How Invisalign Palatal Expander Compliments The Invisalign+ Journey

You might have come across something called a palatal expander, or the more official term—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 Invisalign treatment. Basically, a palatal expander creates space in the mouth for teeth to align properly.

What makes Invisalign Palatal Expander (IPE) different from the older, traditional expanders is that the IPE is designed for optimal comfort by utilising modern orthodontic technology, and is even cleared by the FDA! Traditional expanders are often fixed in the mouth and use metal wires and screws to make the appliance wider. That can feel pretty uncomfortable, sometimes even digging into the gums or cheeks, causing soreness. The Invisalign version on the other hand, can be removed by the patient and is made from smooth material, so it doesn’t poke or scratch. It simply gives you a peace of mind knowing that your child in treatment is comfortable wearing it.

A palatal expander can complement the Invisalign+ journey by creating additional space in the mouth, improving the fit of your teeth and enhancing the effectiveness of the aligners. Let's explore how these clever little arch expanders work, making it an essential part of your child’s orthodontic adventure! Top 5 FAQs included at the end of the article.

What is a palatal expander?

A palatal expander is a dental device that is used to expand the palate (roof of the mouth). Hence, the palatal expander is always placed on the upper arch. Imagine it as a small tool that gently pushes the sides of the upper jaw apart, little by little.

Why does anyone need a palatal expander? It is required when the upper dental arch is just too narrow, which creates a broad range of complex challenges, such as—

• Insufficient Space for Adult Teeth: A small jaw will not provide enough room for all teeth to fit properly, resulting in common challenges such as misaligned and crowded teeth.
• Bite Irregularities: When the upper jaw is narrow, it makes it difficult for the upper and lower teeth to fit together correctly, creating dental jaw imbalances.
• Breathing Difficulties: A narrow or underdeveloped palatal arch can hinder proper breathing in kids, leading them to breathe through their mouths. Mouth breathing can create additional health issues, further affecting your child's overall well-being.

How does a palatal expander work?

To understand how it works, let's talk a little bit about the anatomy of the upper jaw. So, there is an important structure called a mid-palatal suture in the upper arch. This is a growth line that runs down the middle of the roof of the mouth, where the two halves of the upper jaw meet. In children, this suture is still soft and flexible because their bones are still growing and developing.

Since the suture hasn’t fully fused yet in children, the palatal expander can take advantage of this flexibility to gently guide the jaw’s growth. 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. This makes it easier to correct dental problems early on, avoiding more complicated procedures down the road.

A palatal expander therefore works by applying gentle, 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 suggests that children should have their first orthodontic check-up by age 7. This age is significant because, this is when most kids have both their baby teeth and permanent teeth, or a mixed dentition during treatment. This combination provides the dentist with a picture of how their teeth and jaws are developing. This proactive approach is called Early Intervention, and 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. The earlier the treatment begins (ideally around age 7-10 years), the better the results. The good thing about starting treatment early is that it makes it non-invasive, meaning that it does not require any surgery or major changes to the dental structures.

However, if we wait until after the mid-teen years, the palate becomes more rigid, making rapid expansion much more challenging and less effective. By that point, palatal expansion in adults in conjunction with surgery will be necessary. Furthermore, 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+ treatment.

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

Now, this is where it gets interesting. Sure, there are other palatal expanders available that does the same job, but what makes the Invisalign Palatal Expander system stand out? Let's explore below.

1) Traditional Palatal Expanders: The old-school approach

A traditional palatal expander is a metal orthodontic appliance that’s fitted to the roof of the mouth. It’s been around since the 1860s! It’s made up of two metal bands that sit on the posterior teeth, connected by a single piece of screw in the middle. A special 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—

1. Metal Screws: The most noticeable part is the screw in the middle. It needs to be manually adjusted regularly to make the appliance wider, which can be complicated as well as uncomfortable for both the patient and the person helping them.
2. Not Removable: Most types of traditional palatal expanders are fixed in place by the dentist. It cannot be taken out when eating or cleaning, which makes maintaining oral hygiene harder.
3. Comfort Issues: There will be discomfort of metal parts as they rub against tongue and cheeks, causing irritation.
4. Eating Challenges: Certain foods, especially if it is sticky or chewy, can get stuck or trapped around the device.
5. Speech Impact: It might take some time to get used to talking with the palate expander in place, which 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. Align Technology is the same 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.

1. 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, which is smooth and comfortable.
2. Removable Appliance: One of the biggest advantages of IPE is that it’s a removable appliance. This means it can be taken out while brushing so it’s much easier to keep teeth clean.
3. Comfortable Treatment Experience: There’s no metal to rub against cheeks or tongue, which reduces the risk of irritation or discomfort, allowing for exceptional patient experience.
4. Discreet Appearance: Traditional metal palate expanders are very noticeable but Invisalign expanders are less so.
5. 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, therefore improving experiences for patients.

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.

1. Maxillary Skeletal Constriction (Narrow maxilla): If your child’s upper jaw is narrower than the lower jaw, it can affect the way they bite. An expander can widen the upper jaw to improve this.
2. Unilateral Posterior Crossbite: This is when one side of your child’s upper teeth sits inside the lower teeth. It can cause jaw problems or make chewing awkward. An expander can help align the teeth correctly on that side, making it easier to bite and chew.
3. Bilateral Posterior Crossbite: This is similar to the unilateral crossbite but affects both the right and left sides.
4. Expansion Greater Than 6mm Desired: If the dentist determines that your child needs a significant expansion—more than 6mm—then a palate expander is often the best option.
   
   

So, while not every child will need one, if your child experiences any of these issues, an IPE could be a great tool to help create a healthy smile. To determine your suitability for Invisalign, it's essential to consult with your dentist, who can assess whether this treatment is the best option for your child’s specific situation.

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

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

1. Prevents future dental issues: One of the biggest advantage is that it can help avoid more complex dental problems down the road, which also means saving on future treatment costs.
2. Creates space: IPE creates the extra space needed for adult teeth to move into their correct spots.
    
3. Improves bite alignment: By expanding the upper jaw, it can also help in aligning the bite. This means that the way the upper and lower teeth come together will be more natural, reducing issues like overbites or crossbites.
   
   
4. Easy to maintain oral hygiene: 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!
   
   
5. Less pain and anxiety in patients as compared to traditional palatal expanders: Compared to traditional palatal expanders, IPE tends to be more comfortable, with less pain and anxiety.
   
   
6. Non-metal and removable, thus suitable for those who frequent regular MRIs: 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.

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

Your dentist will evaluate whether a palatal expander is necessary. They'll look for issues like narrow arches, crossbites or crowding that may require a palatal expansion treatment plan. If an expander is deemed necessary, the dentist will explain the benefits and what to expect during treatment.

3) Custom Treatment Plan

The dentist will take x-rays and scans using digital scanning technology (intraoral scanners) to allow for precise 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. It usually lasts for about one month. During this time, your child might feel some pressure, which is normal, as the expander is doing its job to create space for 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

After completing three months with the palatal holder, your child will begin wearing the Invisalign clear aligners. These aligners will gradually move the teeth into their desired positions. Worn for 20-22 hours a day, these aligners are virtually invisible, offering a discreet alternative to traditional braces.

9) Retention Phase

Once the treatment with aligners is finished, your child will enter the retention phase. This involves wearing retainers to maintain the newly aligned teeth and prevent any shifting back to their original positions. Click here to learn about the various retainers (invisalign+ retainer) at Dental Designs.

Top 5 FAQs on Invisalign Palatal Expander!

Q) What is the Invisalign Palatal Expander system?

The Invisalign Palatal Expander system is an orthodontic device used to gradually widen the upper jaw. It utilises patented technology from Align Technology to create a series 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.

Q) 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.

Q) 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.

Q) 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.

Q) How much does each expander widen the palate?

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

Conclusion

The Invisalign Palatal Expander represents a significant advancement in the field of orthodontic care, offering an intervention treatment solution for patients with a narrow maxilla. This orthodontic device uses proprietary technologies from Align Technology with commitment to innovation.

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 precisely 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.

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References

1. 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.