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Updated on October 3, 2022

Palate (Palatal) Expanders: Types, Treatment Indicators & More

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What is a Palatal Expander?

A palatal expander is a custom-made dental device. It's used to widen the upper jaw to create more space for the teeth. Dentists or orthodontists may use a palatal expander before placing traditional dental braces.1

Dentists may also refer to them as orthodontic expanders.

The expander has two halves that attach to the upper teeth on each side. These halves are connected in the middle of the palate by a screw.

You'll turn this screw periodically with a special key on a schedule provided by your orthodontist. This maintains gentle pressure on either side of the jaw, slowly widening the palate.

Once you reach the desired jaw width, you'll continue to wear the expander for several months. This additional time allows new bone to form in the gap, stabilizing palatal expansion.

What Does a Palatal Expander Do?

An orthodontist may use a palatal expander to widen the roof of the mouth if someone has a narrow upper jaw or a misalignment between the upper and lower teeth. This creates more room for the teeth and can correct other potential issues.2

Dentists recommend palatal expanders for people with:

Malocclusion (crossbite)

With malocclusion, the top and bottom teeth do not meet properly. In particular, palatal expanders correct crossbites, where the upper teeth sit inside the lower teeth.

Narrow maxilla (upper jaw)

A maxilla (upper jaw) that's too narrow may not give the teeth enough room to erupt in the correct position. As a result, teeth may become crowded, crooked, or overlap. 

They may also block other teeth from emerging (impacted teeth). Palatal expanders are often used to create more space for a child’s permanent teeth. 

If someone has a narrow maxilla and it's left untreated, they can experience other complications, such as:

  • Crowded teeth
  • Eating and chewing difficulties
  • Speech problems
  • Narrow smile

According to Dr. Nandita Lilly, one of NewMouth’s in-house dentists, “palatal expanders are the gold standard when it comes to correcting crossbites in children. A proper occlusion will prevent potential jaw joint issues, sleep disordered breathing issues, and speech problems.”

Cleft palate

A palatal expander may also be used as part of the repair process for a cleft palate. Once cuts have been made in the bone surrounding the palate, an expander may be placed to create space for new bone tissue to grow.

How Long Does a Palatal Expander Stay In?

The jawbones are not fully formed until after puberty. Therefore, children may see results from palatal expanders more quickly than adults.4, 5

A palatal expander usually remains in the mouth for at least 6 months and as long as 1 year. An orthodontist may remove the original expander after 6 months and replace it with a smaller appliance.5

If the expander is removed too early, the bones may gradually relapse to their original position. Bone replacement takes about a year to complete. 

Types of Palatal Expanders

There are several types of palatal expanders, including:

Removable palatal expander

If your upper jaw requires minimal expansion, your orthodontist may recommend a removable palatal expander. Although removable, you should wear the expander at all times, except while eating, playing sports, or brushing your teeth. 

With a removable expander, you’ll need to turn the screw two or three times a week, depending on your doctor’s recommendations.

Hyrax rapid palatal expander

The Hyrax is the most common fixed appliance used to expand the palate. It's made of two metal wings with bands that fit snugly around individual back molars. The orthodontist glues the bands onto those molars, securing the expander.

palate expander hyrax braces 1

You'll need to turn the central screw on a regular schedule. Your orthodontist will provide the key and instructions on how to use it.

Because the Hyrax consists of only bands and wires with no acrylic covering, it's easy to keep clean. Another advantage is that it doesn't irritate the palatal mucosa because the teeth bear the pressure.6

Haas expander

The Haas design resembles the Hyrax but incorporates acrylic. It's bonded to the back molars and exerts positive pressure on the palate and teeth. 

Like the Hyrax, it has a central screw that requires periodic turning.

Quad-helix appliance

A quad-helix expander offers the benefit of not needing to be adjusted once it’s in place. It’s designed to expand on its own.

Instead of a turnscrew, this expander has four active helix springs. The orthodontist glues it onto the back molars in a compressed position. It then gradually expands without the need for manual adjustments.

How Much Does a Palatal Expander Cost?

The cost of a palatal expander may depend on several factors, including:

  • Your location
  • The dentist or orthodontist
  • Your insurance coverage
  • The treatment plan

Palatal expanders can be used independently or as part of a comprehensive orthodontic treatment plan with braces.

By itself, treatment with a palatal expander can cost between $1,000 to $2,500. Comprehensive orthodontic treatment that includes an expansion appliance can cost $3,000 or more. The cost may vary based on treatment length, types of braces, and any other necessary orthodontic work.7

Most insurance plans cover a portion of the cost, as palatal expanders may be considered medically necessary. You should check with your insurance provider for specifics on your coverage. 

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Side Effects of Palatal Expanders

The most common side effect of using a palatal expander is mild discomfort. You may feel pressure or soreness in your teeth and upper jaw for the first few days after adjustments.

Other typical side effects include:

  • Toothache
  • Mild gum irritation
  • Difficulty speaking
  • Bad taste in the mouth
  • Dry mouth or lips
  • Mild difficulty eating
  • Headaches

Although uncomfortable, these side effects are temporary and should improve as your body adjusts to the appliance.

Other less common side effects may include:

  • Relapse — the palate shifts back to its previous position
  • Root resorption — the body may dissolve a tooth's root because of pressure from the expander
  • Open bite — a gap develops between the top and bottom teeth when the mouth is closed
  • Palatal separation — the mid palatal suture in the middle of the hard palatal can separate

Most side effects are minimal, but if you experience severe pain or other problems, contact your orthodontist immediately. 

Minimizing Side Effects

Orthodontic appliances such as palatal expanders can be uncomfortable. However, there are some things you can do to minimize discomfort and other side effects:

  • Ask your dentist about using over-the-counter (OTC) pain relievers as needed for discomfort
  • Opt for soft foods like mashed potatoes, ice cream, jello, yogurt, eggs, and applesauce for the first few days
  • Avoid chewy foods like gum, hard or sticky candy, popcorn, ice, and nuts that can get stuck or break the palatal expander
  • Cut raw vegetables and fruit into bite-size pieces rather than biting directly into them
  • Use a soft-bristled toothbrush to keep your teeth and the palatal expander clean
  • Floss daily since food is likely to get caught under the expander
  • Use a water jet or a syringe filled with water to flush out any food caught under the palatal expander

Alternative Treatment Options

If an orthodontist doesn't think a palatal expander is the best choice for you, there are other options. Orthodontic treatments to address a narrow mouth or crowded teeth may include:

  • Tooth extraction — removing one or more teeth creates more space for the remaining teeth to move into alignment
  • Traditional braces — wires and brackets can move teeth into their proper positions
  • Jaw surgery — sometimes, a surgical procedure may help realign the upper and lower jaw

Summary

A palatal expander is an orthodontic appliance used to widen the upper jaw. It can help correct crowded teeth and malocclusion.

Palatal expanders usually are recommended for around 6 to 12 months. They’re most effective when used pre-puberty before the bones fuse.

Treatment costs can range from $1,000 to several thousand, depending on the dentist, location, and insurance coverage. Most insurance plans cover part of the cost, as expanders are usually considered medically necessary.

7 Sources Cited
Last updated on October 3, 2022
All NewMouth content is medically reviewed and fact-checked by a licensed dentist or orthodontist to ensure the information is factual, current, and relevant.

We have strict sourcing guidelines and only cite from current scientific research, such as scholarly articles, dentistry textbooks, government agencies, and medical journals. This also includes information provided by the American Dental Association (ADA), the American Association of Orthodontics (AAO), and the American Academy of Pediatrics (AAP).
  1. Farhadieh, Ross D., et al. Plastic and Reconstructive Surgery: Approaches and Techniques. John Wiley & Sons, 2015.
  2. Koch Göran, et al. Pediatric Dentistry: a Clinical Approach. John Wiley & Sons, 2017.
  3. Yoon, Audrey, et al. “Distraction Osteogenesis Maxillary Expansion (DOME) for adult obstructive sleep apnea patients with narrow maxilla and nasal floor.” Sleep medicine, 2020.
  4. Agarwal, Anirudh, and Rinku Mathur. “Maxillary Expansion.” International journal of clinical pediatric dentistry, 2010.
  5. Baccetti, T, et al. “Treatment timing for rapid maxillary expansion.” The Angle orthodontist, 2001.
  6. Proffit, William R., et al. Contemporary Orthodontics. Elsevier/Mosby, 2019.
  7. How Much Do Braces Cost?” CostHelper Health.
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