Does my child need an expander?


Does my child need an expander?

While a small percentage of children can definitely benefit from Phase I (early) treatment, in general, most children with normal growth and development do not need an expander or any other form of early treatment. It is important to get your child evaluated early in case there is an indication for an early treatment. This is why the American Association of Orthodontists recommends that every child have an evaluation by an orthodontist by the age of 7. 

Injudicious early treatment can lead to increased total time in treatment, thus prolonging the time that a child is in braces. This can increase the chance of cavities or unsightly decalcified white spot lesions, root shortening, gingival recession, and patient burnout. This is why it is important for parents to familiarize themselves with the evidence-based indications for early treatment, like expanders.

What is an expander?
An expander is designed to widen the upper jaw. The left and right boney halves of the upper jaw have not fused together yet in young children. This allows widening of the upper jaw without the need for surgery. Bone fills in the area between the left and right halves once expansion is complete.

Why would my child need an expander?
The primary reason for an expander is a posterior crossbite. Crossbites can interfere with normal growth of the jaws and compromise the ability of full orthodontic treatment to establish a nice smile and healthy bite later in development. A posterior crossbite is a condition in which the back teeth do not overlap correctly. This is often the result of a narrow upper jaw.

Sleep Apnea: Does my child need an expander for sleep apnea?
Sleep apnea is a debilitating sleep disorder that can compromise other aspects of one’s health. There are certain things you should know before getting an expander for sleep apnea. First, confirm that your child has sleep apnea. Snoring is not enough to diagnose sleep apnea. Accurate diagnosis will likely require a sleep study by a qualified expert. If your child does not have diagnosed sleep apnea and a posterior crossbite, there is little reason to do expansion. While expansion of the upper jaw can widen the nasal airway and thus increase airflow through the nose, it is not guaranteed to cure or even reduce sleep apnea symptoms. This is because a narrow nasal airway is only one of many factors (e.g. Body mass index, tonsils & adenoids, neurological source) that can cause this sleep disorder.

Doing expansion on a child that does not have a posterior crossbite can create another problem called a buccal crossbite. It could make the upper teeth too wide to fit with the lower jaw and make it difficult to chew.
Article by
Carlsbad Orthodontist