How to turn an expander

Step 1

Start with having the child lie on his or her back, with their head at the edge of a bed or over the arm of a sofa. Use adequate lighting from a bright lamp or flashlight.

Step 2

Have your child open their mouth as wide as possible, as that will minimize the gag reflex.

Step 3

Now place the key in the center hole and start turning in the direction of the arrows that are on the expander.

Step 4

Turn the expander toward the back of the mouth until you can see the next hole

Step 5

Carefully remove the key in a down and back direction. Caution: Be very careful not to “unturn” the expander when removing the key

Additional Directions

• Be sure to follow the doctor’s instructions as to how often to turn the expander
• Try to make the adjustments at about the same time every day

Cautions for all expanders

• Pulling an expander key in an outward direction can cause separation of the metal portion, which may be swallowed
• Do not skip any days of turning the expander. Skipping a day may lengthen the time for the expansion
• If nuts, seeds or hard food particles block the key hole, carefully clear the hole with a toothpick before turning
• If you cannot keep a scheduled appointment, DO NOT continue to turn the expander until after you have spoken to the doctor

Diet and cleaning your expander

• Maintain a soft diet for the first few days after receiving the expander
• Avoid hard or sticky foods, like popcorn or caramels. Those type of foods might dislodge the expander
• Brush thoroughly after meals to keep the expander free of food and plaque

What to expect with an expander

• A temporary lisp or slurred speech
• Excess saliva for a few days
• Possible initial difficulty in chewing and swallowing
• Pressure on the teeth, palate and nose after adjustments
• Temporary irritation of the tongue
• Possible headache
• A slight change in facial appearance
• The bite may feel “off”
• Certain foods will catch on the expander
• A temporary space will appear between the upper front teeth as expansion progresses

If you have excess saliva, swallow before speaking. With discomfort use a mild, over-the-counter pain reliever. If you are experiencing any other issues with your expander, click here for our emergency help page.

These are normal and expected effects of a rapid palatal expander and are not reasons to remove the expander prematurely. Braces are usually required following palatal expansion to align the teeth and fine-tune the bite.