Drs. Poco and Buchanan's Advice on Expander Appliances
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Crowding and lack of space for the adult teeth is a very common problem for orthodontic patients. In growing individuals the tendency is for the jaws to lengthen but narrow over time. In adults, the narrowing and crowding continues over an entire lifetime. Expansion or widening of the jaw is an effective treatment in certain growing patients with overly narrow or constricted jaws. Expansion is most effective before puberty when the jaws are still moldable.
HOW THEY WORK
Upper jaw expansion works by opening the sutures of the upper jaw and allowing the new bone to grow. Expansion of the lower jaw involves uprighting tipped lower teeth, since there is no lower suture to open.
Expanders can be cemented appliances (fixed or glued in) or removable (retainers).

HOW TO USE
There is a key that is inserted into the appliance and turned as directed by the doctor. An arrow next to the keyhole indicates the direction of the turn. Some initial pressure or tightness for about 5 minutes should be expected. A space may open between the front teeth. This is a good sign, showing that the suture is opening. The front teeth will generally drift to close that space or we will later close with partial braces.
CLEANING AND CARE 
OF YOUR EXPANDER
Cool water, toothpaste and a toothbrush are needed to clean your expander. If your expander is cemented in, brush it as you would your teeth, paying special attention to the bands that hold it in. Brush gently along the gum line to remove the plaque. If your expander is a retainer, take it out of your mouth and brush it with the same brush and toothpaste as you would your teeth. Plaque sticks to plastic retainers better than teeth, so extra brushing is important, especially around the top of the retainer and where the wires join the plastic. Brush often, at least three times a day and at least for two minutes at a time.
FOR RETAINERS ONLY
If plaque builds up on the retainer over time, it will dry and harden like tartar on the retainer and be difficult to remove with a brush. Denture cleaners like Efferdent or Polydent are effective in removing this tartar. Follow the directions on the package. Remember to leave the retainer in the cleaner for no longer than 10 minutes. Use once a week if needed. To economize, try lemon juice first to dissolve and loosed the tartar before brushing. You may not need anything else!
GETTING USED TO YOUR EXPANDER
Speech is different for the first few days with any orthodontic appliance, including expanders. Try practicing talking or reading out loud, saying many different words to practice placement of your tongue. You will have a juicier mouth for the first few days, that's okay. If your expander gets food stuck to it while you are eating, try to take small sips after each bite of food to help wash it down. Don't worry, after just a few days it will feel like an old friend!!

                                    


 
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