An Expander in Every Child's Palate

"Every night before bedtime, my daughter tilts back her head so that a pair of metal plates inside her mouth can be cranked apart another quarter of a millimeter. We turn a jackscrew with a wire tip; it spreads the bones within her upper jaw. At times she groans or even cries: she says that she can feel the pressure up into her nose. This is normal. My daughter is 9 years old. She has a palate expander."

"On Reddit's r/braces forum, a practitioner based in Frisco, Texas, said he was surprised by "how many parents ask me, 'Hey, does my child need an expander? Everyone else seems to have one.'" His colleagues seemed to notice something similar. "Everybody's being told they have a narrow jaw, and everyone's being given an expander," Neal Kravitz, the editor in chief of the Journal of Clinical Orthodontics, told me."

"Today, the reshaping of a child's smile may commence a few years earlier, at 7, 8, or 9 years old. At that point, the two sides of the upper jawbone haven't yet joined together, a fact that is propitious for a different orthodontic process: instead of straightening, expansion. During this phase of life, when kids still have some baby teeth, a tiny dungeon rack may be wedged between a child's upper teeth, then used to spread her upper jaw."

A nine-year-old uses a palate expander, cranked nightly to widen the upper jaw; the device spreads the midpalatal bones and can cause groaning or pressure felt in the nose. Palate expanders have become common among young children, with some fourth-grade classes reporting nearly one in four students wearing them and practitioners receiving frequent parent inquiries. Expansion treatment is performed around ages 7–9, when the two sides of the upper jaw have not yet joined, enabling the screw-based appliance to separate the suture and create space. The appliance dates back to at least 1860, when Emerson Angell described a similar central-screw device.

Read at The Atlantic