Orthodontic treatment in adults is on the rise. Thanks to more discreet appliances and innovative approaches, it’s easier than ever to get your dream smile, even if your 18th birthday is long gone. But if a narrow upper jaw is part of your concerns, will palatal expanders work?
The answer isn’t cut and dry. There are many variables at play, from the type of expansion you need to your overall and oral health. Below, we have the details you need to better understand palate expansion in adults.
Table of Contents
What Is a Palatal Expander?
They go by many different names: palatal expanders, palate expanders, even orthodontic expanders. But these terms all refer to the same type of appliance — one that widens the upper jaw.
Palate expanders are tailored to the unique dental anatomy of the patient, with designs based on either physical molds or digital scans.
Typical Palate Expansion Patients
The average palate expansion patient is between the ages of 7 and 14. At this age, the anatomy of the upper jaw and nasal passages is stable enough to withstand the pressure of an orthodontic expander, but still malleable enough to respond well to treatment.
Orthodontists typically want patients to have at least some of their adult teeth. Patients should also have good oral health and either be able to handle the adjustments on their own or have a parent or helper they can rely on.
How Palate Expanders Work
The specifics of how palate expanders work vary between appliance designs and patients. But to understand their intended function, we need to start with a quick anatomy lesson.
Right now, you have fewer bones than you did the day you were born — 300 at birth vs. 206 today. That’s because of bone fusion, which occurs naturally as you age. One spot where multiple bones fuse into one? The upper jaw.
As an infant, your upper jaw had three parts: two maxillary bones and an intermaxillary suture — a fibrous joint that connects the two bones. When you were about 15–17 years old, these parts fused together, forming the maxilla.
Orthodontic expanders spread the palate by directing pressure against the maxillary bones, pushing them away from each other. Most expanders have two halves connected by a jackscrew. When you turn this screw, it widens the expander — which increases the pressure on the maxillary bones, resulting in skeletal expansion, dental expansion, or both.
Signs You Might Need a Palatal Expander
- Crowded teeth
- Overlapping teeth
- Crooked teeth
- Misaligned bites
- Impacted teeth
- Difficulty chewing
- Speech problems
- Breathing problems
- Poor sleep
What Conditions Do They Correct?
Palate expanders can help address a wide variety of conditions. As long as they’re related to the umbrella condition of a narrow maxilla, palatal expansion treatment can help correct or minimize the following issues.
- Crossbites: This is when some of the top teeth sit inside the bottom ones, while others don’t. Expanders correct crossbites caused by a narrow upper arch sitting inside the lower one.
- Crowded Teeth: When teeth lack the space to erupt properly, they crowd together or rotate. Expanders can make room for all the teeth to sit in their proper locations.
- Impacted Teeth: Like crowding, this condition occurs when there isn’t space for proper eruption. Expanding the jaw creates space to correct or avoid impaction.
- Cleft Palate: Palate expanders don’t correct this condition on their own, but are often an integral part of multi-stage treatment, making space for other approaches to work.
- Narrow Smile: This is a cosmetic concern, not a medical one. A wider jaw equals a wider smile, which might boost confidence.
- Speech Difficulties: Palatal expanders make speech worse until you adjust, but widening the upper jaw makes it easier to speak clearly.
- Eating Difficulties: A misaligned bite or restricted tongue movements hinder the ability to chew food properly. A wider palate can improve chewing and digestion.
- Restricted Airway: Sometimes, a narrow upper jaw creates narrow nasal passages. This can cause a collapsed airway or a reliance on mouth breathing.
Can Adults Use Palatal Expanders?
Yes — but there are caveats. Children achieve better results than adults, and adults’ results are often less predictable, slower, and require greater intervention. Still, if you are an adult with a narrow upper jaw, you have options.
The Limitations of Anatomy
Palate expansion typically works best after the nasal passages are stable but before the maxilla fuses. This puts the ideal treatment window for most people between the ages of 7 and 14. During this time, it is possible to achieve significant expansion with an appliance alone, and often in as little as 2–3 months.
Once the intermaxillary suture calcifies, fusing the maxillary bones together, it is difficult to cause skeletal changes with an appliance alone — though not impossible. Treatment tends to take longer (possibly more than a year) and usually works best when an orthodontist uses implants, surgery, or other treatments along with the expander.
Skeletal vs. Dental Expansion
Palate expanders can cause two forms of expansion: skeletal and dental. Skeletal expansion is when the jawbone itself becomes wider — this is the expander’s primary purpose. Dental expansion is when the teeth move closer to the outer edge of the gums.
Depending on your needs, your doctor may opt for skeletal expansion, dental expansion, or both. Skeletal expansion is typically considered more desirable because it produces stable and meaningful changes to the anatomy. The problem is that it is hard to achieve in adults without surgery.
Dental expansion is easier and works with patients of all ages. It can stand on its own if the jaw is just slightly too narrow, making room for the teeth to align properly and giving the tongue more space. However, it is very limited in movement, since pushing the teeth too close to the edge of the gum line can cause them to fall out. Additionally, dental expansion requires retainers to maintain the results, and skeletal expansion doesn’t.
Surgically Assisted Expansion
When an expander alone cannot deliver the results an adult patient needs, surgical intervention can help correct a narrowed palate. This doesn’t have to mean extensive, painful jaw surgery.
In most cases, the invasive elements of surgically assisted expansion are quick outpatient procedures, requiring little more than an implant in the intermaxillary suture or jawbone to help increase expansion. However, it is possible that the surgeon will make cuts in the bone, depending on what the patient needs.
Complications of Palate Expansion in Adults
Palate expansion is generally considered safe for patients of all ages, but older teens and adults are more likely to experience certain complications. First, since their bones are hard and their sutures have calcified, expanders tend to cause more discomfort in older patients. Second, treatment tends to take 3–4 times as long.
Finally, results are often slightly less predictable and somewhat unstable when compared to those in younger patients, with relapse being a bigger risk because of the reliance on dental expansion.
Types of Orthodontic Expanders for Adults
Palate expanders can work for adult patients, but you need to get the right type. Thanks to newer models and protocols, adult patients have more options than ever before. Below are some of the most common expander appliances used with patients 18 and older.
Removable Palate Expander
These orthodontic expanders primarily make small changes — either minimal skeletal expansion or purely dental expansion. The latter makes them great for adult patients. You need to wear this type at all times except when eating, playing sports, or cleaning the appliance and your teeth. Most patients only need to turn the screw 2–3 times a week (compared to 1–2 times per day with other models).
Surgically Assisted Rapid Palate Expander (SARPE)
After the upper jaw has fused, a SARPE device might be the best option to achieve meaningful and lasting changes. An oral surgeon will open the suture of the upper jaw, then implant this expander directly into the mid-palatal structure and attach it to the molars. This allows the daily turns to achieve skeletal expansion, not just dental.
Mini-Screw Assisted Rapid Palatal Expansion (MARPE)
This palate expander relies on mini-screws implanted directly into the palatal bones. The expander attaches to these screws and pushes against them with each adjustment. Thanks to the placement and strength of the screws, this technique can separate the bones even after fusion in many patients, requiring minimal surgery.
Implant-Supported Palate Expander
Implant-supported orthodontic expanders work for both teens and adults. Rather than relying on the molars to apply pressure to the jaw, the surgeon inserts four mini implants to function as anchors. This requires working with both an orthodontist and an oral surgeon.
Are There Palatal Expander Alternatives?
Palate expanders can be the ideal solution to a narrow upper arch and the issues it causes — but for adult patients, they aren’t always the best choice. Before you sign on for palate expander treatment, talk to your orthodontist about the alternatives. Some that might work for you include:
- Braces: If your orthodontist is looking at dental expansion alone, braces offer a solid alternative. They can deliver more comprehensive and predictable tooth movements than expanders.
- Teeth Extraction: If widening the upper arch is risky or impossible, or if the teeth are severely impacted, removing them could be the best option. This can make room for other teeth to come into alignment and eliminate impaction.
- Jaw Surgery: Teens and adults who need a significantly wider upper arch, or who need to treat both arches, will likely benefit more from jaw surgery than palate expanders — or a combination of the two.
Final Thoughts
Palate expanders can help adult patients widen their upper jaws and bring their teeth into alignment. However, they often won’t achieve the same results they would in children without surgical intervention.
Ask your orthodontist about all your options and the changes they can deliver, then determine which approach is best for you.
Frequently Asked Questions
What do orthodontic expanders do for adults?
It depends on the type. Most will help push the teeth toward the edge of the gum line, making room for better alignment and allowing slightly more freedom for tongue movement. Some can widen the jawbone, then hold it in place while the bones fuse.
Is adjusting to a palate expander difficult?
For some people, yes. Others find it simple. The hardest part is typically learning how to swallow with the expander in place, and forming correct speech is a close second. Most people will adjust their eating and speech habits within days of getting their appliance.
Will palate expansion be painful?
Adult patients have a greater risk of experiencing pain with treatment. This is mostly because of the reliance on surgical interventions and the fact that their bones have already fused together. Still, you shouldn’t experience genuine pain outside of the surgical spots, and it should subside within days. Otherwise, you’ll probably have some soreness like any other patient.
Do I need to alter my diet when wearing a palate expander?
Yes. At first, you need to relearn how to swallow safely, so start with liquids, then move to very soft foods. Avoid hard and sticky foods throughout treatment, since they can dislodge or distort the appliance.
How long does palate expansion treatment last?
Adult palatal expansion treatment usually takes longer — sometimes 12 months or more. However, there are many variables at play, and you shouldn’t set your expectations until you get an expert opinion from an orthodontist (or two).
What will my results be like as an adult palate expander patient?
It depends on your starting point, the type of expander you get, if you need surgical interventions, how your body responds to treatment, and how well you follow instructions.
What is the best tool for keeping orthodontic expanders clean?
A water flosser is often the best option for cleaning a palate expander. It can gently knock debris loose and requires less precision and finesse than a brush. It also comes with less risk of damaging the appliance.
What are the typical side effects of palate expanders?
- Jaw soreness
- Tooth soreness
- Sinus pressure
- Headaches
- Speech changes
- Increased saliva production
- A gap between the two front teeth
What do I do if I lose the key to turn my expander?
Talk to your dentist or orthodontist. They can give you a new one. If you lose it over the weekend, you should be fine to skip a day or two.
Join The Discussion: