Palate Expansion in Children
How we knew to do it, the ideal age to start, how it's going, cost, myofunctional therapy, and our full treatment plan.
My 5 year-old started the palate expansion process two months before her fifth birthday. We’ve had a great experience and I cannot believe how much her mouth has changed in a few short months.
I have experienced serious dental trauma (my top four front teeth had to be pulled and I’ve had 5 or 7 root canals and major gum surgery). My mom took me to a bad dentist who ruined my teeth and I want to do everything I can to make sure my kids don’t go through what I went through.
I really struggle with what to share when it comes to my kids, but this doesn’t feel wildly personal, and I know it can help others who felt as lost as I did. I’m going to share some more of our results and scans at the bottom of this post with my paid subscribers, since I usually keep that information a bit more “private.”
So let’s talk about palate expansion.
Palate expansion is the process of widening the jaw. This is often done in children to correct cross-bites or crowding, to improve breathing, and to make room for incoming permanent teeth. It can also improve facial symmetry (which is impacted by a cross-bite), chin alignment with the nose, posture, and much more. My daughter needed help with all of it and will likely need two rounds of expansion.
How we knew she needed palate expansion
When my daughter was 3.5 or 4, our dentist mentioned that she would need palate expansion. I asked if our oldest (who was 6 at the time) would need it as well, and she said she looked fine. I regret not pushing further, because she does, in fact, need it.
Starting at around 5 is ideal because their jaws are easier to expand at this age. I believe our usual dentist offers palate expansion, but when I told my good friend about it, she recommended seeing a dentist that specializes in airway orthodontics. I reached out to the one she took her kids to, and we booked a consultation.
What are aligners?
A typical palatal expander fits on the roof of the mouth and is attached to the upper molars with a screw in the center. A parent or caregiver turns the screw with a key. Over time, the jaw is pushed apart.
Our aligners look more like invisalign, don’t need to be adjusted, and can be removed. My daughter gets a new one every 5 days, and is about to start her 13th aligner tonight. The process has required next to no effort. She wears them 24/7 — even to eat — and just removes them to brush her teeth morning and night, and cleans them after eating when she’s able to.
What was the process like?
The consultation was thorough and expensive. I’ll get into pricing below. It took almost 2 hours and included breathing tests, scans, photos, and videos. The doctor also sent us home with a pulse oximeter to monitor her breathing overnight, which is when we confirmed that her sleep was terrible because her breathing was so bad.
Side note: She had her tonsils and adenoids removed in May, and started with the aligners in April. Her breathing, sleep, and mood have done a 180. I can’t believe how much it all helped her so far.
The practice also recommended myofunctional therapy (google pediatric OMT), which isn’t too involved but we’re not the best at doing her daily exercises.
How has she done with the aligners?
I am shocked at how easy it’s been. She hasn’t fought wearing them, has never complained of discomfort, and we’ve had zero issues. We go in every month or so for updates, and to take measurements. When we started, she was 24mm, and is now just under 30mm. The goal is to get her above 35mm.
How do you know if your child needs this?
If you're seeing crowding, bite issues, or chin/jaw misalignment, it's a good idea to consult a pediatric orthodontist for an early evaluation.
This feels like a tricky one to answer, because our dentist gave me a heads up that my middle daughter should start at age 4/5, which is the ideal age. The same dentist also told me my older daughter’s mouth looked fine, and then recommended pulling a baby tooth so an adult tooth could grow in. I would get your child looked at by an orthodontist or airway specialist.
Some would do this for cosmetic purposes, and of course I want my kids’ teeth to look good. But — it’s also so important if there are breathing issues, facial structure issues, a cross-bite, over-crowding (i.e. no room for adult teeth to come in etc). If you are dealing with any of that, I would recommend an evaluation. You can also get them looked at before doing a more in-depth (and expensive) evaluation. I had them look at my oldest today before moving forward with a full eval. I’ll get into pricing below.
When is the best age to start?
Around age 5.
Does it hurt?
She hasn’t complained of pain once.
Is she sleeping better?
Yes, but that’s because we had her adenoids removed (for a second time — did you know they can grow back?!) and tonsils removed 3 months ago. If you’re worried about sleep or breathing, I would recommend seeing an ENT.
Starting later with my 7 year-old
When my oldest lost her second top front tooth, I was surprised when months later, the adult tooth hadn’t started to grow in. When we were at the dentist earlier this year, she told me we’d need to pull the baby tooth next to that tooth because there wasn’t enough room for the adult tooth to come down.
This is where palate expansion comes in — this could have been avoided.
I really regret waiting until now to have her evaluated but had a feeling she needed it, so the doctor said to bring her along to our next appointment. Her bottom teeth look really crowded, and the tooth that was pulled hasn’t grown in months later.
I brought my 7 year-old in with us today, and they confirmed what I knew. She needs palate expansion, and we’re starting a little late, so it won’t be as easy and might look a little different (that’s as much info as I have — I’m not being vague), but it will be ok. Her more in-depth evaluation will take place next month, and I will share more in the coming months once we have a plan and get started.
Will she still need braces?
She will still need braces, although I am planning on invisalign. I had a lot of ear infections when I was little, and the medication weakened my enamel, which caused a lot of problems for me, so I’m not taking any chances. So yes, we’ll still need braces (or invisalign) but there will ideally be less to correct.
I’m going to answer the rest of the questions and share some of our specific case below.