The Difference between an Expander and Damon Braces
Dr. Karen Conn of Bryn Mawr Orthodontics explains that an expander is not a one-size-fits-all solution and there are alternative treatment options
As an orthodontist, parents often ask me, “Does my child need an expander?” And, “Is there an alternative treatment option?”
While an expander can be a valuable tool in orthodontics, it is not a one-size-fits-all solution. Not everyone needs an expander, and overuse can potentially lead to unwanted side effects.
An expander is primarily used to correct a posterior crossbite, broaden a v-shaped arch, create space in severely crowded patients, and help treat certain sleep related breathing disorders. Let’s break each of the situations down a bit:
- Posterior Crossbite: A posterior crossbite happens when the upper back teeth bite inside the lower back teeth. An untreated posterior crossbite can lead to uneven tooth wear, jaw problems, skeletal asymmetry, and difficulty chewing.
- V-shaped arch: A v-shaped arch is a narrow palate or constricted maxillary arch. A v-shaped arch can lead to crowding, misalignment of the bite, and sometimes cause speech impediments.
- Severely Crowded Teeth: Crowding is caused when there is inadequate space for the adult teeth to naturally erupt. By not addressing severe crowding at the proper time, adult teeth can become stuck and not properly erupt. In some cases, teeth can become impacted and require orthodontics along with a surgical procedure to properly bring the teeth into the arch.
- Sleep Related Breathing Disorders (SRBD): SRBD is a broad term that includes conditions that disrupt breathing during sleep. Some common symptoms include snoring, restless sleep, bed wetting, night terrors, daytime sleepiness, difficulty concentrating, teeth grinding, mouth breathing, and tongue tie. An expander is a non-surgical option that can help to improve breathing during sleep and reduce the risk of health problems associated with SRBD.
Luckily, we have effective ways to correct these orthodontic issues!
Expanders
Expanders are appliances specifically designed to widen the upper jaw. They're most effective during childhood when the jaw is still growing, typically between the ages of 7-10. After age 10, the palatal suture fuses and an expander is not a predictable treatment option. Here's how they work:
- The Appliance: Expanders come in various designs, but they all have a screw mechanism that is turned to gradually widen the upper palate to correct a posterior crossbite, broaden a v-shaped arch, create space in severely crowded patients, and help treat certain sleep related breathing disorders.
- Treatment Time: Expander wear time varies depending on the severity of the crossbite and crowding. It typically takes a few weeks for the desired expansion to occur, followed by a period of wearing the expander to stabilize the new width. Overall, expanders are typically worn for 7-9 months.
- Benefits: Expanders are minimally invasive and can predictable address the underlying cause of a posterior crossbite, severe crowding, and a v-shaped arch in a growing jaw.
- Cons: Expanders do not precisely pinpoint the crowded areas and in those situations a combination of an expander and braces are required to effectively achieve the ideal result. In addition, an expander does not address any cosmetic concerns; an expander does not correct alignment and rotations of the teeth.
Damon Braces
Damon braces in Bryn Mawr are a type of advanced braces system that uses specialized brackets and wires to move teeth precisely. They can be a great option for correcting a posterior crossbite or severe crowding. Note that these modern braces are not the same as twin brackets or the traditional braces that other offices may routinely use.
- The Appliance: Damon braces use self-ligating brackets that reduce friction compared to traditional braces. This allows for gentler and more efficient tooth movement.
- Treatment Time: Treatment time with Damon braces can vary depending on the complexity of the case, but it's generally between 9-12 months for early treatment.
- Benefits: Damon braces are a comfortable option that offer more precise tooth movement to accurately target areas of insufficient space for crowded out teeth. Damon braces also address additional orthodontic concerns beyond a crossbite and crowding such as rotated, misaligned, and flared teeth. This approach also reduces the need for multiple appliances in the mouth.
- Cons: Damon braces do not correct an underlying skeletal problem with a narrow palate.
Choosing the Right Approach
The best option for your child depends on several factors:
- Age: Expanders are most effective when the jaw is still growing, typically between ages 7 and 10. Damon braces can be used throughout childhood and adolescence.
- Severity of Crossbite: For mild to moderate skeletal crossbites, expanders might be sufficient. More severe cases might benefit from a combination of an expander and braces. Damon braces can be used in mild cases with a dental crossbite.
- Dental Versus Skeletal Crossbite: An expander widens the palate to achieve a skeletal change in a patient with an underlying skeletal crossbite. This is an ideal appliance for patients with a v-shaped arch and skeletal crossbite. Alternatively, Damon braces are effective at correcting a dental crossbite due to the position of the teeth.
- Crowding: While an expander can create general space in a severely crowded patient, Damon braces can more precisely target areas that are lacking space for adult teeth to erupt.
- SRBD: Expanders can help to widen the upper jaw, which can help to open up the airway, allow more room for the tongue, and improve breathing during sleep. Studies have shown that maxillary expansion can also help shrink enlarged adenoids and tonsils.
- Additional Orthodontic Needs: If your child has other orthodontic issues or cosmetic concerns alongside a crossbite or crowding, Damon braces might offer a more comprehensive solution.
The Takeaway
Both expanders and Damon braces are effective tools for correcting a posterior crossbite and crowding in young patients. During a consultation, an orthodontist can assess your child's specific needs and recommend the best course of treatment. Early intervention is key for a healthy and beautiful smile, so don't hesitate to schedule an appointment!
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Karen Conn, DMD, MS is a Board-certified orthodontist and co-owner of Bryn Mawr Orthodontics (Bryn Mawr, PA), where she specializes in Invisalign and braces for children, teens and adults. She has been recognized as a Philadelphia Magazine Top Dentist, Main Line Today Top Dentist, Suburban Family Top Orthodontist, and is among the nation’s top 1% of Invisalign providers. Dr. Conn received her undergraduate and doctorate degrees from the University of Pennsylvania. She completed her residency in Orthodontics and Dentofacial Orthopedics at Temple University, where she also earned a master's degree in Oral Biology.
Bryn Mawr Orthodontics is an award-winning practice that was voted the Best Orthodontist in The Philadelphia Inquirer’s 2024 Philly Favorites contest. Bryn Mawr Orthodontics serves its neighbors in Bryn Mawr, Gladwyne, Villanova, Ardmore, Haverford, Wynnewood, Narberth, Radnor, Penn Valley, Bala Cynwyd, Merion, Wayne, and the entire Main Line.
To learn more about Bryn Mawr Orthodontics, visit https://www.brynmawrorthodontics.com/. Contact the office today (484-383-0055) or complete this form to schedule a free consultation.
