friend who has only met my DS 2x. He took one look at him and suggested the same treatment. Ryan was in between spacers at the time and our friend didn't know we had already started the treatment. The friend is a retired dentist!

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We decided not to go with an expander for our two children in braces.

 

Basically they break apart the semi-fused bones on the top of the pallate (this fissure then fills in with new bone - much like any other 'broken' bone would.) These are the bones that fuse when a baby's soft spot closes.

 

Side effects can also include a lisp (usually temporary) and a slight change in facial features (widening of the nose.)

 

We got several opinions from different orthodontists, and we went with the one who said he could do it w/o an expander. My daughter got her braces off last year and her smile looks lovely. My son is 1/2 way through his braces, but things are looking good so far.

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Not sure exactly what type they will use, but some are placed on the roof of the mouth and then tightened every now and again. They are called Palate Expanders. It gives more room in the mouth.

Most orthos and dentists realize there are healthy advantages to not removing teeth, so they try to avoid it.

I don't find it a money scheme.

 

:iagree:This has been our experience. I had teeth pulled that I really miss at this point in my life. My kids won't have that experience.

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My dentist gave us two orthodontist to get opinions from. The first one wanted to put an expander in that would remain in place and put braces on at the same time.

 

The second, which my dentist said was the best for crowding and cross bite problems, wanted to do an expander first then braces. This expander looks like a retainer that she removes from her mouth and turns with a key twice a week. I like that option since she can remove the retainer to scrub it.

 

I am glad she is keeping all her teeth and I like the her face.

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I had teeth pulled when I was young for braces. Now with all the new technology, teeth can be saved and not pulled needlessly. That is what the expander will do and it does work. My second son had an expander and it has done wonders for his teeth.

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My older two had crossbites that were corrected with palate expanders. Dd had hers along with brackets on the top teeth for around 6 months, then top brackets again about 18 months later. Ds had the expander only and has not needed additional work. Neither had problems with the expander, even ds who is typically sensory-sensitive.

 

I had 8 permanent teeth pulled to make space in my small mouth along with 3 years of braces. I would have loved a palate expander instead and am glad my kids have had that option.

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My ortho gave us a choice. I had the perm teeth pulled when I was a kid (same crowded mouth) and never noticed a difference. I asked him the pros and cons, and he just said that some people don't want to lose the healthy teeth, and sometimes the expander gives a "wider" smile.

 

My dd happened to be super afraid of the dentist at that time, and also the biggest whiner ever. I didn't want to face the next year or whatever cranking that stupid thing. There was also the expense.

 

We went with having the perm teeth pulled. I was really happy ortho didn't try to pressure us and just gave us honest options.

 

ETA, DD and I both had 4 perm teeth pulled.

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Expanders are HELL and awesome.

 

Hell? Because they hurt. And you have to crank them. It can be difficult--you need to make a full turn or you can't place the pin in...you'll understand later.

 

Awesome because they work fast, and my girls teeth are already a gazillion times better and they've only had them about 6 weeks. It's freaking amazing.

 

 

It's all also VERY expensive, so just make sure you have some good wine at home, because it may be the last you get. ;)

 

My girl's teeth were *horrible* Their palate was a triangle and they had a huge over bite.

 

Last week the Dr put the first of the braces on (with the expander) and they're already looking beautiful.

 

Please don't get her teeth pulled, it's not a money making scheme, it's actually very helpful and gives them a perfectly shaped palate that gives the teeth room. I can't imagine pulling instead of just getting the expander.

Edited by justamouse
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My dd was in Damon braces, they expanded at the same time that they straightened. The first two orthos planned to pull 4-6 adult teeth, have her in braces with headgear for 2-3 years, then have her in retainers for another 5-6 years.

 

The ortho we ended up using said that he could do with a maximum of 2 adult teeth pulled (actually didn't pull any teeth) and without headgear. SHe was in her braces for 2.5 years. She will have to wear her retainer full-time for 6 months (3 months left) and then can switch to wearing it just at night.

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My DD had a hyrax put in when she was 9 years old. 11 years ago, I had never even heard of it, but it seems to be SOP these days.

 

She needed one because her upper palate was too high and it caused her difficulty with breathing while she ate, and she snored something fierce because of it too.

 

She had it on for about 8 months, then full braces for two years. It was worth every penny.

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DD12 just got her expander and braces. Unlike everyone else, we don't have a key to turn. It gets adjusted by the dentist every 6 to 8 weeks when they adjust the wires on her braces.

She got expanders on top and bottom and braces on top. The bottom braces will be put on in about six months. We had to have the bottom expander taken off. She's tongue-tied, and it caused a major problem immediately. The ortho said we could either have an oral surgeon clip the frenulum or he can try expanding her bottom jaw with just the braces. DD wanted the latter so we're expecting her to be in braces for 2 1/2 to 3 years now. Her teeth are really bad...we pulled baby teeth to make room for adult teeth that couldn't come in, adult teeth that took 4 years to come in and finally erupted above/below and in front of other teeth, and a 75% cross bite. Her teeth attract plaque like crazy, in part because she's tongue-tied and can't run her tongue along her teeth like we do without thinking; I worry about her teeth surviving braces that long.

 

If I had a second chance, I would insist her frenulum be clipped as an infant. They used to clip any tongue-tied infant's frenulum at birth but now they only do it if it interferes with birth. It's such and easy thing when they are young (I know because DD3 needed hers clipped) and so much more complicated when they are older.

 

 

DS10, on the other hand, has a bionator. That's the modern day equivalent of head gear. They are using it to correct his 90% crossbite. That's so bad that his bottom teeth actually dug into his upper palate and left indentations up there. Without correction, it could break the skin and cause infections. He'll get braces later.

Edited by joannqn
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Dd1 had a crossbite, and thus had an expander. I think it was a butterfly -- no key to turn. She got the braces years later from a different ortho in a different town, and had them for a total of 16 months.

 

Dd2 had severe crowding, so had a penguin expander -- no key. Currently in braces. We expect it the braces to be on about 18 months.

 

Neither has had permanent teeth removed. Once teeth are pulled they are GONE. As I'm getting older and older I'm realizing how fragile our teeth are -- the old fillings fall out, molars crack, root canals happen -- it's really important to hang on to all the teeth you can while you're young.

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Dd had a expander at age 8. Just like pps described you turn it every night until the ortho says to stop. And you leave it a while. Worked great. A couple years ago ped dentist said we could think about stage 2 braces. She has crowding,but he said it was not essential to address. So, we've opted not to. so, if you do the expander you may or may not need stage 2.

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Ds16 got an expander when he was 7 yrs. old. The ortho at that time said it gave ds a 25% chance of not needing braces when he was older. Unfortunately, my son didn't fall into that lucky percentage. He got braces last January and will be in there for a total of 2.5 yrs. because of all the crowding issues. I wish I had pursued braces at a younger age but I was clueless. I think earlier would have prevented the problems he has now that require him to have braces. Oh, and our ortho. did not recommend pulling healthy teeth when they could be corrected with the braces. We felt comfortable with that recommendation.

 

I definitely recommend more than one opinion though. Finding the right doctor that you feel comfortable with is very important. They need to explain to you quite clearly the benefits and consequences of what their recommended plan would be. One might suggest pulling teeth while another one might recommend an expander. You need to really understand it all when you make the final decision. It can be overwhelming. Sorry!

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they do still pull teeth if it's needed but an expander will move the jaw apart. My ds had one to correct his jaw from thumbsucking. I hated having to turn the key every day. He hated it coming off b/c of all the nasty stuff up in there, lol, he said it felt gross to touch. Luckily brushing fixed that lol!!!

 

Compared to the braces I thought the expander was easy. I just had to remember to turn the key daily for awhile(back and forward, back and forward) and try not to poke him when I did it :tongue_smilie:

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Neither has had permanent teeth removed. Once teeth are pulled they are GONE. As I'm getting older and older I'm realizing how fragile our teeth are -- the old fillings fall out, molars crack, root canals happen -- it's really important to hang on to all the teeth you can while you're young.

 

:iagree: I had 4 removed for braces and my 4 wisdom teeth were impacted. I had to have a root canal for a back molar in May. It only lasted two weeks and I had the pain return. In August, it was extracted. I now have to pay a lot for an implant since I have 8 missing teeth. Otherwise, I would lose the top tooth eventually because it had no partner on the bottom and I would be out a lot of teeth for eating. I had several opinions and they all agree I should get the implant. All the oral surgeons said it wouldn't be as much of a problem to go without the back tooth if I didn't have the 4 extracted from braces.

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I just went for a cousult on this very thing with my 8 year old. He is going to have an expander that sits behind his front teeth and is cranked my the ortho. He will also have upper braces because he said the front teeth tend to move backward when the jaw is expanded. The main reason you do it is because the lower jaw will shift to accommodate the narrow upper jaw. If you don't correct it well, you get problems with jaw popping when you're an adult (yup- its me!). The palate also starts to solidify more past age 9 so you've got to start early.

 

Beth

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