The palatal expander is specifically designed to expand, or widen, your upper arch (jaw). This is achieved through pressure exerted on the upper molars by the continual activation of the appliance. As the arch expands and adapts to its new position, the pressure you feel will ease.

When to Activate
The doctor will provide you with the following information: Please adjust your appliance ¼ turn every ______day(s) for the next _____week(s). We will schedule an appointment to see you after that time to evaluate your progress and instruct you regarding future adjustments.

Activating the Expander
For visibility reasons, activation is most easily accomplished by someone other than the patient. To activate the expander:

• Have the patient lie down; have good light available (a flashlight can help).
  
• Insert the key into the key hole in the center hole of the expander.
  
• Carefully push the handle toward the back of the mouth. This rotates the key and expansion screw.
  
• Remove the key from the back position (toward the tongue).
  
• NOTE: Pulling the handle forward when removing will undo the activation.

What to Expect

• The expander is rather large and bulky, and may interfere with your speech initially, but you will adapt to it quickly. (Reading aloud at home tonight is a good way to practice saying many different sounds.)
  
• Activating the expander may cause some slight pressure on the teeth near the nose, on the roof of the mouth, or toward the cheekbones. This sensation usually subsides within several minutes and Advil or Tylenol is rarely needed.
  
• A noticeable effect of the expander may be separation of the two front teeth. This is normal and the space will close naturally when the expansion is stopped.
  
• After full expansion is achieved, you will continue to wear the appliance for 3 to 4 months. This allows time for new bone to fill in and insures that the widening will not relapse.

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