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Dentistry/jaw expander


Dear Dr. Myerson,
My 7 y/o girl was recommended upper jaw expander 'to make room for the future adult teeth', and braces in the future.
Now her face is proportional,jaws are perfectly aligned, she has front 2 upper (with a visible space between them) and 2 low (look N) adult teeth in place.
The questions are:
1. What are possible complications of jaw expanders: face changes, jaws misalignment (her orthodontist said that she wouldn't probably need lower expander, that the lower jaw 'will follow' the upper, is it right?), bite problems, etc...
2. How long it safe to wait (until what age)to see if her jaws will grow and teeth align naturally w/o intervention?'to make room for the future adult teeth', and braces in the future.
Now her jaws are perfectly aligned, she has 2 upper and 2 low adult teeth in place.
Thank you
-Ludmilla Bondarenko

You ask some very important questions.  When I see a youngster in my office with the same situation I ask the same questions.  And that is why I don't recommend expansion when there is no problem with the width of the upper jaw.  I also ask myself, how often does the "lower jaw follow the upper jaw", and what do you do if it doesn't follow the upper jaw now that there's a problem with the bite as a result?
One thing I do know is that in situations like this the jaws will certainly grow but not in any way that will allow the teeth to align naturally without any future orthodontic intervention.
Here's what you can more incisors emerge the crowding will get more pronounced.  Permanent teeth, for the most part, are larger than the baby teeth they replace.  Jaws will grow but mostly not in the area where the teeth are developing.  The early crowding you see can be seen as nature's warning.   There's more to come.
Now, I've not examined your daughter so I don't have all the necessary information available to make any recommendations except for this.  Go get a second opinion, ask all the right questions, find an orthodontist whose explanations make sense to you after you hear the answers and let that orthodontist follow your daughter as she grows and develops.


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Dr. Randolph Myerson


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.


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.

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.

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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