Palatal Expansion
Widening the upper jaw to enlarge the floor of the nose and create room for the tongue.
What it is
Palatal expansion uses a custom orthodontic appliance to gradually widen the upper jaw (maxilla) at the midline. The maxilla is actually two bones joined by a suture (a fibrous joint) along the roof of the mouth. In children and adolescents, that suture has not yet fused, and a properly designed expander can separate the two halves over weeks, growing new bone in the gap. In adults, the suture is fused and a surgical or mini-implant assisted version (MARPE or SARPE) is used.
Why we do it
The roof of the mouth is also the floor of the nose. Widening the maxilla enlarges the nasal cavity, lowers nasal airway resistance, creates room for crowded teeth without extractions, and gives the tongue space to rest properly on the palate. A narrow, high-arched palate is one of the most reliable predictors of mouth breathing, snoring, and pediatric sleep-disordered breathing. Expansion is one of the few non-surgical interventions that meaningfully changes the bony airway.
What happens during the procedure
After scans and records, a custom expander is fabricated. The appliance attaches to upper back teeth (or, in adults, to small bone-anchored mini-implants in the palate). The patient or parent turns a small key in the center of the appliance once or twice a day. Each turn delivers about a quarter millimeter of expansion. Over 4 to 6 weeks of active turning, the palate widens. The expander then stays in place for an additional 4 to 6 months as new bone fills in the gap.
Who it’s for
Children ages 6 to 14 with crossbite, narrow palate, crowded teeth, mouth breathing, or documented sleep-disordered breathing. The earlier the better for skeletal change. Adolescents and adults with the same issues, treated with mini-implant-assisted versions (MARPE) or surgical assistance (SARPE). Always part of a coordinated plan with orthodontics, airway evaluation, and (when indicated) myofunctional therapy.
Recovery and what to expect
There is no recovery period. Mild pressure or soreness is normal during the first few days of turning. A small temporary gap may appear between the upper front teeth as the palate widens, which closes naturally over the following weeks.