The rapid palatal expander (RPE) is an appliance that gently widens the upper jaw to make it properly fit with the lower jaw.
Types of Expanders
Depending on the patient's age and amount of needed expansion, there are two types of appliances used in our office. If an expander is part of the overall treatment plan, the rationale for which type will be discussed at the treatment consultation appointment.
The bonded expander is glued to the teeth with a fluoride-releasing cement. Due to the cement used, there is no risk for cavities on the teeth underneath the expander. Additionally, there is a platform along the back teeth to provide a solid biting surface for the patient's comfort.
The temporary anchorage device (TAD) supported expander is attached to tiny anchors placed on the upper jaw. It causes minimal discomfort and allows for effective expansion of older adolescents. Additionally, braces may be placed at the same time as the expander.
Activating the Expander
In a well-lit area tip the patient's head back. It often helps to have your child lean over the back of a chair or armrest to direct light onto the palate.
Place the key in the center hole until it is firmly in place. Do not worry about poking your child. The key is adjusted so it will not go in far enough to injure the palate.
Push the key towards the back of the mouth. The center will rotate and the new hole will appear. The rotation stops when the key meets the back of the expander. You must always activate for a full turn, otherwise you may lose the next hole. THIS IS CRITICAL.
To remove the key, let it fall out of the expander. The safety string or key handle will prevent it from being swallowed. Do not pull it forward to remove. Otherwise, you will have negated the turn.