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If your palate expander (or your child’s palate expander) is loose, you’re probably panicking right now. You’re right; it’s an emergency, so here’s what you need to do.
For palate expanders that are loose on one side, push the metal band back onto the tooth with your finger and stick to soft foods. Stop turning the screw of your expander. Make an emergency appointment with your orthodontist, preferably on the same day.
If your palate expander falls out, do not attempt to put it back in your child’s mouth. It is a choking hazard. Make an emergency appointment with your orthodontist. Put the palate expander in a ziplock bag and take it to the orthodontist’s office.
For some patients, palate expanders become loose and fall out more frequently. So, if this has already happened to you, there’s a chance it will happen again.
Keep reading to learn why palate expanders become loose (it’s not always your fault), and how to prevent it.
What to do with your loose expander until your orthodontist sees you
If you notice your expander is loose, treat it as a true emergency. Palate expanders become loose on one side at first and then fall out completely if you don’t act fast.
Signs of a loose expander include a wobbly feeling of the device inside your mouth and the band hanging down slightly from the molar.
In some cases, the metal band can go all the way past the tooth, which makes it harder to push back in. This loose band can interfere with the bite and even chip the bottom teeth.
There are some things you can do to minimize damage, so don’t panic and follow this checklist:
What to do if the palate expander Falls Off
If the expander has fallen out completely, do not attempt to put it back in your child’s mouth because it’s a choking hazard.
Contact your orthodontist or any office that provides care for orthodontic emergencies. Even your general dentist might help if there are no other options.
Remember, this is more than just a broken bracket or a poking wire. If the palate expander falls out of the mouth before the suture grows new bone, it will undo weeks of hard work.
If you’re older, you can put your palate expander back in and hold it in place for a short while until you get to the office. This may prevent losing all the expansion. Refrain from eating during this time.
Is a loose palate expander an emergency?
A palate expander that’s loose on one side or falls off is a true orthodontic emergency. To save whatever expansion is left, your orthodontist needs to glue your appliance back on immediately.
The goal of the palate expander is to widen the upper jaw by opening up the suture. This process happens quickly, usually in the first couple weeks after the expander is put in place, resulting in a huge front gap.
If the expander becomes loose or falls off completely, the suture can close up in a matter of seconds, negating much of the progress that has been made.
The problem with closing sutures is that we can’t open them back up again to the same degree.
Palate expanders work by sticking to back molars, which act as pillars for expansion. These molars are displaced during expansion and stay that way for months.
Once the suture closes, we can’t restart the expansion process, because we risk pushing the molars completely outside the bone.
Palate expander keeps Falling Out? Here’s why
Although they are generally effective, palate expanders can sometimes become loose. It’s an issue that’s either caused by the patient, the doctor, or the lab technician.
Here are the reasons why your palate expander keeps getting loose:
1. Chewing On Hard, Sticky Foods
Palate expanders can become loose if the cement that holds them in place is broken or cracked. This can happen if the patient chews on foods that are hard or sticky.
Children, in particular, are either not careful enough or don’t realize the importance of mindful eating. But kids will be kids. That’s why we need a sturdy expander and pay extra attention when bonding it to teeth.
This leads me to my next point:
2. Wet Teeth
When the palate expander is being fitted, it’s very important that teeth are dry so that the cement can bond properly. However, keeping a child’s mouth wide open, cheeks retracted, and tongue away from the molars can be a challenging task.
We try to get that expander in as fast as possible, but if there’s any saliva on the molars, we risk the appliance becoming loose.
3. Poorly Fitting Bands
The molar bands that attach the palate expander to your teeth need to fit properly in order to be effective. If your back teeth are misaligned or flared, it can be difficult for the dental technician to get the bands to fit correctly.
The tension that builds up inside the expander bands as you turn the screw can cause the expander bands to dislodge.
4. Short Molars
In some cases, the molars may be too short for the bands or braces to get a good grip. This is more common in children, as their molars are still erupting.
In these cases, a bonded expander may be a better option than a banded expander.
A bonded expander uses acrylic blocks on multiple teeth to provide stability rather than metal bands on just the molars.
5. The process of expansion
The expansion itself can put so much pressure on the palatal expander’s cement that it can cause it to crack. Your palate expander can become loose as a result.
Every patient’s bone resistance to expansion will vary greatly, so there’s not much we can do about this.
When to Replace a Loose Palate Expander
If your palate expander is still stuck to one side of your teeth, your orthodontist will remove it and check if it fits back.
In some cases, a loose palate expander may need to be replaced. This happens if it can’t be properly re-bonded to the teeth or if there’s something wrong with the bands or the screw.
Some expanders have a poor fit due to the movement of the teeth or simply small lab errors that become obvious in the mouth.
Your orthodontist will be able to determine if a replacement is necessary. You’ll get a new impression or scan to receive your second palatal expander. If your palate expander is still stuck to one side of your teeth, your orthodontist will remove it.
If the molars are still in a good position and the expander screw hasn’t been turned too much, it’s not too late to start again with a new device.
Getting a new palate expander means you’ll start the expansion process all over again.
Preventing your palate expander from becoming loose is crucial during the first four months of treatment. That’s when the expansion is still unstable.
Once the bone has begun to fill in the suture, the expansion is more stable. A loose expander during the later stages of treatment (months 6 and onwards) is not as serious.
Remember to check your child’s expander bands daily. If you notice that the expander is loose, stop turning the screw. Call your orthodontist’s office immediately.
Stick to soft foods while waiting for your next appointment. This will reduce the risk of your expander coming off completely.