Orthodontics for Children and Adults

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Jaw expansion and crowded teeth

The RME (Rapid Maxillary Expander) or RPE (Rapid Palatal Expander) is an expander that is used where the upper jaw is too narrow relative to the lower jaw. If an upper jaw expander is required you will usually find that the relationship of the back teeth is reversed, with the upper teeth biting inside of the lower teeth.

Benefits of RME and RPE

Widening the upper jaw with the use of a RME or RPE helps to:

1. Achieve a better bite.
2. Create a little more room for any crowded teeth.
3. Improve the nasal airway- a narrow or deep upper jaw may make it harder to breathe through the nose. When widening the upper jaw, the air passages also widen, thus allowing easier breathing through the nose. Once the upper jaw has been expanded, new bone fills the space and helps maintain the increased width.

• The difference between a jaw expander and braces is that braces move the teeth, while an expander gently separates and widens the two parts of the upper jaw making more room for crowded teeth and promoting symmetry.
• Often there is a shift of the lower jaw to one side to accommodate the narrow upper jaw. This often results in asymmetrical lower jaw growth over time. There are often asymmetries of other facial bones as well.

The most significant reason for expanding the upper jaw using rapid palatal expansion in childhood is to intercept the problem of asymmetrical lower jaw growth before it results in facial asymmetry.

After the jaw expander has been cemented in place, the patient will be required to check it every day and turn the screw as instructed. Parents will need to assist!

How to turn the expansion screw:

1. Have the patient lie on a bed or couch with the mouth wide open.
2. Carefully insert the key into the hole in the middle of the appliance.
3. Gently but steadily push the key from the front towards the back of the mouth. (Be careful not to reverse the turn!) You know you have turned far enough when you are able to see the next screw hole.
4. If something seems amiss, call our office as soon as possible for an appointment.

For most patients this procedure is not painful. However, the pressure of the screw turning may cause a tingling sensation at the bridge of the nose and/or tooth sensitivity. The sensitivity usually lasts about 5 minutes and then starts to disappear.

As a parent or guardian it is your responsibility to:

• Confirm turning the screw of the expander as prescribed.
• Closely follow the schedule and instructions provided by Dr. Fine
• Be regular with the turning of the screw. Do not rush or delay the schedule.
• Ensure that the expander is carefully cleaned each time the teeth are brushed. The use of an oral irrigation device (i.e. "Water-Pik") will help keep the appliance clean and prevent irritation.

Note: treating an underdeveloped lower jaw requires a different procedure and orthodontic measures To find out more about how an under developed lower jaw can be treated follow the appliances link to “Twin Block” and CBJ.