Does turning the expander hurt?

Most children feel brief pressure or tingling for a few minutes after a turn, not sharp pain.

What if we miss a turn?

Don’t do two turns to catch up. Carry on at the next scheduled turn and let us know at the next visit.

Can my child play sports with an expander?

Yes. Wear a mouthguard for contact sports; ask us which one to use.

Why did the gap between the front teeth close?

The gums gently pull the front teeth back together after turning stops. The jaw stays wider.

Can my child use an electric toothbrush?

Yes. An electric toothbrush works well around an expander.

Early treatment

Caring for a palatal expander

A palatal expander gently widens your child’s upper jaw. A parent turns a small screw with a special key on the schedule your orthodontist gives you. Expect brief pressure after turns and a gap between the front teeth. Brush the expander after meals, and call us if it feels loose or the key won’t turn.

Reviewed by Dr. Yugal Behl, orthodontist · November 3, 2026

What does a palatal expander do?

In growing children, the upper jaw is two halves joined in the middle. An expander fits on the upper back teeth and sits against the roof of the mouth. Each turn of the screw widens the two halves a tiny amount, making room for teeth and helping correct a crossbite. After turning ends, the jaw sets in its new, wider shape.

How do I turn the expander?

Turn it exactly as your orthodontist prescribes. Turns are done by a parent or another adult. Our team will show you how at the visit, and you’ll go home with written instructions.

Sit your child with their head tilted back, in good light.
Find the small hole in the screw in the middle of the expander.
Put the key in the hole until it feels secure.
Push the key toward the back of the throat, as our team showed you, until it stops. A new hole will appear at the front.
Take the key out by pulling it down and toward the front, without pulling it back the other way.

What’s normal with an expander?

Pressure across the roof of the mouth, nose or cheeks for a few minutes after a turn
A gap opening between the upper front teeth. This is a sign the expander is working, and the gap usually closes later as treatment goes on.
A slight lisp for the first few days. Reading aloud helps.
Extra saliva at first, which settles quickly

How do we clean the expander, and what can my child eat?

Food can collect between the expander and the roof of the mouth. Brush the expander, teeth and gums after meals. Rinsing with water, or using a water flosser, helps flush out food.

Avoid sticky candy, caramel, gum and hard foods like nuts, which can loosen the expander or jam the screw.

When should I call?

Call us if:

The expander feels loose or rocks when your child chews
The key won’t go in, or a turn won’t finish (don’t force it)
There is pain that doesn’t ease with an over-the-counter pain reliever you would normally use
There are sores or swelling around the expander
The expander has come out (keep it and call us right away)

What happens when the turns are done?

When the jaw is wide enough, turning stops. The expander usually stays in place for several months, as your orthodontist advises, while the new bone sets. Then we remove it and plan the next step of treatment.