When the orthodontist does your initial exam they may determine that if need an expander. An expander can be placed on the top or the bottom arches. There are fixed expanders or removable ones. Another name for an expander is an rpe.
At your initial records appointment if you are getting a fixed expander they will place separators. These are little rubber bands that are flossed in between your teeth. The purpose of them is to create space to fit molar bands around your teeth at the following appointment. You may encounter a little discomfort for a day or so with them. If you get the removable expander you will not need these.
Next appointment, this is the day they remove the separators. Then the orthodontist or orthodontic assistant will try molar bands on your teeth. If you only need an upper expander you will only need two. It sometimes takes a few times to find the right size. They may ask you to bite on a bite stick to help seat the molar band properly. Some offices then remove the bands with a band remover and some keep them in and remove them later on. An impression is then taken of your teeth. Again if you’re only getting the top expander you only need one impression. The impression is alginate material that takes a foot print of your teeth. An impression tray to try in to find correct size for your mouth then the impression material is placed in the dental tray. It is a pudding like texture that turns hard after being in your mouth for less than about 2/3 mines. Take deep breathes in your nose while the tray is in. Keep in mind that the tray cannot be removed from your mouth until the material hardens. If it is taken out to early you will need to redo it and there will be a mess in your mouth. If it is difficult for you and you have a gag reflex. Try lifting each leg one after the other holding them each for 5 seconds at a time.
You are now done with the first appointment. Next you come back to insert your separators again and then the following appointment get your expander. If you get a removable one the orthodontist will explain how to take in and out and care for it. If a fixed expander they will now cement the rpe in your mouth. The separators are removed and the bands you tried on at the previous appointment that are attached to the rpe are tried in. This is to make sure the lab made a perfect fit. It’s then removed and the cement is placed on the bands and it’s placed on your molars in the back. A light is used to cure and set the cement.
Now someone will show whoever came with you how to turn the key with the expander. You normally have to do 1-2 turns daily for 7 days. You may feel pressure when this is being done. Take Tylenol or Advil if needed. You will return to the office in about 2-3 weeks and they will determine if you need to do more turns. If not, the appliance needs to stay in or you keep wearing it for about 6 months. You may notice a space open up in the front teeth. This s normal and should close on its own in the future.