How Invisalign Palatal Expander Compliments The Invisalign+ Journey

You might have come across the Invisalign Palatal Expander System, while reading up on Invisalign for your child. It sounds complicated but it's really just an early intervention tool that helps set the stage for their Invisalign+ journey. Basically, a palatal expander creates space in the mouth for teeth to align properly. 

Traditional expanders are often fixed in the mouth. They use metal wires and screws to widen the appliance, which in turn widens the palate. That can feel pretty uncomfortable, sometimes even digging into the gums or cheeks, causing soreness. The Invisalign Palatal Expander, on the other hand, can be removed by the wearer. It is made from smooth material, reducing the likelihood of poking into cheeks. This makes it ideal for children.

This guide helps you know how these little arch expanders work, making it a crucial part of your child’s orthodontic treatment plan! Top 5 FAQs are included at the end of this article.

An Overview: What is a Palatal Expander?

A palatal expander, in broad terms, is a dental appliance that helps to widen the roof of the mouth. These are attached to the upper arch and work by means of controlled pressure exertion on the jaws, slowly widening the maxilla. This supports proper tooth positioning during the Invisalign+ journey.

Why do you need a palatal expander?

A palatal expander may be recommended by your dentist when the upper dental arch is just too narrow, which creates a broad range of challenges, such as:

• Insufficient space for adult teeth: Small upper arch may lack space for the eruption of permanent teeth and lead to crowding or malocclusions;
• Incorrect bite: Due to a narrow jaw, the upper teeth may not align properly with the lower ones leading to bite issues, such as crossbites;
• Breathing difficulties: A narrow or underdeveloped palatal arch can hinder a child’s breathing. Oftentimes this leads to mouth breathing. This creates additional health issues, further affecting your child's overall well-being.

How does a Palatal Expander work?

In order to explain the working mechanism of palatal expanders, it’s helpful to understand the anatomy of the upper jaw. The midline of the upper palate is divided by the mid-palatal suture. It runs along the centre of the roof of the mouth and joins the two halves of the upper jaw. In children, this suture is still soft and flexible because their bones are still growing and developing.

Palatal expanders take advantage of this characteristic feature of the mid-palatal suture in childhood. The expander pushes the two halves of the upper jaw apart, and over time, new bone forms in the gap, permanently widening the jaw, or creating a maxillary expansion.

A palatal expander, therefore, works by applying controlled, continuous pressure on the bones of the upper jaw in a lateral direction, to allow for palatal arch expansion.

Why is Palatal Expansion treatment started so young?

The American Association of Orthodontists states that a child's first orthodontic checkup should be done by 7 years old. By this time, many children have mixed dentition. This means they have both baby and permanent teeth. This allows the dentist to identify any developmental concerns related to tooth formation and alignment.

This proactive approach is called Early Intervention. It can help prevent minor issues from escalating into more serious problems as the child grows. This is why palatal expansion is started at a young age. Palatal expansion is part of an interceptive treatment solution and therefore is most effective during childhood, particularly between the ages of 7 and 12. Most dentists recommend starting expansion treatment in children using palatal appliances before they stop growing.

In case we wait until after the mid or late teen years, the palate will fuse, making palatal expansion much more challenging and less effective. By that point, palatal expansion in adults may be required in conjunction with surgery. Also, any expansion done in adulthood with permanent dentition has a higher chance of relapse.

It's important to understand that the purpose of a palatal expander isn’t to straighten your teeth directly, but to create space by widening the upper jaw. Once the jaw has expanded enough, your child will move on to their Invisalign+ journey.

What is the difference between a traditional Palatal Expander and Invisalign Palatal Expander?

We explored in the above sections on what palatal expanders do in general and why they are important. Let's now see how Invisalign Palatal Expanders (IPE) differ from the traditional ones.

1) Traditional Palatal Expanders: The old-school approach

The traditional palatal expander has been around since the 1860s. It is an orthodontic device made from metal bands that sit on both sides of posterior teeth, connected to a jackscrew mechanism in the middle by metal wires. An activation key is needed to turn the screw regularly to make the appliance wider, which slowly pushes the sides of the upper jaw apart to create the needed space.

Here’s why the traditional appliances can be a bit tricky to deal with:

• Metal Screws: The first thing one will see about the traditional appliances is that there is a metal screw located at the center. This needs to be adjusted periodically as per the treatment plan, which may cause some discomfort.
• Non-Removable: Most palatal expanders in the category of traditional ones are permanently fixed to the teeth. So, patients cannot remove those by themselves when eating food and performing other activities like brushing teeth.
• Can be Uncomfortable: It will cause irritation in the mouth when rubbing against the tongue and cheeks due to the presence of metal.
• Challenges when Eating: Chewy or sticky foods tend to get caught around the appliance.
• Speech Issues: The device might cause difficulties while speaking. This can be frustrating for younger patients.

2) Invisalign Palatal Expander: The modern alternative

The Invisalign Palatal Expander system (IPE) is a removable alternative as well as an effective alternative that is designed to be more comfortable. This system uses a series of removable devices that gradually adjust the upper jaw. It is designed to work with Invisalign aligners for early intervention treatment of children. IPE utilises patented technology developed by Align Technology, which is a medical device company.

IPE utilises patented technology developed by Align Technology, which is the same medical device company behind the Invisalign® clear aligners and the iTero Element® scanner. In December 2023, the IPE system from Align Technology received FDA clearance (with regulatory approval starting in 2024) for helping with dental and skeletal expansion in growing children.

• No Metal, No Screws: IPE device design does not involve bulky metal screws and discomfort of metal parts. It is custom-made using 3D printed nylon, giving it smooth contours.
• Removable Appliance: It can be removed while brushing teeth. This is especially beneficial for young children to maintain oral hygiene.
• Comfortable Treatment Experience: The absence of metal wires and metal bands offers patients a pleasant treatment process. It also eliminates the risk of metal allergies.
• Discreet Appearance: Traditional metal palate expanders are noticeable but Invisalign expanders are less so.
• No Manual Adjustments: Patients receive a series of expanders that they can change out on their own, moving up to the next one as they progress.

What are the indications of Invisalign Palatal Expander?

Determining whether your child needs an Invisalign Palatal Expander (IPE) as part of the orthodontic treatment depends on a few factors related to their dental development. Here are some signs that may indicate its necessity.

• Constriction in maxillary skeletal structure (Narrow maxilla): If the width of the upper jaw is smaller than the lower jaw, it influences your child's bite alignment and causes problems in jaw functioning. Expansion of the upper jaw helps to achieve its optimal size.
• Unilateral posterior crossbite: In a normal bite, the upper back teeth sit slightly outside the lower back teeth when the mouth is closed. In unilateral posterior crossbite, the upper back teeth will sit inside the lower back teeth on either the left or right side. This can cause jaw issues and potentially make chewing uncomfortable.
• Bilateral posterior crossbite: This type of posterior cross bite affects both sides of the mouth.
• Expansion Greater Than 6 mm Desired: If the Invisalign dentist determines that your child needs a significant expansion (more than 6 mm), then a palate expander is often an appropriate option.

If your child experiences any of these conditions, an Invisalign Palatal Expander could be an effective tool to help create a healthy smile. We recommend consulting with an Invisalign-accredited dentist. They will conduct a thorough checkup and determine your child's suitability for Invisalign.

Click here to ask us your questions! We are here to help.

What are the benefits of Invisalign Palatal Expander (IPE)?

• It can help avoid more complex dental problems down the road. This also means saving on recurring treatment costs in the future.
• IPE creates the extra space needed for adult teeth to move into their correct spots.
  
• It supports bite alignment with the upper jaw expansion. This means that the way the upper and lower teeth come together will be more natural, reducing issues like overbites or crossbites.
  
• With traditional fixed expanders, it’s common to see swollen gums upon their removal by the dentist at the end of the treatment, due to the difficulty patients have in keeping the area clean. But with IPE, patients can pop them out every day, making it simple to keep everything fresh and clean!
  
• Compared to traditional palatal expanders, IPE tends to be more comfortable, with less pain and anxiety.
  
• Some patients with medical conditions such as epilepsy may need regular MRIs. As IPE does not contain any metal, IPE may be preferred over traditional options.

1. Invisalign Palatal Expander Treatment Process

   1) Consultation

   Schedule an appointment with the dentist for an initial assessment, ideally before your child turns 7 years old.

   2) Diagnosis

   The dentist will decide if your child needs a palatal expander based on clinical signs like a constricted upper arch, crossbite, or crowding. If so, they will outline a treatment plan and discuss expected results.

   3) Custom Treatment Plan

   The dentist will take x-rays and scans using digital scanning technology (intraoral scanners) to allow for proper measurements for a treatment plan that is tailored specifically to your child.

   4) Attachments and Issuance of Palatal Expanders

   Once the expander is ready, it will be issued to your child. Small buttons or attachments will be bonded to the posterior teeth of your child to hold the palatal expander. The aligner dentist will explain how to properly insert and care for the device.

   5) Activation Phase

   In this phase, the palatal expander will need to be changed regularly - typically every day or every two days, as per your dentist's instructions. This activation of the invisalign process gradually widens the upper jaw. This normally takes about a month. During this period, your child may experience slight pressure; however, this is natural as the expander does its job of creating room for the teeth.

   6) Holding Phase

   After the activation phase, your child will transition to the subsequent holding phase. During this time, they will wear the palatal holder full-time, including when eating and drinking. Each holder will be changed every two weeks and worn for a total of three months. This is a maxilla post-active expansion phase that allows the expanded palate to stabilise and ensures that the new width is maintained while the surrounding bone and tissues adjust.

   7) Scan for Invisalign Clear Aligners

   Two months into the holding phase, your child will return to the dentist for a scan to create custom Invisalign clear aligner options. At Dental Designs Clinic, we offer Invisalign+ for kids aged 5 to 8 years old and Invisalign+ Teen for teenagers. It’s essential to keep wearing the palatal holder full-time during this period to ensure the expansion is solidified before transitioning to aligners.

   8) Aligners Phase

   Once your child has been through three months using the palatal appliance, they can use the Invisalign clear aligners to shift the teeth into place. The patient must wear the clear aligners for 20-22 hours a day.

   9) Retention Phase

   After completing the alignment process using the aligners, your child will be moved into the retention stage. Here, he or she will have to wear retainers that will ensure that the teeth remain in place. Click here to learn about the various retainers.

   Conclusion

   The Invisalign Palatal Expander changes how narrow upper jaws are treated in modern orthodontics. Instead of old-style methods, it brings a fresh approach made possible by Align Technology's systems. Built with precision, this tool expands the palate to support your child's Invisalign+ journey.

   It is designed with patient comfort in mind for palate expansion, positioning itself as a modern alternative to metal palatal expanders. IPE utilises digital orthodontics and digital scanning from an intraoral scanner to tailor the device to the individual patient's anatomy.

   Is your child ready to start his/her Invisalign journey? Simply leave us a message here to book an appointment.

   WhatsApp us at : +65 8200 9092

   Call us at : +65 6221 8284

   Top 5 FAQs on Invisalign Palatal Expander

   1. What is the Invisalign Palatal Expander system?

   The Invisalign Palatal Expander is a dental device that expands the palate. The device utilises patented technology from Align Technology to manufacture a set of 3D-printed expanders. These expanders follow the shape of the palate and fit over three back teeth that has sufficient clinical crowns: the first primary molar (or first premolar), the second primary molar (or second premolar), and the permanent first molars.

   Each expander is custom-made from medical grade nylon with 3D printing technology to match each patient’s unique mouth - no metal involved.

   2. How do the expanders work?

   Patients receive a series of removable expanders, each worn 24/7, even during meals. The expanders should only be removed when switching to the next one or for brushing and flossing.

   3. Do I need to remove the palatal expander when eating and drinking?

   The Invisalign Palatal Expander is designed to be worn while eating and drinking, making it much easier for young children to adapt to treatment without disruptions to their daily routine.

   4. How often should the expanders be changed?

   Expanders are typically changed every day or every other day, based on the dentist’s instructions. This process usually continues for about a month. It’s a good idea to keep the original expander in a bag for reuse in case there’s any relapse.

   5. How much does each expander widen the palate?

   Each expander works to gradually widen the palate by about 0.25 mm, to achieve a total expansion of at least 6 mm.

   References

   • Inchingolo, A. M., Patano, A., De Santis, M., Del Vecchio, G., Ferrante, L., Morolla, R., ... & Dipalma, G. (2023). Comparison of Different Types of Palatal Expanders: Scoping Review. Children, 10(7), 1258.