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Dentistry/Nose widening with palatal expander


Hello Dr. Teig, I saw an earlier post similar to a situation that I am having with my daughter. It is related to the widening of her nose and facial changes after having a palatal expander. She is 13 and half and a year ago she had a palatal expander. We turned it about 32 times / once a day. She may have had a small crossbite but the expander was used more to make room for a crowded mouth. As I was turning the appliance, I brought to the attention of the orthodontist that it looked like my daughters nose was swollen. He said it may be but didn't show concern of any permanent changes. I did bring it up again but was told that it would not have been from the palatal expander but more from her natural growth. I disagree because there were such visible changes in her entire facial appearance specifically during the 6 weeks she had the expander. I am so upset and feel like the orthodontist somewhat is ignoring my concerns. She may have a great smile after her braces are off in about a year but I can't get passed the fact that her face has changed so much. It actually keeps me up at night. I feel like I want to discuss with the ortho again but I don't know why - particularly if there is nothing they can do. It's not fair that I will be paying for surgery later because of something that they did not consider during her treatment :( Do you have any advice?

Roni - You are definitely observant of the spreading of the lower face with palatal expanders.  This situation always occurs and after the palatal expander has been stopped and removed, many have the nasal area return to close where it was.  Others retain a wide nose and need to have plastic surgery to regain a narrower nose.

You are correct that the doctor should have advised you in advance.  Advice is tough now.  I would suggest that you wait to see if there is any relapse of the nasal area after the expander is removed.  The orthodontist should have advised you in advance of the possibilities.  I wish I could come up with a simpler answer, but for now time is important.  Waiting to see if there is a nasal relapse might be a good idea.  Surgery can always can be done, for now see if natural growth reverses the nasal situation will occur.  

Sorry there is not a simpler more predictable result.  


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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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