Congratulations, your expander is out! (Now what?)
The day has finally arrived; your child’s expander is finally out! After 6mo to 10mo, you no longer have to hear that slurping or see your child drool when watching TV or drinking. But what can you expect now?
These are the expectations we give our patients following removal of a bonded expander (RPE) as seen below:
First, expect a lot of redness around where the acrylic portion of the expander touched the gums; this made a great seal during treatment but after months, the gum tissue gets a bit irritated if not outright angry. But rest assured this is completely temporary and will pass after only a few days. In the meantime, have your child rinse with a mouthwash a few times a day.
It is possible a baby tooth (or teeth) may come out with the expander since the roots resorb naturally; these will heal and provide little if any discomfort because the roots are already gone but they can be rough under the tooth.
You may see some bleeding when your child brushes for the first couple of days; this is completely normal. In fact, you really want to avoid a professional cleaning for at least a month after removing an expander. We will clean the teeth at removal. You may also see a few pieces of glue that we didn’t get; your child can spit these pieces out if they show up (this isn’t normal but it does happen).
Your child will notice that their teeth “do not fit right”, that there are premature contacts in the back that seem to change daily. This will be normal for about a month or until a retainer is placed.
Your child’s gums may be too irritated to eat rough foods such as toast or hard sandwiches; Try to keep somewhat of a soft diet for one to two days until the irritated gum tissue heals.
Next, If your child is in limited braces on upper teeth, we will normally place orthodontic metal bands around some of the molars. To do this, we normally have the child back 1 to 2 weeks after removing the expander to let them heal. We will then either place spacers for another week or go ahead and band the molars right away. Then we will extend the wire from front teeth back to the molars for anchorage as we finish our Phase I plan.
If your child does not have braces and there is no plan for early braces, we will take impressions for a clear retainer 1 to 2 weeks after removal. Then we will deliver a clear retainer a few days later. Once in the retainer, we will ask that your child wears the retainer @1 week full time (day and night) to get used to it and then to continue wearing the retainer when they sleep for another 6 to 12months (we will monitor)
After expansion, there is going to be considerably more space for teeth to erupt and they will usually erupt looking better. There may be baby teeth that can be removed to assist eruptions or reason to recommend further treatment; we will be monitoring your child’s development now until all teeth are erupted or until further treatment might be necessary. So figure a few days to feel back to normal and a lifetime worth of results to enjoy!
If you have questions or comments concerning this or any orthodontic question, please feel free to make a complimentary new-patient appointment at either my Steiner Ranch location or my North-central Austin location on West 35th street and MoPac.
Dr. James R. Waters is a 1996 graduate from UTHSC Dental School in San Antonio, 1997 graduate of Advanced Dentistry from the UNMC in Nebraska and the 2001 Valedictorian graduate from the prestigious Saint Louis University Orthodontic Program receiving the J.P. Marshall award for clinical excellence in 2001. He holds a Bachelor’s Degree in Science, Doctorate in Dental Surgery, a post-doctorate certificate in Advanced Dentistry, post-doctorate Degree in Orthodontics & Dentofacial Orthopedics and a Master of Science Degree in Orthodontics and is a Diplomate of the American Board of Orthodontics. Dr. Waters and his wife of 20 years live in Austin, TX with their 4 children where he has a thriving, multi-faceted Specialist practice with locations in Steiner Ranch and North-Central Austin. You can learn more about Dr. Waters at BracesAustin.com.