Why is the Dental Profession Obsessed with Maxillary Expansion? By: Dr. Nishita Ondhia

Why is the dental profession obsessed with maxillary expansion?

You hear it all the time, “my child has an orthodontic expander.  I am not sure it is needed, I think it is a money grab! Honestly!”

Or you hear, “My orthodontist says expansion is not needed, but all my child’s friends have an expander.”

So Why and when do you expand? And by Whom?

Read “Breath” by James Nestor and “Breathe, Sleep, Thrive” by Dr. Shereen Lim. 

These two books drive home the message that proper nasal breathing and tongue posture is crucial to the development of a child’s face; mouth breathing negatively affects face formation and one’s overall health and wellness.

We expand the maxilla to affect the structure of the face and thus promote more efficient nose breathing. Nasal breathing is paramount as it sets in motion a cascade of ideal muscle use positively affecting craniofacial growth.

When do we expand?  We expand the maxilla at different ages/stages depending on the diagnosis.  Note, the maxillary palate is actually the floor of the nose.  The wider the palate, the wider the nose, the more probable we effortlessly nose breathe.  Under the age of 5, we expand to prevent neurocognative diseases. Under the age of 7, we expand to prevent traumatic occlusions including a cross bite, underbite, deep bite or crowding.  We are not in the business of straightening teeth at this stage, there are no teeth to straighten.  Expansion in teens is treating malocclusion and trying to regain space for ideal orthodontic alignment.  In adults, this includes everyone ages 12 and up as all the adult teeth are present, we are expanding to find space – at this point we are trying to fit a square into a circle (it is late in the game but still helpful).

Who can expand?  Any dental professional who has an interest and is trained in craniofacial development.  General dentists with this expertise are well positioned to provide early interventional orthodontics.

The take home message?  We need to nasal breathe.  Expansion of the maxilla at any stage, is a well researched method to provide the facial structure needed promote nasal breathing.  Lack of space causes poor tongue posture leading to mouth breathing.  If diagnosed, start early, it will set you on the right path for ideal health and wellness.

-Dr. Nishita Ondhia