Palatal Expanders: When Are They Really Necessary? 

A palatal expander is a commonly used orthodontic appliance designed to widen the upper jaw. These devices come in various designs, but they all serve the same fundamental purpose. While palatal expanders are used in orthodontic treatment, only about 1 in 10 kids need them and benefit from their use.

When Should a Palatal Expander Be Used? 

A palatal expander may be recommended for your child for several reasons, but the primary indication is to correct a dental condition known as a crossbite. In a normal bite, the upper teeth should overlap the lower teeth when the mouth is closed. A crossbite occurs when the upper teeth come into contact inside (or behind) the lower teeth. 

What Causes a Crossbite? 

A crossbite is typically the result of a narrow upper jaw, which may be due to underdevelopment of the jaw, often influenced by genetic factors (i.e., if parents have a smaller jaw) or habits like thumb sucking. 

How Common Are Crossbites and When Can They Be Diagnosed? 

Crossbites are relatively uncommon, affecting about 1 in 10 children. Although a crossbite can be diagnosed as early as 4-5 years old, it is rarely treated at that age. The optimal time to address a crossbite is around age 7-10. 

Does My Child Need an Expander for a Crossbite? 

If your child has a crossbite, the short answer is yes—a palatal expander is one of the few orthodontic treatments recommended at a younger age (7-10 years) to prevent growth issues. If left untreated, a crossbite can lead to asymmetrical jaw growth. 

What If My Child Doesn't Have a Crossbite? 

If your child does not have a crossbite, the benefits of using a palatal expander are limited. The upper jaw can only be expanded slightly, but in many cases, it will shrink back to its original width a few years later. This makes palatal expansion for crowded teeth alone ineffective.  

Why Are So Many Children Being Prescribed Palatal Expanders? 

Some dental practitioners believe expanders can benefit most children, but the current scientific research does not support this. Current best practice is that palatal expanders only be used when there is a clear, evidence-based indication, such as a crossbite. If your child is recommended a palatal expander and does not have a crossbite, we suggest getting a second opinion. 

Dr Ana Low, Dr Andrew Marriott and Dr Andrew Lush are the only Dental Council certified orthodontists in the Nelson and Tasman Region. They exclusively do orthodontic treatment for children, teenagers and adults. 

We have two convenient locations at 27 Waimea Rd in Nelson and 57 Salisbury Rd in Richmond. If you would like to make an appointment for you or your family please contact one of our friendly team by submitting a form here or email us at admin@nelsonorthodontics.co.nz.