Will a Palate Expander Work in my Case? (photo)

Please do not have the "4 premolars" removed, especially because your orthodontist is giving you the option of expanding the upper jaw.  The removal of bicuspid teeth can cause many future health problems for you.  The reason your upper teeth are crowded, in all likelihood, is that your upper jaw is narrower than ideal.  In a research project by a university orthodontic faculty member, it was discovered that almost all patients who come to an orthodontist (95% in his practice) have a narrower than ideal upper dental arch.  Therefore the problem is not that you have too many teeth (needing some to be removed), but that your jaw is too small.  This can be corrected at any age with slow palatal expansion (SPE).  Correct the problem with this method.  Don't create future problems.  If you or your orthodontist want further information, please see my book "Straight Talk about Crooked Teeth" available through Amazon and other sources.

A palatal expander will only tip the back teeth out in a non-growing adult  A palatal expander in an adult will not work and should only be used for skeletal expansion where there is a posterior crossbite and/or upper and lower jaw constriction.  The suture in the roof of your mouth fused at around 16 years of age.  To expand this suture as a non-growing adult would require a surgically assisted maxillary expansion by reopening the suture and zygomatic buttresses.  If you are not in a crossbite the expander is useless.  You need some minor expansion to bring your laterals out of crossbite.  If it is within 5-6 mm of crowding this can be resolved with orthodontic expansion.  I don't see any pictures of the sides of your teeth to determine the extent of your constriction, but if the upper teeth are lying outside the lower teeth your are fine.  Space can also be made by some minor tooth removal between teeth we refer to as inter-proximal reduction, so there are several options to prevent tooth removal, which I would avoid if your crowding is not severe or the position of your teeth are so protrusive that you can't get your lips to close.  

Find a good board certified orthodontist that went to a reputable program in your area and you will be fine.

Best regards,

Dr. Jim Awbrey 

I agree with Dr. Lauson, PLEASE do NOT extract bicuspid teeth. Palatal expansion will work and you will be 100% more satisfied with the end results. Don't just think about straight teeth, you also want a more beautiful smile, a better looking face and a healthy TMJ and airway. Straightening teeth is easy, what can be a bit more of a challenge is making sure that straightening the teeth doesn't detract from facial beauty or damage a TMJ or compromise an airway. 

By the way, Dr. Lauson's book is terrific too.

Good luck!