An important aspect of family dentistry is a procedure called palate expansion, which is the most effective way to prevent bad bites, crowded teeth and other misalignment issues at a young age. At Point Loma Comprehensive Dental in San Diego, we take child dentistry very seriously and know that addressing these issues before the jaw fully develops can have lifelong benefits. This was not always the case, however.
In the mid-20th century, after World War II, the people who grew up in the generation we now know as the baby boomers were just discovering orthodontics. During that time, it wasn’t until a child was 12 years old that procedures were initiated, usually involving pulling a bunch of teeth and aligning what was left. Known as retractive orthodontics, it involved headgear designed to push the teeth backwards to make room for crowded front teeth. The result was often a restriction of the airway, which many believe has led to the rise in sleep apnea in adults.
By the 90s, we had begun to look at this phenomenon and wondering, what can we do for children, to make room for incoming teeth, without making their airway smaller. Which is why you now see 8- and 9-year-olds wearing braces. Often, what they have is a palate expander, an appliance that fits over a few back teeth in the upper jaw with a screw in the middle. A special key, similar to an Allen wrench, is used to turn the screw a small amount each day to create tension. This, in turn, widens the jaw arch to make room for all the teeth, rather than removing teeth to make room in the small arch.
In addition to widening the jaw arch, a palate expander can influence growth by putting pressure on growth plates in the child’s forming skull. Suture lines mark the edges of those growth plates. So, if you put a couple of bands on an 8-year-old’s upper molars, and you attach those bands to the palate expander, you can apply pressure and push the teeth apart, but what you’re really doing is growing the suture in the base of the skull. The teeth are just the vehicle to put the pressure on the suture, so the bone can fill in. Most orthodontists will leave the appliance in place for a few months after the desired expansion is achieved to allow new bone to form. In most cases, palate expansion treatment takes three to six months. What you end up with is a child who, four generations before would have had four bicuspids removed and everything pulled back, who instead winds up with a wider airway and more room for their teeth.
This is why we check to see how much room is available in your children’s mouth at an early age. If the jaw appears narrow, palate expansion may be necessary to prevent dental crowding as the permanent teeth grow in. By widening the jaw arch, we also widen the base of the nose, which in turn makes the airway larger. By not retracting teeth, the airway isn’t pinched. Everything is widened and kept forward, allowing air to flow more naturally. What this means for adults who had palate expansion as children, is that it cuts down on snoring and lessens the chances of sleep apnea developing later in life. For our patients here at Point Loma Comprehensive Dental, palate expansion is a win-win situation.