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Dentistry/palatal expander

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Expert: Dr. Randolph Myerson - 3/3/2010


Question
sorry my question was confusing. One orthodontist wants to use a palatal expander for several months or more on my 12 yr old daughter, then follow with braces some time later. He said that it would mean no teeth pulling and more room for her permanant teeth. She has no crossbite. 2 other dr's say they would just use braces and pull a couple teeth if necessary.  I don't know what is the best course but know that the expander adds a hefty price tag. Does palate expansion make a big enough difference in the long term to justify the price tag? I also worry that since she allready has jaw problems that the expander might worsen it.

Answer
Thank you for clarifying your question.  I'm going to try to give you some general answers without the benefit of adequate information regarding your daughter's dentition, bite, jaw relationship, facial structure and other aspects of her situation which are essential for an understanding of her treatment needs.
Expanding the upper jaw can provide some additional space in the upper dental arch for her teeth to be aligned.  Whether this has any influence on her "jaw problems" is unknown.  However, in the absence of a crossbite, it seems to me that expansion of the upper jaw will make the upper jaw too wide for the lower jaw. This, in turn, would require expansion of the lower jaw which is very unstable and would probably relapse or return to it's natural width following treatment.  Palatal expansion doesn't seem to make sense to me, but then I've not examined the patient nor the diagnostic information necessary to make a treatment decision.

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Dr. Randolph Myerson

Expertise

Please limit your inquiry to questions about orthodontics (braces) and children's dentistry. I am both an Orthodontist and a Pediatric Dentist, having been trained in both of these dental specialty fields. Orthodontics is the dental specialty that treats problems of tooth, bite and jaw alignment using braces and removable appliances. Pediatric Dentistry is the dental specialty also known as dentistry for children, which deals specifically with the dental problems of this special age group from infants to adolescents. I am also experienced in Forensic Dentistry, the application of dentistry to law enforcement and identification using dental records.

Experience

I have been in the private practice of orthodontics and pediatric dentistry for over 20 years. Prior to that I served for three years on the Cleft Palate and Cranio-facial Reconstruction team at Children''s Hospital of Philadelphia and was an Assistant Professor of Dentistry at University of Pennsylvania School of Dental Medicine. I also served as a dentist in the U.S.Air Force, stationed at Andrews AFB in Washington, DC.

Organizations
I am a Fellow in the American Academy of Pediatric Dentistry, and a member of the American Association of Orthodontics, as well as a member of the American Dental Association and the Dental Society of the State of New York.

Education/Credentials
I received my BA in Biology from Frankin & Marshall College in 1969, and my dental degree from University of Pennsylvania School of Dental Medicine in 1973. In 1978 I received both my Certificate in Orthodontics from University of Pennsylvania School of Dental Medicine, and my Certificate in Pediatric Dentistry from Children''s Hospital of Philadelphia after completing a three year Teaching Fellowship in Orthodontics and Pediatric Dentistry in 1978.

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