By Dr. John White
Owner, Smiles by White
Here’s the skinny on expanders. There are ways to widen the upper dental arch without using an expander, but often a cemented palatal expander is the best solution.
Sometimes the upper posterior teeth are tipped inward and the arch wires in braces can tip them outward, which will make the upper jaw wider without the need for an expander. However, in cases where we really need to widen the upper arch, it is best done with an expander—especially for growing children ages five to 15. Once you get older, the expanders don’t work quite as well and they are less comfortable.
So, yes, we can expand the shape of the upper arch using braces and Invisalign, but we cannot make the upper jaw (the maxilla) and the two sides wider without using some type of expander.
Not every child’s jaw is big enough to accommodate his or her permanent adult teeth, which can result in crowding and misalignment. By using an expander, we can make room for the teeth without the need for extraction.
There are different types of expanders. A slow expander tends to focus on making the dental arch wider, while a rapid expander makes the upper jaw itself wider.
The bottom line is that we can expand with archwires, with removable appliances, with traditional braces and Invisalign, but if you are looking for a true upper jaw widening it is most effectively done in adolescence with a cemented-in expander.
In my practice, we use a dental CAT scan to determine the width of the lower jaw and the width of the upper jaw. Depending on the patient, we will expand the jaw or the teeth to make those two fit.