How Is a Palate Expander Removed? All You Need to Know

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Removing a palate expander, like removing any banded fixed appliance, can sound dramatic, but I assure you it’s quick and (almost) painless. If you’re wearing one right now, I’m sure you’re wondering how your orthodontist is going to take it off.

Well, you’re just in the right place. I’m going to walk you through exactly what’s going on when we remove palate expanders, step by step.

You’re also going to learn how to care for your teeth and gums once the expander is off. And lastly, I’ll touch on what usually comes next, depending on whether you’re wearing braces or not. Let’s get started!

When Is It Time To Remove A Palatal Expander?

How exactly do we know when it’s time to remove a palate expander? Treatment times vary on a case-by-case basis, so I’m sure you’re curious about when you’ll get out of this contraption.

The average time spent in expanders is 6 to 9 months, and most orthodontists inform the patient about the exact treatment duration well in advance. But aside from time, there are a couple of other factors that determine if the upper jaw expansion worked as planned:

We look at how the upper teeth are positioned in relation to the lower teeth, particularly the molars.
We look at the overall bite and whether we need to allow teeth to relapse, or we need to keep them in place for longer.
If you’re wearing a facemask, once the mask is no longer needed, it’s time to take the expander off.

I have an entire article just on treatment duration for palatal expanders, so if you’re curious, you can read more about it there.

What To Expect When It’s Time To Remove Your Expander

It’s time to get into the nitty-gritty of things. You’re probably both excited and scared to get your palate expander off. Don’t worry, as you’ll soon learn, it’s no big deal. The orthodontic expander itself will be off in a matter of seconds, it’s the cleanup that takes longer.

I’ve been doing this for a long time, and if 8-year-olds can handle it, so can you. Then again, 8-year-olds are tough little humans. Here’s what to expect:

Removing Banded Palate Expanders

If you’re wearing a banded palate expander, which is most likely since it’s so widely used, then the process of getting it off should be quick and easy. You probably have bands on your permanent teeth, and all we have to do is help them come off.

For this purpose, we use a special instrument called a band-removing plier. The top jaw of the plier has a very sharp gripping surface that’s designed to hook onto the band, right at gum level. Your gums may be sore or inflamed, so this part may hurt a little bit, as we need to dig into the gums.

The bottom jaw of the plier has a rubber or plastic component that rests on the occlusal part of the molar. We use the molar as a lever, or a stop, press on it and pull on the band. This is why your back teeth may hurt a little bit since they’ve been subjected to a lot of force these past months.

Most orthodontists are very quick and skilled at taking expanders off, so it should only take a couple of seconds. This will help keep the pain at a minimum, and any discomfort you might have will quickly subside.

If your orthodontist used a composite glue that hardens under UV light, you might hear a loud crack as this plastic-like material breaks. Don’t worry, you didn’t just hear your teeth breaking, and you may feel pieces of cement in your mouth.

Once the palatal expander is off, you’ll most likely have some cement residue left on your back teeth. The cleanup is easy since we only need to take care of two teeth. Your doctor will use a fine burr, an ultrasonic device, or even a manual scaling instrument to get the cement off.

During this cleanup, you may notice your gums bleeding, which is entirely normal.

Once the expander is off and your teeth are all cleaned up, your orthodontist may want to take a dental impression, bond braces on your back teeth, or simply allow your teeth and gums to rest for a few weeks.

Removing Bonded Palate Expanders

If your orthodontic treatment requires a bonded palate expander, I’m sure you’re very anxious to take it off. After all, it’s a bulky and uncomfortable device that’s necessary, but very disruptive in terms of eating and speaking.

The process of removing a bonded palatal expander is a little different since we’re not dealing with metal bands. Bonded palate expanders are made up of thick acrylic blocks that are glued to multiple teeth, so they won’t lose their grip as easily.

Most banded palate expanders only need a thin layer of glue to adhere to teeth, but oftentimes, this glue is so strong that removing the expander can prove to be challenging. The key is not to over-etch or cover the teeth with too much cement, so hopefully, that won’t be your case!

Removing the bonded palate expander is just as simple as the banded one. We grab the band-removing plier and place the sharp jaw in the back of the bonded expander where we’ll hopefully find an embrasure or a ledge. If it’s covered in glue, it’s best to clean it out beforehand to create a gripping point.

Once the sharp tip is inserted on the edge of the expander, we squeeze the plier tightly and twist. It’s the tight squeezing and the twisting motion that breaks the seal.

Similar to the banded expander removal, you’ll hear a loud crack from all the cement breaking. We repeat the motion on the other side and voila! the expander is off.

Sometimes, the seal doesn’t break due to excess cement, or the expander can break leaving some segments bonded to teeth. This is rare, but if this happens, we proceed to remove it as we would a dental bridge that’s permanently glued to teeth. This involves using the high-speed burr and some sharp instruments, but don’t worry, the expander will be off soon.

Once the bonded orthodontic expander is off, you’ll probably have cement left on 6 teeth or more, which means we need to clean up more teeth. Since you’ve had a thick piece of plastic on your teeth for 6 months or more, your gums will probably be inflamed, raw, and red. Don’t worry if you see a lot of bleeding.

The First Week After Removing The Orthodontic Expander

Now that your palatal expander is off, it’s time to do a little damage control. Since these devices are so difficult to maintain clean, most patients’ gums become swollen and red. This is temporary, and we can deal with a little gingivitis if it’s only for a few months.

Once you’re at home, you can rinse your mouth with salt water for the first week and brush your teeth thoroughly. You can stimulate your gums with a soft brush to help them heal faster. Don’t worry if they look a little rough, in a couple of weeks your gums will be completely healed.

Next, you’ll want to go see a dental hygienist as soon as possible. You’ve had little access to your back teeth for the past 6 months so you may be dealing with some plaque, and even some cement stuck under your gums. Your hygienist will help to restore ideal levels of oral hygiene, as well as apply some much-needed fluoride.

Lastly, don’t forget to periodically see your dentist to check for cavities or periodontal disease. Both cavities and periodontal damage can occur in as little as 6 months, so it’s better to be safe than sorry.

Use a fluoride rinse daily to minimize chances for tooth decay or gum disease. Your orthodontist will double-check for this as well, but it’s always best to get a second opinion from a dentist.

Potential harm to your teeth and gums

Palatal expanders don’t cause issues in and of themselves, but they can facilitate plaque accumulation. You should be aware of a few potential dangers of wearing a palatal expander for longer than 6 months:

Gum bleeding – the metal band that sits on molars can often dig into the gums, causing swelling and bleeding. The area will become unconfortable, and patients usually skip brushing it because it hurts. This can result in food particles getting trapped, leading to gum inflammation, or, worst case scenario, periodontal disease.
Tip: A good water flosser at a gentle setting can help prevent most of these gum issues.
Cavities on molars – poor fitting bands are usually to blame for cavities underneath molars, but a diet rich in sugar expedites this process. It’s best to brush the area thoroughly and avoid sugary foods and drinks.
Impinging expander wire or screw – some of the palate expander’s components can sit too close to the roof of the mouth, irritating the area and causing it to swell. As a result, the gum often grows on top of the expander’s metal components. This issue resolves itself as soon as the expander comes off.

Braces Or Retainers – Which Orthodontic Treatment Is Next?

If you’re older, chances are you’re wearing an orthodontic expander in tandem with braces, but this is not always the case. Your orthodontist may choose to bond braces right away, or take impressions for clear aligners.

Most doctors choose to leave the gums to recover a little bit before moving on to braces, so you might get a little break.

If it’s your pre-teen child wearing the expander, then you have two options. Your orthodontist will either allow your child’s teeth to settle naturally, or they will take a dental impression and order a Hawley retainer to maintain the transverse expansion.

How Do You Remove A Palate Expander At Home?

I’ve seen this question pop up online, and I really want to address it in case you want your expander off, but for whatever reason, you don’t want to go back to your orthodontist.

Palate expanders are not designed to be taken off easily. This is because if they accidentally come off before it’s time to remove them, a lot of the expansion will be lost. Removing expanders at home without the proper instruments and knowledge is nearly impossible, and I urge you not to try.

If you don’t want to see your orthodontist again, just go to another doctor, explain your situation, and ask them to remove your expander. It should cost next to nothing. Remember, you’re in control of your treatment, and if for any reason you should decide to stop, you can do that. There may be consequences, but you can still choose to stop.

Conclusion

Hopefully, I’ve cleared up some of the confusion and fear related to removing palate expanders. Remember not to freak out if you hear loud cracks – your teeth will be fine! And while your gums will look red and raw, they heal much quicker than the skin, so you should be back to your old self in no time. Good luck!