Palatal Expansion and Tooth Gaps
An orthodontist might recommend palatal expansion when it’s necessary to widen the palate to make room for crowded teeth. This treatment is most frequently recommended for children and adolescents, as the optimal time for palatal expansion is when the bones are still maturing and are therefore more easily modified and manipulated. In many cases with children, dental specialists can even widen the palate before the adult teeth erupt, preventing issues like crowding before they even arise. Crowded teeth and other orthodontic issues that arise when a person’s palate is too narrow could lead to oral hygiene challenges, jaw pain, and other medical concerns, in addition to the evident cosmetic issues. When the palate is expanded, a gap may appear between the front teeth as they migrate away from each other when given more room in the jaw; especially when palatal expansion is part of a largely cosmetic treatment, this may cause concern. A gap appearing in the teeth is a normal part of palatal expansion therapy and will be addressed as an element of the patient’s overall orthodontic treatment.
Palatal expanders are recommended for patients whose upper jaws are too narrow to properly accommodate their teeth. The palate is made of two separate bones that suture together in the middle, in a union called a mid-palatal suture. In childhood, the mid-palatal suture is made of cartilage, which is more flexible than bone, but as a person matures, this area fuses together and becomes a single piece of bone. This usually happens in adolescence, between the ages of 14 to 18. When palatal expanders are used when the mid-palatal suture is still cartilaginous and flexible, they separate the two bone plates and hold them in place, stabilizing them and allowing bone to grow where the cartilaginous suture once was. Once the bone has grown in, the palatal expander is removed.
Palatal expanders move the two halves of the maxillary bone, which makes up the upper jaw and palate, separating them. It’s completely normal for a gap to appear between the front teeth during this expansion process. In fact, the gap that appears is actually a sign that the palatal expansion therapy is working. When a gap forms between the two front teeth, this is an indication that the palate is successfully expanding. Once the palatal expander is removed, after a period of several months in which bone is replacing cartilage and the width of the palate fixes in place, the jaw can be expected to retract back slightly. This is also normal, and when orthodontists calculate their treatments, they factor this bone response into the equation. The shorter explanation for this is that the gap that forms during palatal expansion treatment is by design, and as the bone settles into place following expansion, the gap will naturally close. In many cases, additional orthodontic treatments will accompany palatal expansion, so when a gap between the teeth doesn’t close on its own, it will be addressed in the overall plan. In younger patients, parents often notice that the gap that appears during palatal expansion disappears on its own as the jaw adjusts and the teeth adapt into their appropriate positions. While the appearance of a gap between the teeth may be alarming at first, it shouldn’t be a cause for concern and is most likely a natural part of the overall orthodontic treatment.