Posts for: June, 2014

KristinCavallarisSpaghettiCatcher-FirstStepToAWinningSmile

Kristin Cavallari's flawless smile has been featured on TV, film and magazine covers. But the 25-year-old actress and reality-show personality didn't always have a perfect set of teeth. In fact, she told Dear Doctor magazine — where readers recently voted to crown her with the “Smile of the Year” award — that her dental treatments began the same way many do: with orthodontics in sixth grade.

“I had the ‘spaghetti catcher,’ which is what everyone used to call it,” she reminisced. But by that, she didn't mean a strainer — she's talking about what dentists call a “palatal expander.”

In case you're not familiar with this orthodontic device, a palatal expander takes advantage of the natural growth patterns of a child's upper jaw to create additional space for the top set of teeth. How does it work? Basically, it's similar to braces: By applying gentle pressure, the appliance creates changes in the jaw. Unlike braces, however, it's invisible — it fits between the upper teeth, close to the roof of the mouth.

During the three to six months a child wears the palatal expander, it pushes the left and right halves of the upper jawbone apart, and then maintains and stabilizes the new, wider spacing. Since the palatal bones don't fuse until after puberty, tightening it a little bit each day for the first few weeks provides a quick and painless method of making the upper jaw a bit roomier. And that can be a very good thing. Why?

There are lots of reasons. For one, it can relieve the condition called “crowding,” when there is not enough space in the upper jaw to accommodate the proper alignment of the permanent teeth. In the past, teeth often had to be extracted in that situation. It may even allow “impacted” teeth — ones which are blocked from erupting by other teeth — to come in normally.

It can help treat a “crossbite,” when the back top teeth come down to bite inside (instead of outside) the lower back teeth. It also generally shortens the total time a child needs for orthodontic treatment. That's good news for any teenager — even if their own day-to-day “reality show” isn't featured on TV!

If you would like more information about palatal expanders, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Palatal Expanders” and “Early Orthodontic Evaluation.”


CaughtEarlyCross-BitescanbeCorrectedWithPalatalExpanders

There’s more to orthodontics than simply moving teeth. Especially with children and adolescents, we also want to guide the development of the entire facial structure to solve certain types of malocclusions (poor bites).

One such concern involves the upper jaw and palate (roof of the mouth), known collectively as the maxilla. In some individuals, the maxilla is narrower than normal. This causes the upper teeth to fit abnormally inside the lower teeth when occluding or “biting down” and is known as a cross-bite. A cross-bite may restrict the amount of space for your teeth to erupt (appear in the mouth) in proper alignment. It can be so severe the individual may have to shift the jaw to one side to completely bite down.

If a cross-bite is caught early, there’s a non-surgical treatment to widen the maxilla and help prevent upper teeth misalignment. But there’s a limited time window of opportunity: this is because the maxilla is actually formed by two bones with a seam that runs down the middle of the palate. The two bones will eventually fuse, usually at the beginning of puberty; until then there’s a slight separation.

Before the bones fuse, we can use a palatal expander to widen this seam and encourage permanent bone growth in the resulting gap. The expander is made of two metal halves joined in the middle by a small screw device that fits between the teeth. You or your child turns the screw a very small amount once or twice a day with a special key and the action pushes the maxilla outward on either side: the slight tension created stimulates bone growth. Over time, the new bone will have added width to the maxilla and eliminated the cross-bite.

While it’s possible to correct this after the maxilla fuses, it will require surgery to separate the bones. The palatal expander helps us correct the problem in the most non-invasive way possible, but it must be done before puberty. Discovering this type of malocclusion early is one of many reasons why regular dental visits should be an important part of your child’s healthcare.

If you would like more information on palatal extenders, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Palatal Expanders.”