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Orthodontics/braces and expander



My 9 year old daughter saw an orthodontist today, after a dentist referral for possible expander.

The orthodontist wants to install an expander on the roof of her mouth.  He also wants to install braces on the front 4 teeth (some permamenent, some baby) and then use a retainer.  This will cost $3400 with insurance.

He said she will also need full braces when she is older.

This seems like a lot of treatment at a young age to me, especially since we will need to pay for full braces when she is older.  I've read there are differing opinions on aggressive treatment at young ages.  What do you think of this plan?  What would you think of just the expander without the braces or retainer?  Does the cost seem appropriate?


I'm not an orthodontist (I provide resource information in this field) but my own daughter had similar treatment at age 9. In fact, before that, she had a tongue-crib cemented in place to counteract tongue-thrust, so we got into treatment quite early. My understanding is that once you use the expander, and therefore create spaces, you need to at least have the retainer to hold those spaces open to keep the room for the permanent teeth to fit once they start coming in. The palate is easier to expand at age 8 or 9 than older.

I hear the main issue is that dentists/orthodontists would greatly prefer to not pull any teeth, but instead depend on using the expander to make room. In general, I would definitely get a second opinion from another orthodontist. In the meantime, here are some references I've found: (which explains doing this at an early age, rather than waiting for 12 or 13);topic=86495.0 (some comments refer to kids with cleft palate but otherwise mostly general thoughts, mostly positive)

One tip based on my experience: only turn the device once a day! On the first day my daughter had it, the orthodontist turned it once, to show me how, then I went home and turned it again that night, thinking I needed to get on the schedule - but no, that was too much for one day. But after that my daughter did not complain about pain - just keeping it clear of food was a bit of a challenge. I hear that a Waterpik is great for that.

Hope this helps.  


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Pamela Waterman


I can supply tips, hints, recipes and resources about a braces-friendly lifestyle, for parents of children and teens in braces as well as for adults in braces. Although I am not a medical/dental professional, I have colleagues in the field and will do my best to point you to additional resources.


I am the author of two specialty award-winning cookbooks of soft-food recipes and tips targeted to all ages of braces-wearers (including adults) and give workshops to dental hygienists to help them help their patients with this type of information. I have worn braces both as a teen and as an adult, and am from a family of three generations of braces patients. I regularly contribute information to the public website of the American Association of Orthodontists and Orthotown magazine.

Women in Orthodontics, American Academy for Oral Systemic Health, Independent Book Publishers Association, Society of Women Engineers, Society of Manufacturing Engineers

Orthotown, Cricket, Family Fun, Highlights, Better Homes and Gardens Kids' Rooms, Chicago Tribune, East Valley Tribune (Phoenix AZ), Healthy Alternatives, Organic & Natural, Desktop Engineering, Machine Design

BS Astrophysics, MS Radio Astronomy/Electrical Engineering

Awards and Honors
Good Parenting Award from Glyph Award - Best Cookbook, Arizona Book Publishing Association Finalist Glyph Award - Best Cookbook, Arizona Book Publishing Association Finalist - Next Generation Indie Books, Independent Book Publishing Professionals Group

Past/Present Clients
American Association of Orthodontists, Smile for a Lifetime

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