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Jaw Expansion: Orthodontic Expander Appliances

Patient Age Implications

Many parents have learned that consulting with more than one orthodontist concerning upper and lower jaw size relationships in their child can lead to confusion about what to do and when to do it.

The timing of orthodontic treatments involving jaw expansion treatment is a controversial topic for some doctors. Some say start early while others insist it is better to start at a later age, when some of the baby teeth have been lost.

One of the difficulties in starting treatment too early is a patient compliance issue. Children can tire of orthodontic treatment and may be unwilling subjects for a second phase of treatment (2 phases are normally required when treatment starts early). A second negative feature is the cost....

Starting treatment when there are still a few baby teeth remaining seems to be a popular way of gauging when treatment should start. Perhaps more importantly, starting at this later age usually eliminates the need for 2 treatment phases. A report in one Orthodontic Journal indicates that 90% of all growing patients can achieve treatment success in only one phase when started at the appropriate time.

Specific conditions and treatment needs do exist, nonetheless, for some patients that may require 2 phase treatments.

Appliance Types

Expanders are orthodontic devices that are designed to alter the shape of an upper and/or lower jaw. They are most commonly used to correct sizing differences between two jaws or to correct a crossbite. They are also commonly use in the upper arch to create more space for teeth to erupt and develop in (i.e., treatment for teeth crowding).

Expanders can be nonremovable (cemented in place) or they can be removable. An adjustment mechanism operates with a key, enabling the doctor and parents to maintain the gradual movements of teeth in a timeframe defined by the child's treatment plan.

Sometimes jaw expansion can be achieved without the use of dedicated expanders in cases where the severity of bone size differences are slight.


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