Rapid Palatal Expander

Common dental malocclusion, like anterior and posterior crossbites, is prevalent in young children, due to copious etiologies. Essentially, a crossbite is where the teeth have not formed proper alignment, due to inadequate width of the maxillary arch. If left untreated, the condition can lead to further skeletal growth impediments. That is why we have rapid palatal expander. This device distributes force upon the mid-palatal sutureand the circum-maxillary suture, in order to assist their growth and improvement.

What Is a Rapid Palatal Expander?

Rapid palatal expander or RPE is an orthodontic tool to help correct abnormal growth patterns of the palate. It is helpful for people with narrow, crowded and protrusive upper jaws. The tool works by gently widening the palatevia stretching of the central palatal connective structure.

Due to how the tool works, it is only suggested for those who have not yet completed growing, as their palate will be susceptible to change, and not closed shut. The RPE is widened every other day, as instructed, either by the patient or by their parent or guardian. As the palate becomes wider, the upper stature rejoins with newly formed bone.

When Do You Need A Rapid Palatal Expander?

An RPE will be beneficial in the following clinical cases:

  • Skeletal class II (with maxillary constriction)
  • Skeletal class III
  • Correction of crossbites (uni/bilateral, anterior/posterior)
  • Extreme crowding in dental region
  • Nasal breathing issue improvement

Does Age Matter When Using Rapid Palatal Expander?

As mentioned, rapid palatal expanders are only offered to those who have not yet completed growing. As a general rule of thumb, the device should not be used in females above the age of 13, or in males above the age of 15. This is because young people's bodies are still undergoing skeletal growth, meaning that their bones have not yet fully formed, making the RPE useful in correcting any abnormalities; as for it to work, there needs to be some form of separation between the bones already, which is not the case in fully developed adults.

Possible Issues When Using rapid Palatal Expander

Although highly safe, use of a rapid palatal expander may lead to some possible issued arising. The first one can be the device become loose or fall off. This is especially true for those who can't help but wiggling the RPE.Another issue that may arise, although vary rare, is the occurrence of a nose bleed. As the palatal structure which aims to widen, is also the base of the nose, expansion may lead to a patient experiencing a nose bleed. Once the bleeding is controlled or has stopped, call the health care professional to receive further guidance. After a period of time, on most occasions, you will be able to turn the RPE once more without issue.

FAQs About Wearing Rapid Palatal Expander

1. How Does Wearing a Rapid Palatal Expander Feel?

You will initially experience excess volumes of saliva within your mouth as it adjusts to the RPE. When turning the screw, you will feel pressure on the roof of the mouth and/or the teeth, which will last around 1 to 5 minutes. After the first week of using the appliance, there should be no discomfort. During the early stages of application, ibuprofen can be helpful in relieving any discomfort. The device should cause no pain to the patient, as mentioned above, only pressure will be felt, which is similar to the pressure you would feel when pushing your thumb against your teeth.

2. How Long Should You Wear the RPE?

On average, most devices of expansion will be retained for around 9 to 12 months, at least for 6 months. If it is removed too early with no retention, the teeth may relapse. That being said, expansion of the upper palate is usually completed within 3 months, while expansion of the lower palate takes, on average, around 6 months.

3. How Can You Activate the Rapid Palatal Expander?

When trying to activate the rapid palatal expander, you will need to use a special key in the process. If you are unsure as to how to use it, then follow the simple steps below, or speak with your orthodontist:

  • Wrap the string that is attached to the key on one finger, as to prevent the key being dropped and swallowed.
  • Locate the keyhole and then insert the key into it. This will not cause the key to touch upon the roof of the mouth due to the bend in the key.
  • Next, push the key to the back of the mouth then the cylinder rotates backward. Also, turn the key sufficiently to ensure the next keyhole can be seen at the front, so that you can enter the key into that hole fornext activation.
  • At last, remove that key from the device, and turn as instructed by your orthodontist.

Caring Tips After Wearing Rapid Palatal Expander

1. Diet Changes

There are many foods that may cause impairment to your dental device, that are suggested to best avoided whilst the appliance is in use. Foods that are exceedingly crunchy, hard, sticky, or chewy, can all cause unwanted complicationto your dental device.

For this reason, foods that should be avoided include toffee, starburst, gummy bears, jelly beans, popcorn, mints, lollipops, thick pretzels, and jawbreakers, etc. Besides, you should also try to avoid bad habits, such as chewing on pens, or your fingernails. This can also cause harm to your dental device.

2. Keep Good Hygiene

Flossing and brushing will not only become more difficult with a rapid palatal expander, but also more vital. This is because, due to the metal appliance within your mouth, there are more places for food and plaque to build up. For this reason, try to brush at least three times a day, and ensure that you remember to floss on a nightly basis. When brushing, note to brush both your teeth and metal parts of the rapid palatal expander.

3. More Tips to Note

Some other tips that will help are listed below:

  • Count how many times the appliance has been turned; never turn more than recommended.
  • If the appliance is loose, refrain from turning it. Instead, make an appointment with your orthodontist so they can correct the issue.
  • When turning, a space may open between the two front teeth. This space should disappear on its own once the turning has stopped.
  • If you are experiencing too much resistance when turning the key, or none at all, you should visit your orthodontist so they can make a readjustment to the appliance.
  • Speech may be affected and slurred at first, and swallowing may be difficult to achieve. This will be improved while the tongue adapts to the appliance. 
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