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

Im 22 years old. I just recently visited my orthodontist and for my case she recommended me to wear a palate expander for about 3 months as she says my only problem is in four my frontal upper teeth ( to see if it works) to gain some space to straightening my upper teeth, if it does not work the other option she gave me was to extract 4 premolars. Should I go for this? Is there another way to avoid extractions or another recommended treatment? Will this work at my age?

Doctor Answers 3

Don't have "4 premolars" extracted!

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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.

Palatal Expansion for Severe Crowding

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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!

Your case is not that difficult

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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 

James J. Awbrey IV, DMD
Atlanta Orthodontist

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.