{"id":3463,"date":"2021-03-12T20:10:37","date_gmt":"2021-03-12T20:10:37","guid":{"rendered":"http:\/\/caugheydds.com\/?p=3463"},"modified":"2024-06-29T00:53:08","modified_gmt":"2024-06-29T00:53:08","slug":"rapid-palatal-expander-pros-and-cons","status":"publish","type":"post","link":"https:\/\/caugheydds.com\/2021\/03\/12\/rapid-palatal-expander-pros-and-cons\/","title":{"rendered":"Rapid Palatal Expander: Pro&#8217;s and Con&#8217;s"},"content":{"rendered":"\n<figure class=\"wp-block-image is-resized\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-4581\" src=\"https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/cropped-Child-trusts-dentist.jpg\" alt=\"\" width=\"367\" height=\"244\" srcset=\"https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/cropped-Child-trusts-dentist.jpg 1920w, https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/cropped-Child-trusts-dentist-300x200.jpg 300w, https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/cropped-Child-trusts-dentist-1024x682.jpg 1024w, https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/cropped-Child-trusts-dentist-768x511.jpg 768w, https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/cropped-Child-trusts-dentist-1536x1022.jpg 1536w\" sizes=\"auto, (max-width: 367px) 100vw, 367px\" \/><\/figure>\n\n\n<strong>How can a palate be expanded?<\/strong>\n\nThere are three main options for expanding a palate:\n<ol>\n \t<li>ALF (Alternative Light-wire Functional): a very light wire appliance that exerts a subtle force over time, attracting the tongue to the roof of the mouth, and encouraging a stable swallow pattern. The ALF is adjusted both by the action of the tongue during the swallow, as well as by the dentist every 3-6 weeks.<\/li>\n \t<li>RPE (Rapid Palatal Expander): a rigid semi-customized appliance frequently bonded to a right and left molar, with hardware in the palate space, often blocking the tongue. These are expanded by the patient or parent weekly using screw-turns or occasionally directly by the dentist.<\/li>\n \t<li>MSE (Maxillary Skeletal Expander): similar to RPE, the hardware is bonded to molars and activated in a similar way, but the MSE also requires implants to be screwed into the patient\u2019s hard palate (and sometimes the hard palate itself is surgically punctured to speed up the process)<\/li>\n<\/ol>\n<figure id=\"attachment_2478\" aria-describedby=\"caption-attachment-2478\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/caugheydds.com\/wp-content\/uploads\/2017\/09\/apnea-patient-with-ALF-in-mouth.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-2478\" src=\"https:\/\/caugheydds.com\/wp-content\/uploads\/2017\/09\/apnea-patient-with-ALF-in-mouth-300x200.jpg\" alt=\"alf improves nasal valve function\" width=\"300\" height=\"200\" srcset=\"https:\/\/caugheydds.com\/wp-content\/uploads\/2017\/09\/apnea-patient-with-ALF-in-mouth-300x200.jpg 300w, https:\/\/caugheydds.com\/wp-content\/uploads\/2017\/09\/apnea-patient-with-ALF-in-mouth-500x333.jpg 500w, https:\/\/caugheydds.com\/wp-content\/uploads\/2017\/09\/apnea-patient-with-ALF-in-mouth-1200x800.jpg 1200w, https:\/\/caugheydds.com\/wp-content\/uploads\/2017\/09\/apnea-patient-with-ALF-in-mouth-768x512.jpg 768w, https:\/\/caugheydds.com\/wp-content\/uploads\/2017\/09\/apnea-patient-with-ALF-in-mouth-1536x1024.jpg 1536w, https:\/\/caugheydds.com\/wp-content\/uploads\/2017\/09\/apnea-patient-with-ALF-in-mouth-2048x1365.jpg 2048w, https:\/\/caugheydds.com\/wp-content\/uploads\/2017\/09\/apnea-patient-with-ALF-in-mouth-113x75.jpg 113w, https:\/\/caugheydds.com\/wp-content\/uploads\/2017\/09\/apnea-patient-with-ALF-in-mouth-480x320.jpg 480w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-2478\" class=\"wp-caption-text\">ALF (Alternative Light-wire Functional) appliance<\/figcaption><\/figure>\n\n<figure id=\"attachment_3465\" aria-describedby=\"caption-attachment-3465\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/Screen-Shot-2021-03-12-at-3.04.32-PM.png\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-3465\" src=\"https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/Screen-Shot-2021-03-12-at-3.04.32-PM-300x217.png\" alt=\"\" width=\"300\" height=\"217\" srcset=\"https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/Screen-Shot-2021-03-12-at-3.04.32-PM-300x217.png 300w, https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/Screen-Shot-2021-03-12-at-3.04.32-PM-103x75.png 103w, https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/Screen-Shot-2021-03-12-at-3.04.32-PM.png 436w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-3465\" class=\"wp-caption-text\">RPE (Rapid Palatal Expander)<\/figcaption><\/figure>\n\n<figure id=\"attachment_3464\" aria-describedby=\"caption-attachment-3464\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/Screen-Shot-2021-03-07-at-7.59.36-AM.png\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-3464\" src=\"https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/Screen-Shot-2021-03-07-at-7.59.36-AM-300x246.png\" alt=\"\" width=\"300\" height=\"246\" srcset=\"https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/Screen-Shot-2021-03-07-at-7.59.36-AM-300x246.png 300w, https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/Screen-Shot-2021-03-07-at-7.59.36-AM-500x410.png 500w, https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/Screen-Shot-2021-03-07-at-7.59.36-AM-91x75.png 91w, https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/Screen-Shot-2021-03-07-at-7.59.36-AM-480x394.png 480w, https:\/\/caugheydds.com\/wp-content\/uploads\/2021\/03\/Screen-Shot-2021-03-07-at-7.59.36-AM.png 668w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-3464\" class=\"wp-caption-text\">MSE (Maxillary Skeletal Expander)<\/figcaption><\/figure>\n\n<strong>Why don\u2019t you use rapid palatal expanders?<\/strong>\n\nDr. Caughey is naturally a very gentle person who loves working with children. Besides being gentle in general, the ALF process respects the patient\u2019s need for sutural homeostasis. The midline palatal suture is not a straight line \u2013 and expansion does not happen in a linear way. The midline palatal suture connects from the left and right sides like tectonic plates; when the subtle pressure of the tongue presses on this suture, the midline opens at such a small increment that bone can easily fill the gap as it goes.\n\nWe have some concerns about RPE and MSE. If the expansion occurs without the function occurring simultaneously (because the hardware of these appliances block that very function), who\u2019s to say the function will come online after treatment? Also, due to the non-linear nature of expansion, a rigid appliance can create asymmetry in the cranial vault \u2013 problems from this may not show up until lateral in life, in the form of migraine, dizziness, vision distortion, etc.\n\nFurther, sudden or drastic change can cause dissociation for the patient; what we seek is for the process to be integrating of the patient\u2019s face, bite, and health. This doesn\u2019t mean the RPE or MSE treatment is wrong, as there are certainly plenty of children who have experienced this type of care and withstood it well. But since we don\u2019t know which children are resilient enough to handle heavy forces, we don\u2019t risk it \u2013 we treat everyone gently.","protected":false},"excerpt":{"rendered":"<p>How can a palate be expanded? There are three main options for expanding a palate: ALF (Alternative Light-wire Functional): a very light wire appliance that exerts a subtle force over time, attracting the tongue to the roof of the mouth, and encouraging a stable swallow pattern. The ALF is adjusted both by the action of&hellip;<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_themeisle_gutenberg_block_has_review":false,"footnotes":""},"categories":[11],"tags":[],"class_list":["post-3463","post","type-post","status-publish","format-standard","hentry","category-functional-growth-appliances"],"gutentor_comment":0,"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.3 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Rapid Palatal Expander: Pro&#039;s and Con&#039;s - www.caugheydds.com<\/title>\n<meta name=\"description\" content=\"Why use a crowbar when a feather works better? 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