What evidence exists for palate expanders working? both my children (ages 9 and 11) have had or are currently wearing palate expanders. a friend told me that her orthodontist believes in pulling teeth and that palate expanders will not work. i am concer

Palatal : Palatal expanders have a long and successful track record for correcting transverse deficiencies of the upper jaw. It can also be used to expand a lower jaw and variations of this procedure are being performed to lengthen jaws. The science behind the procedure is sound and the procedure is successful if performed properly. It sometimes required the assistance of an oral and maxillofacial surgeon if the palatal bone has fused, but at ages 9 and 11 it is possible to be done without surgery. I am not sure why your friend was told that it would not work.

Dr : Dr funari has hit the mark with his answer to you. Your friend has given you third party information. Palatal expansion has been used for a very long time and most certainly will increase the amount of space avalable and reduce the need for extractions. The palatal expanders may not be appropriate for your friend's children, but they may be correct for yours.

Palatal : Palatal expansion is one of the most predictable and stable procedures that can performed in orthodontics. When done at the appropriate age and with appropriate protocols, it has profound effect on promotion of long-term oral health. This procedure has been done for countless years both in adolescents and adults (via surgery like dr. Funari mentioned) with positive research to support its use. Extraction of teeth only to camouflage an otherwise easily correctable transverse skeletal problem in adolescents is not appropriate in most instances. However, extraction of teeth for other reasons may be advisable. Determination of what is or what is not appropriate is the role of a solid orthodontic diagnosis and treatment plan come into play. Developing a customized treatment strategy to properly achieve the goals is the crux of orthodontics and it is imperative to do so because every case needs to be evaluated on an individual basis.

Expanders work: Palatal expansion is an old orthodontic approach with years of success behind it. Best done prior age 9 to allow for room for the permanent teeth to erupt. Pulling teeth causes premature aging of the face in many cases. We try to keep all the teeth in most all cases: full face orthodontics.

They work: 27 years experience in dentistry has shown that they work as designed.

Good Evidence: At the age of 9 and 11 palatal expanders tend to work very well depending on the amount of expansion needed. They will work up antil a point. Orthognathic surgery may be considered for the future if necessary. Removal of premolar teeth is also and option but one needs to make sure that the patients skeletal abnormality is addressed and not just camoflage it by moving and removaing teeth.

Depend on the age: Extraction orthodontics should be done at the early age (11-13) if it was chosen as the mode of treatment. However, in the adult, extraction of premolars should be avoided if possible due to the inability to close or maintain the complete space closure at the extraction site. Most of the relapse cause by large tongue with the tongue space being reduced by closing extraction space in the adult.

Lots: Over 65 years of history and reams of research papers attesting to the efficacy of palatal expansion in pre-tweens, tweens, and teens. With surgery can also be done for adults. Orthodontists try very hard to find non-extraction solutions, but still 30% of ortho patients require extractions, even many who also require palatal expansion. Sounds like your orthodontist's on the right track.

Palatal expanders: A large body of "information" is often advanced supporting use of devices which claim to "expand" palates, "when done at an early age". The issue is what actually happened with them? Did the patient just "grow" correcting the expansion? But long term stability of the "expansion" is quite subjective, results often reached by comparing dimensions of a (growing) 11 year old to the developed teen.

Tons: expanders are VERY effective devices. They are used worldwide by just about every reputable orthodontist, especially on kids that age.