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Dealing with a rapid palatal expander can be a tricky experience, especially when you’re new to the process. You might be facing a common issue: your palate expander key won’t turn no matter how hard you try. Before you panic, let’s understand why this could be happening and what you can do to fix this problem.
The main reason why your palate expander key might not turn is a poor technique, but the good news is that this is easily fixable. Most of my patients that struggle with incomplete expander activations fail to use the key properly.
But don’t worry, I’ll try to explain everything clearly, just like I would to my patients. As you read along, you’ll learn various troubleshooting tips and tricks to make your palate expander experience more manageable.
How do I turn the expander?
Your orthodontist may have already explained this to you, but we’ll go over the basics again, just in case there was something you missed.
On the day of getting your palate expander, you received a special key and were instructed to place it inside the expander hole and make a complete turn. In this section, I’ll explain how to find the expander hole, what a complete turn looks like, and how to avoid an incomplete activation.
First things first, let’s locate the expander hole. You should find it in the middle of the screw, at the center of the appliance. On one or both sides of the key hole, you’ll see arrows facing the back of the mouth.
An expander screw has 4 holes, but you should only be able to see one at the front of the appliance from your angle. Your orthodontist will see both holes when inspecting the expander with a mirror: both the front hole (the one you’re about to activate) and the back hole which was used for the previous activation. Here’s how everything should look:
Once you’ve found the hole, get your key and focus on the following:
Next, push the key in the direction of the arrow (toward the back of your mouth) until the next key hole is visible. This is where you’ll be placing the key during the next turn.
Carefully remove the key from the back once the turn is completed. If you experience difficulty pulling the key out without reversing the turn, gently wiggle it. This is where most patients struggle and accidentally reverse part of the turn.
If you accidentally reverse the turn, slide the key back into the previous hole and fix the turn. This might be easier said than done, since the hole may be not visible at this point. Getting someone to help would be a good idea.
You’ll know you’ve reached a full turn when the key will no longer be able to move toward the back of the mouth. Be sure to look for the new hole once the key is removed to confirm you did the turn correctly.
Why can’t I see my expander hole?
Sometimes, locating the hole in your palatal expander can be challenging. Don’t worry, this is a common issue faced by many patients, but it often just takes a phone call (or reading this article) to fix it. There are several reasons why you may not be able to see the hole clearly:
Here are a few extra tips to help you find the hole in your palatal expander:
- Sit in a comfortable position with your head tilted backward, such as lying down on a couch with your head in someone’s lap.
- Use a flashlight or strong overhead light to illuminate the roof of your mouth.
- Open your mouth wide and gently pull back your cheeks to expose the expander fully.
- Slowly scan across the surface of the appliance, looking for the small circular hole.
Keep these tips in mind when searching for the hole in your palatal expander. With practice and a little patience, you should be able to find and activate the appliance without much trouble.
Remember, if you’re experiencing difficulties turning your palate expander key, it’s essential to consult your orthodontist for assistance. They can assess your specific situation and provide appropriate guidance to ensure your treatment progresses smoothly.
What happens if I miss a day of turning the expander?
If you miss a day of turning your palate expander, don’t panic. It’s important to understand that the expander works gradually by applying constant pressure to move the bones and widen your palate. This means that missing a day won’t cause a major setback.
It’s essential that you do your best to keep up with the recommended turning schedule given to you by your orthodontist. Consistency is key to successful treatment, and missing turns more frequently may slow down the progress and prolong the treatment time, or even cause the suture to fail to open.
In case you do miss a day, follow these steps:
- Communicate with your orthodontist: Let your orthodontist know that you missed a turn, and ask if any changes need to be made to your schedule.
- Resume the prescribed schedule: Continue with the regular turning schedule as instructed by your orthodontist, avoiding any temptation to double-turn to make up for the missed day. This could cause unnecessary discomfort and overpressure on the palate.
- Monitor your progress: Keep an eye on how the expander feels and the gap between your front teeth. If you notice any unexpected changes, notify your orthodontist immediately.
While turning the expander twice in a day might seem like a faster way to achieve desired results, it is not recommended unless instructed by your orthodontist.
Some treatment strategies require turning the screw twice per day for a while, especially for adults and teenagers. I personally have my patients turn the screw once per day. You should never turn the screw twice to make up for days you forgot unless your orthodontist says it’s okay.
Stick to the instructions provided by your orthodontist, as over-expanding can cause discomfort and harm to your teeth and jaw.
Turning the expander too many times can lead to over-expansion, causing pain, discomfort and potential damage to the teeth, suture and upper jaw.
Unfortunately, some patients leave the office only to return after many weeks, with the expander turned all the way open. Because of situations like these, the expander has a built-in mechanism that only allows 40 turns which equals 10mm of expansion. Any other subsequent turns don’t actually do anything to the appliance.
So if you’ve turned your expander indiscriminately, all is not lost, and you should see your orthodontist as soon as possible to assess any potential damage
Once you’ve reached the desired expansion and stopped turning the key, your orthodontist will provide you with further instructions.
In most cases, they’ll recommend keeping the expander in place for at least a couple of months to retain the achieved width and to ensure proper bone formation and stabilization in the area.
It is possible to turn the expander by yourself, but it is always best to have someone assist you, like a family member or a friend.
Insert the key carefully into the hole and push gently in the direction of the arrow. Make sure the key is fully inserted before turning it and rely on your senses to keep it inside the appliance at all times. Once you feel you can no longer push towards the back, and you can fully see the next hole at the front of your appliance, the turn is complete.
Do not remove the key to check things until you finished turning all the way back. It will be much harder to reinsert it mid-way.
Initially, you might experience some pressure or discomfort when turning the key, but this should subside after a few turns. If the pain persists or you notice anything unusual, stop activating your palate expander and contact your orthodontist for advice.
Most patients don’t even need over-the-counter medication, but for the first couple of days, you can take some acetaminophen or whatever you use for dental pain. I suggest you activate your appliance in the evening so it doesn’t bother you during the day.
If you lose your expander key, reach out to your orthodontist as soon as possible. They can provide you with a replacement key and ensure your treatment stays on track. If you’re away and can’t access your orthodontist’s office you can order the key from a safe source.
In the meantime, avoid using random sharp items. It’s true that some things like dental probes can get the job done, but unless you’re a dentist or orthodontist, you could cause damage to the screw or cause your appliance to come loose.
Dealing with a palate expander key that won’t turn can be frustrating. To tackle this issue, start by double-checking your technique. Ensure you’re inserting the key correctly into the hole, applying gentle, consistent pressure as you turn it all the way. DO NOT pull back when removing the key – try to wiggle it out instead.
Don’t hesitate to reach out to your orthodontist if you’re continuously experiencing issues turning the palate expander key. They can provide valuable guidance or adjust the expander if necessary. Maintaining good oral hygiene is essential for keeping your expander functioning optimally, so always brush and floss regularly.
Whether you’re new to braces or a braces veteran, taking care of your teeth (and your health) during orthodontic treatment is crucial. That’s why I’ve put together a list of orthodontist-recommended tools that will make caring for your braces a breeze: