AnnMaxillofacSurg_2011_1_1_32_83152_u2I’ve mentioned on numerous occasions the benefits of orthodontic treatment during childhood, when we can guide the child’s growth to create orthodontic improvements that otherwise would require surgery if attempted in adulthood.

However, I maintain that it is never too late for adults to seek treatment. Even if you have reached adulthood and your teeth’s supporting structures have stopped growing, there still are treatments available that can achieve significant improvements in your smile.

Today I’m sharing some information regarding the great debate between expansion and extraction as a part of orthodontic treatment in adults. First, I’ll explain how expansion is achieved in children, so I can properly compare it to the methods often used in adults.

Rapid Palatal Expansion for Children

The upper jaw consists of two halves of bone that are separated by what is known as a suture, or growth plate. The growth plate doesn’t become fused to the bone until a child is around 14 to 16 years old. Until that fusion happens, steps can be taken to widen a child’s palate to make room for teeth that haven’t yet erupted. Creating more space often eliminates the need to extract teeth.

Expanding the palate also corrects crossbite.

I achieve this additional room by placing an appliance called a rapid palatal expander in the roof of the mouth. It is secured in place by attaching it to molars on each side of the upper jaw. A keyhole is located in the middle of the device. Each day the child or parent uses a small key to turn the appliance, which pushes the two halves of the bone in opposite directions.

A common sign that the expansion is happening is a space that forms between the front two teeth.

Palatal Expansion for Adults

What a lot of people often don’t realize is that tooth extraction isn’t the only way to create enough room for crowded teeth in adult patients. Palate expansion can be an option for adults, too. Once a person has stopped growing, the two halves of the upper jaw have fused together, but they can be separated and widened with a surgical procedure.

Surgically assisted rapid maxillary expansion is an outpatient procedure performed under general anesthesia by an oral surgeon. It involves freeing the two halves of the upper jaw for minimally restricted expansion.

In cases of crowding in an adult mouth, I discuss both options—expansion and extraction—and share the advantages and disadvantages of each. The primary benefit of SARPE is a fuller smile that fits the patient’s true lower arch width. One disadvantage of extracting teeth is that doing so can significantly collapse the dental arches and only compensate for the skeletal discrepancy instead of correcting it. The ultimate decision is up to the patient.

If you’re an adult who has considered orthodontic treatment, I invite you to call our office to schedule a consultation. This consultation includes a comprehensive orthodontic exam and a complete set of X-rays. I use this information to create a recommended treatment plan that will successfully address your unique case.

I look forward to seeing you in the office soon!

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