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Why do upper jaw expansion?

February 13th, 2020

Upper jaw expansion, if needed, is probably the single best treatment you can do for the developing child. The benefits are numerous:

  1. Children with a narrow upper arch are more likely to have Sleep Disordered Breathing (SDB) which includes Sleep Apnea

(Narrow Upper Jaw)

  1. Children with deficient hearing have an improvement after upper jaw expansion
  2.  Improvement in Halitosis
  3. Improvement in nasal breathing- upper jaw expansion has been shown to decrease nasal resistance

                                 (Before expansion)                            (After expansion, airway enlarged)

  1. Increased size of upper airway
  2. Decreased bed wetting

              (Before expansion tongue in low      (Normal tongue position after expansion,                            tongue thrust position)                    tongue in roof of mouth)

        (Before expansion and tongue thrust        (After expansion and resolution of                                          treatment)                                         tongue thrust)

  1. Decreased tongue thrust- normalize tongue position which helps in speech
  2. Improvements in cognitive functions by Sleep Disordered Breathing (SDB) patients after expansion because their sleep quality improves so can function better during day.

All this, and there is no mention yet of the skeletal and dental improvements which are achieved with upper jaw expansion.

(Before)                                                   (After)

  1. Correcting a functional shift caused by constricted upper jaw with a posterior crossbite allows the mandible to close normally without shifting. This reduces the stress on the TM joints and the potential for asymmetric growth of the condyles.

(Before expansion)                                                 (After)

  1. Developing enough space skeletally to resolve crowding and negate the possibility of extractions later.
  2. Improve the path of eruption of maturing teeth. Allowing them to erupt into supporting gingivae and thus develop healthy gingiva.
  3. Develop a full smile with upright posterior teeth which fill the buccal corridors for maximum esthetics.

Best Age?

We’ve covered all the benefits of upper jaw expansion. Now let’s understand when is the best age for expansion. Research has shown the best time is between the ages of 6 and 10 if you want to maximize the above benefits plus increase the stability. The upper jaw is very malleable during this stage of development so if expanded properly the upper jaw responds well and the results are stable, long term.

This type of expansion is skeletal, the other type of expansion is dental, this is when the teeth are tipped out which is not stable. Prior to age 10 expansion is about 85% skeletal 15% dental, as the child ages the numbers reverse. By 17 y.o. the ability to get skeletal almost zero.

Type of Expander?

The last area of concern is the type of expander used. Again we rely on good research to experience to choose the expander. The fixed quad helix is the top expander for results achieved. We have been using a specifically designed fixed quad-helix for 20 plus years. We custom design the appliance for not only posterior expansion but also anterior expansion, tongue restraining in tongue thrusting patients and crib for finger sucking. By doing this we don’t have to use different appliances and can treat multiple areas with one appliance. The expansion requires 6-8 months with 6 months retention for long term stability.

Don’t hesitate to contact us if we can be of any help!

What does Chlorine do to your Teeth?

January 29th, 2020


What does Chlorine do to your Teeth?

Often times we have patients with discolored enamel around their brackets.  One of the first things to take in consideration, especially in teens, is every day activities, like swimming.

Chlorine is one of the leading causes of teeth discoloration and many people aren’t aware of the problem because you can’t see the pH balance of a pool. This is also known as “Swimmer’s calculus.”  Pools have a high pH level that stains teeth brown and prevents saliva from doing its job in cleansing the mouth. Poor pH balance in a pool can also cause the enamel of teeth to soften, making teeth more susceptible to damage and decay, as well as more sensitive in general.

As the enamel of your teeth wears down from exposure to chlorine, it becomes discolored.  Poor enamel health is common in competitive swimmers because of prolonged exposure to chlorine which could also cause sensitivity.

How can you protect your teeth from Chlorine?

The best recommendation to prevent chlorine from staining  your teeth, would be to try and keep your mouth shut while you’re in the pool. This is nearly  impossible to prevent, but the less amount of pool water you get in your mouth, the better.

Another important thing to do, is to brush and floss your teeth as soon as you get out of the pool. You don’t want the chlorine to sit on your teeth any longer than necessary.  We suggest  always bringing  your toothbrush when you go to the pool to swim.

If you love to swim, make sure you have toothpaste with MI Paste or baking soda. Both of these can help fight the acid caused by pools and lessening the chances of chlorine discoloration of your teeth.

Can my child benefit from an Orthodontic Expander?

January 9th, 2020

Can my child benefit from an Orthodontic Expander?

                This is a common question concerned parents often ask.  They also want to know if their child needs an expander then when is the best age to do it. In this blog we will cover these questions.

Upper Expander

                When parents talk about expanders they are usually referring to upper jaw expanders (maxillary expansion). The lower jaw can also be expanded but that is a topic for another blog. We will focus on upper expanders here.

                Let’s answer the age question first. The best time to do an upper expander is between the ages of 6 to 10 years old. The reason for this is the bones through the sutures are very malleable so are easily reshaped. The older a patient gets the harder the bones are to reshape and the less stable they are when you do.

Narrow “V” shaped upper jaw

There are two types of expansion

1. Dental


                The best type of expansion in most instances is skeletal which is where the bones are reshaped because the results are more stable and the teeth are positioned more ideally over the bone which is healthier. So if you want the best expansion as mentioned earlier then do it in the 6-10 year old range. Dental expansion is where the bone stays the same shape and the back teeth are pushed out. This works best when the back teeth are angled inward.

Now, what are the benefits of using an Expander?

  1. More room for the permanent teeth and avoid extractions
  1. By developing more space, the permanent teeth can come in (erupt) into supporting bone which fosters healthy gums (less recession)
  1. Early skeletal expansion is more stable as noted earlier
  1. Promotes improved nasal breathing- being able to breathe through your nose is extremely important in proper facial development
  1. Decreases incidence of developing sleep apnea (OSA)
  1. Decreases “bed wetting” (enuresis)
  1. Possibly improves hearing in children with hearing loss
  1. Helps resolve tongue thrust which can create open bites of the front teeth and speech issues
  1. Can use to resolve thumb habits
  1. Can reshape narrow “V” shaped upper jaws into normal “U” shape which also can reduce protrusion of the front teeth


     Pre expansion                                             Post expansion

  1. Can also correct “underbites” if designed properly


Pre 3D expansion                           Post 3D expansion

  1. If performed properly can significantly reduce the time in braces as a teen

                The key is to have a properly designed expander which can function in 3D. They have to be fixed (removable expanders, ones that can be taken in and out, do not predictably work!) They also should not have slots which need to be turned by you with a key. The slot is usually turned every other day which causes discomfort and is difficult to do.

                Our office specifically designs each fixed expander to fit the needs of each child. Our patented 3D expander can work in all directions to achieve the most effective results. Other expanders only work in one direction. We activate the expander every 6 weeks so instead of potentially being uncomfortable every other day, the discomfort would be every 6-8 weeks for 3 to 4 visits. The 3D expander stays in for 6 months followed by 6 months of retention to ensure stability.

What are the downsides of expansion?

Really none, the predictability, the reduced need for extractions, the stability, less time in braces as a teen and better results! Plus as we mentioned it can help with sleep and optimum facial development.


If your child is in the 6-10 year old range, call us for a complimentary consultation.

Do vibrating or light emitting devices move teeth faster?

November 26th, 2019

Do vibrating or light emitting devices move teeth faster?

I am often asked this question on new devices that promise faster movement of the teeth which should result in shorter treatment times.

The current unbiased research (in other words, research that is not paid for by the manufacturer of these devices!) doesn’t support any claims of shorter treatment times. So if you have a friend who claims their teeth are moving faster because of using one of these devices or a dentist or orthodontist claims they will accelerate treatment, the research does not back up any of these claims. If it did you can be sure we would use them at Elite Smiles plus are there any long term (haven’t studied) negative consequences of using them, we don’t know.

Call or email if you’re ready to “build a better smile”