Palate Expander and Braces

My son went through the same thing. When he started to lose his baby teeth we began regular dentist visits. They did a panoramic xray on his teeth. While his baby teeth were perfectly straight, the xray showed all these adult teeth that were forming and it looked like an absolute traffic jam. There was no room for them to come down. We did the expander starting in 3rd grade. At that age the palate has not hardened and the bones at the roof of the mouth have not knit. They can shape the bones as they grow. It's easier to expand now than it will be at any other time and it's a lot less painful. My son is 12 now and finishing up 2 yrs of braces. He will be finished with them before 6th grade is through. He'll be free from them for middle and high school and his teeth and bite will be perfect.
When I had braces in the 70's (back before expanders were invented) I had to have 8 adult teeth pulled so there was room in my mouth for the rest. I had braces from grade 5 through 11 and braces for 7 years is misery.
Orthodontists start younger than they use to, but they finish up much more quickly.

I have no experience here and am not reading the replies. But a second opinion is always a good idea. And if you didn't feel you could ask these questions of the ortho, perhaps finding one you can communicate with, even if he or she tells you the same thing. As you said, that's a lot of time and money to be in relationship with a medical professional. You want to be comfortable in all the steps of the process.

I am neither a dentist or orthodontist, but I will share with you what our much trusted family dentist told me just last week, while we were discussing the need (or not) (and when) of our children needing braces. My kids are 12 and 9 years old.

He is quite positive that both my kids will need braces due to pretty big overbites. My son's teeth are fine other than the overbite (no crooked teeth, no crowding, etc). My daughter (the 9 yr old) has teeth that are not coming in quite properly. For ex, her first two permanent teeth came in BEHIND the baby ones... like shark teeth. She also has a tooth that came in sideways (but she is able to clean around it so the dentist says that's not a problem... if it were really tight and she weren't able to clean it, he would want to address it right away). But, here is the interesting part:

When I pressed him about whether she would need orthodontic work right away (due to the crooked tooth especially, even though she has a REALLY bad overbite that I know will require work eventually) he gave me the names of several orthoditists that they refer clients to. Told me I should probably go ahead and call her for a consult and see what they say. Probably it can wait, but better to check and be safe rather than sorry. That the orthodontist he refers his clients to is a regular orthodontist, NOT a "pediatric" orthodontist... Why? Well, b/c a pediatric one "loses" their patients around age 12. So they are more 'aggressive' with treatment. He said "I bet she (meaning my daughter) has a few classmates with braces already" (and my daughter is nodding her head yes to this)... well, their teeth may need further treatment as they grow and the rest of their permanent teeth come in. But the pediatric dentists will have exhausted all the insurance benefits before they are done (grown and matured and need a 2nd round of treatment/work done). By sending us to a "regular" ortho instead of pediatric, that conflict of interest for the doctor is not there! And our child will get the most appropriate treatment at the optimal time (for her mouth AND our pocketbook).
Check your dental insurance coverage. I bet you are limited to how much they pay out. Consider a 2nd opinion from a non-pediatric ortho.

We don't even use a pediatric dentist, and he is AWESOME. We've been going there for over 12 years and our kids have grown up going there. They LOVE him. He doesn't have all the bells and whistles (TV's in all the treatment rooms,etc) but his staff is excellent with the kids and I have never had ANY complaints or fear from my kids.

At 11 he will be too old for a palate expander. I'm surprised the orthodontist didn't explain to you that you can't expand the soft palate after a certain age. It is only adjustable when they are young.

My daughter had a palate expander at age 8. Then braces to correct the upper teeth being spread out at age 9. Then we waited until all her baby teeth fell out and she had braces after that for a little over a year. She was all done with braces the day before she went to high school.

Her dad, on the other hand, didn't have the option of a palate expander back in the day, and he had to have 8 permanent teeth pulled! I'm glad we could do the expander so all her teeth could fit.

She is 22 and still wears her retainer. She has beautiful teeth and a beautiful smile and I'm glad we did what we did for her. My opinion is to take care of their teeth for them while you can. When they're older they'll thank you for it.

early intervention usually works best!

My niece just got her palate expander and she is 15. She will get the braces immediately after the expander

HI, my name is K. and I have 4 teenagers, all of whom have had braces. Our experience with palate expanders is all good. I wore one myself as a child (12) and 2 of my kids have needed them. In all of our cases it has been a necessity at a young age to avoid migraines (that hit about age 12) and having to have the palate broken (after the age of 13) in order to fix the problem later. The migraines stem from a muscle that goes from the upper jaw over the ear and around the back of the head. When there is a cross bite, this muscle twists and causes the most incredible migraines. the reason they work on the kids so young is that their palates are still soft and developing and the work is easy and less painful. If you wait to do this until he is 12, you run the risk that his palate will be more solidified and bonded as a solid unit and the work may or may not be successful as bones will take the path of least resistance....back to where they were. Now it is a matter of training the palate to go to the right place, later it will be moving it out of where it developed and into where they want the right place to be. Does that make sense? If you want more info or want to ask me more questions, please feel free to. I'd be happy to tell you anything I can.
Best wishes,
K.

My son is 14 and is just now getting braces - I wanted to wait until all of his adult teeth were in.

Turns out he has a mis-shappen soft palate and a very bad overbite. So, he is getting a palate expander and appliances that will pull his lower jaw forward, and braces - all at the same time. We had the palate expander, the molar bands and lower jaw appliance support "installed" two weeks ago, and go in for the bands and everything else next week. This has allowed him time to get used to the palate expander and recoup from the mouth tenderness.

Total time is estimated at 3 years with the soft palate and jaw being completed in 14 months.

At 14 he is better able to care for his teeth with the appliances on them than he would have been had I done this at your son's age. He now has to use a WaterPik to clean his soft palate and I bought him a SonicCare toothbrush to help with the brushing. He also understands what foods he cannot eat and has willingly given them up because he wants to have the orthodontic work done.

If your son is not having any significant problems right now you may want to consider waiting. I can tell you, the soft palate appliance is a big deal and a big adjustment.

Orthodontics were a huge priority for me...even if I did have to pay for two phases (Delta paid for half of one phase). My daughter had the expander when she was eight and it was amazing....the jaw moves rapidly allowing space for the other teeth to grow in. In my day they just yanked four teeth and called it a day. My daughter then had braces for a very short time until she was in seventh grade and had them for a year....completely done by the time she entered high school. Now her bottom retainer is bonded in, she wears her top retainer at night (she is 17). I would think a big cross bite would require braces, especially if this is something that is important to you. He can survive obviously without them but for our family it was very important. Good luck!

Well, it sounds to me like they may be able to see what's in your son's future based on the teeth coming in and whether or not there's enough room in his mouth to accomodate them.
They told me pretty early on that my daughter would require some orthodontic work. They pulled some of her teeth and she had braces for a short time. There was not enough room in her mouth for all the teeth and that was something they could easily tell from her early x-rays. Her teeth would have overlapped and crowded had we not had it done. Fortunately, she didn't need the retainers and all of that, but it IS possible to foresee growth patterns and problems at a young age.
You can always seek a second opinion or try the wait and see approach, but in my case, we just saved for it. Her dentist was amazing and I trusted him. When he showed me the x-rays, I could see for myself how her other teeth were going to try to come in. Almost everyone in her family on her father's side had the issue of not enough room for their teeth, especially on the bottom, so it was inevitable.

Best wishes.

Well, the older he is to get the palate expander the more likely they will need to break his jaw instead of using the expander. By 10 his upper palate should be bone through and through instead of cartilage covered in a thin layer of bone. You can wait but it might mean getting braces and wiring his mouth shut for several months. Personally I would go with the expander now.

My friends whose children that have had extenders started at the ages of 7-8 because the bones are growing to their adult sizes in the nose, teeth, jaw bone, ears, hands, and feet. By the time they are 10 their bones are hard and not growing as much.

To fix the issue then they would have to break the jaws and wire the mouth shut in the position they want it to be in. Not only is it easier to do now it would be a lot less expensive. They are growing now and the bone is growing so fast that the extender pulls it apart and new bone forms quickly. It is the better way to go.

Then dentist knows what to expect because he has studied teeth and bone development. I would trust him if you think he's a good dentist. If not there is always a second opinion.

I have 6 kids and some have a major cross bite. Our oldest daughter had a palate adjuster but just before starting braces. We stayed with that orthodontist until she was finished. We recently found a new orthodontist for our 2nd daughter. We liked that he was against palate expanders and he had the latest technology in braces. He says that he can adjust the teeth and jaw without needing a palate expander. He also doesn't believe in having permanent teeth pulled to make room. I would get a second opinion...we go to Frost Orthodontics in Mesa. Tell them that the Lohman Family referred you. Good luck.

I had it when I was a child. I got the palate expander in early 3rd grade for a cross bite. It stayed on for 1 - 1.5 years. It was uncomfortable when my mom had to crank it wider, but generally it didn't bother me having it in (though certain foods like mashed potatoes would get caught in the top and drive me nuts). I got my braces on immediately after in 4th grade. The braces stayed on for 4 years and came off in 8th grade. I did not need a retainer after that. I was given a nighttime retainer/sleep positioner that I only needed to wear for 6 months. It wasn't until 6 years after that my bottom teeth shifted a little. They are no longer perfectly straight, but not noticeably crooked to need braces or any other dental work. They just turned ever so slightly that I can feel it with my tongue but not visually see any problems.

My son is 10 and has the expander in now. It was a little painful when we would have to crank it several days in a row but nothing a little motrin didn't cure. I wish this had been an option for me when I was his age. I had teeth pulled and they had to sand between my bottom teeth to get the bands on - not a pleasant experience. Orthodontists are starting treatment earlier because they recognize that more can be done to the jaw when the bones have not fused yet. My son will have this in for another few months then get his braces (very early teether and now has all his permanent teeth in). My niece however had her expander removed and wears a retainer while waiting for her permanent teeth to finish coming in. If you are concerned, you can get a second opinion from another orthodontist. It also helps to shop around cause there is a range of prices available depending on the orthodontist. Find one you like and trust. Good luck!

My daughter had to have the palate expander. (She had alot of issues dentist wise - anxiety and other... so things were prolonged quite a while.)

They use those for mouths that have cross bites because if they put the braces on .... when the child bites down they are more likely to break the braces off. Since the teeth are not meeting together the way they should.

As for a retainer, they usually leave the expander on until they are ready to put the braces on. The retainer is usually what they give them after the braces come off. (this is the stage my daughter is at currently)

Our little son is 8yo. The dentist (a popular children's dentist, whose husband is an orthodontist) said that he needed a palate expander and some braces also. (His teeth are not crooked but they are large, with space in between the front teeth, and have come in quickly and pushed 2 baby teeth out for the space of one so there are things to address now rather than wait till later when it'll be harder/longer to do so)

However, we heard from a friend whose son recently got braces that they loved their dentist who did NOT recommend the palate expander, so we went in to him for a consult. He explained very clearly and well what happened with the palate expander and how oftentimes there are problems 20-30 yrs down the road (when I mentioned it to my son's teacher she exclaimed that she was beginning to have that problem and she'd had the palate expander about 15 yrs prior, so that reinforces that this dentist knows what he's talking about!)
Anyway, he said my son's mouth had enough room in the roof of his mouth that it didn't need to be expanded, all that was needed was for his teeth to be in the proper place and that itself would help his jaw expand to the size needed.

He also uses a different type of braces (where the wires are freely moving through the braces instead of attached to each one - it somehow is more effective? and causes less pain overall, and we don't have to go in every 2 wks as with standard braces, just every 2 months or so.) and he goes out and gives training seminars at workshops and will be presenting at the 2012 dental convention. So I am confident he is up to date on the best way to treat orthodontic issues. The other dentist/orthodontist are great people and have slick marketing, we liked them but we like this orthodontist better.

He is in Litchfield Park/Avondale (west side of Phoenix) and if you would like a referral, just msg me! We *really* like him and the office staff.

My son was 8 when he got the palate expander - it helps to have it NOW rather than later - while his bones are still growing. He had his braces on for 18 months. What a HUGE difference!!!

He MAY have to have braces a little later but overall, he's VERY happy and so am I!!

he wears "invisible" retainers every night to bed and nothing during the day. Getting his teeth fixed has made a HUGE difference in his self-confidence (even though he's a black belt in Tae Kwon Do!)

I'm a mom now, but my experience with palate expansion is my own. First of all, I recommend getting a second opinion. If your ortho can't deal with that, I would find another.

Anyway, I had a palate expander when I was 12, then braces immediately following to correct a bilateral crossbite. In the end, it worked out, but I did end up needing oral surgery to shorten the mandible, which really sucked. Jaws wired shut for 7 weeks. I think that was just my case, not related to the timing of the palate expander. Anyway, I digress. Perhaps because of the delay in getting the expander, my top teeth being off messed up my otherwise straight bottom teeth. I ended up needing braces on the bottom also so that they could use rubber bands to pull the bottom teeth back into their original position. This may have been avoided if I had done the expansion earlier. Maybe not.

I had a retainer after all this, but then when my wisdom teeth came in (sort of anyway), my retainer stopped fitting til I got the wisdom teeth pulled. I never went back to wearing it, and my teeth probably migrated a little bit.

My experience was less than ideal, but I don't think it was because of timing. Some small part might have been decreased but who knows. I would get a second opinion though.

p.s. I just read some other responses, and I have to disagree that the palate expander won't work after age 10 or so. Mine worked great for the maxilla. I had to have the jaw surgery for the mandible. I had the expander for about 6 months. In three months there was enough space for the "fang" I had to be pulled into place (upper canine tooth), so it can work at age 11 or more. Did it hurt? Not really, at least that I remember. The bad part was getting food stuck in it and the mild speech impediment it caused, which may be a better reason for getting it done earlier than middle school!
Good luck!

I actually had a palate expander before my braces and they waited until all of my adult teeth were in, mostly because I was so resistant to braces at all I think. My dentist knew from a very young age that I would need braces because I had a cross bite and over bite. If your orthodontist has reasons your dentist agrees with I would go with medical opinion on this since every person's needs are individual. That doesn't actually sound like a big deal to me--in a way it would be nice to get this part out of the way and let his mouth get used to the change. If you don't agree with the orthodontist you can always look into a new one and see if you get a different opinion. I technically should still be wearing a retainer 12 years after having my braces out, but I let it go and my teeth have moved too much for it to fit, but my bite is correct.

The younger they get the expander, the easier and less painfulit is for them. Two of mine had to have it. My daughter was about 9 or 10 but my son was around 13/14. We wish we wold have done his sooner but we lived in a different state and had a different orthodontist then.

Even if your sons teeth are straight now, they wont be later if his mouth is too small to accomodate all his adult teeth. That's what the expander does. It makes more room for the adult teeth. When I had braces, they just pulled your permanent teeth out to make room. I am glad my kids didn't have to do that. My daughter only had to wear her retainer at night.

As far as the crossbite goes. Sure, it doesn't affect the way he looks, but over time it will wear his teeth down and possibly cause problems with his jaw later. At least that was what I was told (my other daughter had perfectly straight teeth and a beautiful smile but a huge crossbite).

Hope this helps.
C.