Palatal expander
When the upper jaw is too narrow, the upper back teeth can bite inside the lower ones (a crossbite) and there may not be room for the adult teeth. A palatal expander is an appliance fixed to the upper back teeth, with a small screw in the middle of the roof of the mouth. Turning the screw a little at a time gently widens the upper jaw while a child is still growing, because the two halves of the palate are not yet fully joined. At Suman Dental Care it is planned by Dr. Aashka Doshi, an orthodontist (MDS, orthodontics and dentofacial orthopaedics).
Step by step
- Fit. Bands on the upper back teeth are joined to a screw in the middle of the palate.
- Turn. The screw is turned with a small key, as advised, a fraction of a millimetre at a time.
- Widen. The two halves of the upper jaw move apart at the midline; a gap between the front teeth is expected.
- Settle. The expander stays in for months while new bone fills in, and the gap usually closes.
- 1Consultation and records
The orthodontist examines the bite and takes photographs, X-rays and impressions or a scan. If a wider X-ray is needed, you will be told where to have it taken.
- 2Fit the expander
Small metal bands or a bonded frame are fixed to the upper back teeth, joined to the screw in the middle of the palate. It does not need an injection.
- 3Turn the screw
You are given a small key and shown how to turn the screw, usually once or twice a day for a few weeks, exactly as the orthodontist advises. Each turn widens it by a fraction of a millimetre.
- 4Check the widening
The orthodontist checks progress every 1–2 weeks and tells you when to stop turning, once the upper teeth meet the lower teeth correctly.
- 5Leave it in to settle
The expander stays fixed for several months while new bone fills the widened midline. It is then removed, and a retainer or braces may follow.
- A child whose upper back teeth bite inside the lower teeth (a posterior crossbite)
- A narrow upper jaw with crowding, where widening can make room for the adult teeth
- A child whose jaw shifts to one side when the teeth close together, because of a narrow upper jaw
- Older teenagers and adults: the palate has usually joined by then, so widening needs a different plan, which the orthodontist explains
For the first few days the expander feels large, speech can sound different and there is more saliva. After each turn your child may feel pressure across the nose, cheeks or teeth for a few minutes; this is expected and fades.
A gap usually opens between the upper front teeth as the jaw widens. This shows the expander is working, and the gap normally closes on its own over the following weeks or is closed later with braces.
Brush around the bands carefully twice a day and rinse with water after meals, because food collects on the plate. Avoid sticky sweets, chewing gum and hard foods. Call the clinic if the expander comes loose, the key is lost or a turn is missed.
- Pressure and discomfort after turns are common and short-lived.
- Food trapping and gum soreness around the expander if cleaning is poor; decay is possible under a loose band.
- A loose band needs re-cementing soon, so the widening is not lost.
- Too many or too few turns change the result, so follow the turning plan exactly.
- The bite can narrow again if the expander is removed too early, which is why it stays in to settle.
- Age limits: once the palate has joined, a standard expander mainly tips the teeth rather than widening the jaw.
What affects the cost
We don't publish prices online. After an examination you get a written estimate that lists each item.
Payment by card, cash or UPI.
Questions patients ask
Does a palatal expander hurt?
Turning the screw causes pressure for a few minutes, often felt across the nose or cheeks. It is not usually painful. The orthodontist can advise pain relief for the first days if needed.
Why has a gap appeared between my child's front teeth?
The gap is a normal sign that the upper jaw is widening at its midline. It usually closes by itself over the following weeks, or with braces later.
How long does the expander stay in?
The turning usually takes a few weeks. The expander then stays in place for several months so the new bone can settle. Your orthodontist gives a timeline at the plan visit.
What if we miss a turn or turn it too many times?
Do not try to make up a missed turn with extra turns. Call the clinic and follow the orthodontist's advice.
Can adults have a palatal expander?
In adults the two halves of the palate have joined, so a standard expander mainly tips the teeth. Adults with a narrow jaw need a different plan, which the orthodontist discusses.
Questions about this treatment?
Send a WhatsApp message or book an examination. The dentist explains the options before anything starts.