Palate Expanders Explained: A Parents’ Guide

If you’ve been told that your child needs a palate expander, you’ve no doubt got a lot of questions. This orthodontic appliance sounds intimidating at first, but it’s actually a nifty device that can make a huge difference to your child’s smile and overall oral health.

In the UK, palate expanders are often recommended as a crucial first step in orthodontic treatment for younger patients with teeth crowding issues. The main job of this appliance in orthodontics is to help widen the upper jaw, allowing teeth to align naturally. Treatment is most effective while your child is still growing, which is why early intervention matters.

This parents’ guide covers everything you need to know about palate expanders, from why they’re necessary to treatment cost guidelines and more. 

What is a palatal expander and why is early treatment necessary?

Understanding the orthodontic expander

A palatal expander (also called an orthodontic expander) is a device designed to widen the upper jaw. It’s a straightforward process that takes advantage of your child’s natural growth patterns.

The critical window for treatment

The upper jaw bones develop as two halves that meet in the middle. In children, these bones haven’t fully fused together yet, which makes them easier to guide into the correct position. The age for a palate expander is typically between seven and 12 years old. If your child still has some baby teeth, early intervention is often ideal.

Why does my child need this treatment?

Your orthodontist might recommend a palatal expander for several reasons, including:

Correcting a narrow upper jaw: When the upper jaw is too narrow, it creates problems related to bite alignment, breathing and facial growth. Widening it early sets the foundation for proper jaw development.

Fixing crossbites: A crossbite happens when the upper teeth fit inside the lower teeth. If left untreated, it can cause asymmetrical jaw growth and long-term bite problems.

Relieving crowded teeth: By creating more space in the mouth, expanders help reduce the need for tooth extractions later on. This means your child’s permanent teeth have room to erupt naturally without competing for space.

Preventing impacted teeth: Sometimes teeth like canines don’t have enough room to come through properly and become impacted − stuck beneath the gums or buried in the jawbone. Early orthodontic treatment with an expander can prevent this by creating the space they need.

Supporting better breathing: This is a benefit many parents don’t expect. Widening the palate can actually improve airflow through the nasal passages, helping to address breathing difficulties and mouth breathing issues.

Palatal expansion is typically part of what’s called phase 1 orthodontic treatment, or early orthodontic treatment. This means it happens before your child gets braces, laying the groundwork for a healthier, more balanced smile.

How does the orthodontic appliance work?

As mentioned, your child's upper jaw bones develop as two separate halves connected by the mid-palatal suture. This suture is fibrous and flexible until around puberty, which means the jaw is still malleable.

The expander is usually cemented onto the upper back teeth. In the centre is a screw mechanism. You’ll be given a special key that you insert to activate the expander. Each turn applies gentle, controlled pressure that helps gradually widen the palate.

As you turn the expander, it creates space between the two halves of the upper jaw. Initially, this creates a temporary gap, but over the following months, new bone forms to fill in this space. This is why the retention phase is so important.

The most common type is the rapid palatal expander (RPE), designed for quick transverse expansion.

Types of expanders and the treatment journey

Types of orthodontic expanders

There are two main categories:

Fixed expanders: These include devices like the rapid palatal expander and the Quad Helix. They’re cemented to the teeth, which makes them highly effective because they don’t require your child to remember to wear them. For busy families, this is often the preferred option.

Removable expanders: These look a bit like retainers with an expansion screw built in. They’re used for slower expansion and can be taken out for cleaning. The downside? They require patient compliance, which can be challenging with younger children.

Note that each device is custom-made based on your child’s specific needs and measurements, so what works for one patient might look different for another.

What to expect during expander treatment

The treatment journey typically follows these four steps:

1. The fitting appointment: This is usually quick and painless. Your orthodontist will cement the expander in place or provide instructions for a removable device.
2. The home activation phase: You’ll turn the key as instructed (usually once or twice daily). Don’t worry about this phase, as your orthodontist will give you clear, step-by-step guidance.
3. Regular monitoring visits: These check-ins ensure everything’s progressing as planned.
4. The retention phase: After the gradual widening of the upper jaw is complete, the device stays in place to allow new bone to form and stabilise the results.

Does the palate expander hurt? 

This is the big question on every parent’s mind: Does a palate expander hurt?

The honest answer is that most children experience mild palate expander pain or pressure rather than severe pain. It’s more of a strange sensation than anything truly painful. You might notice your child mentioning tightness or pressure behind the nose, under the eyes, or across the roof of the mouth. This feeling usually lasts only within a few days after each activation. Reassure your child that the discomfort is temporary.

Common side effects to expect

Speech changes: Your child might sound a bit different for the first few days. This is completely normal as they adjust to having the appliance in their mouth.

Increased saliva: The mouth tends to produce more saliva when it’s getting used to something new.

Food trapping: Small bits of food can get caught around the expander, which is why good oral hygiene becomes extra important.

The temporary gap

Here’s something that surprises many parents: You might notice a small gap forming between your child’s front teeth. Before you panic, know that this is actually a positive sign that the expansion is working correctly. The gap is temporary and will close naturally once the retention phase is complete.

Tips for managing discomfort

• Use child-safe over-the-counter pain relief if needed (check with your orthodontist first).
• Stick to soft foods like soup, yoghurt, mashed potatoes and scrambled eggs for the first few days.
• Try turning the expander at night so your child can sleep through any pressure sensations.
• Keep ice lollies on hand; they’re soothing and count as a soft food.

When to call your orthodontist

While mild discomfort is normal, you should contact your orthodontist if your child experiences severe pain, swelling, a loose or broken appliance, or an inability to eat or speak after the initial adjustment period.

Duration of treatment: Active phase vs. retention

So, how long do palate expanders take in the UK?

Active expansion phase

The phase where you’re actively turning the key typically lasts only a few weeks. Usually, it takes between two and eight weeks, depending on how much expansion is needed.

Retention phase

Here’s the bit that catches some parents off guard: The device must remain in the mouth for several months after you stop turning it. This retention phase usually lasts three to nine months and is absolutely crucial for palatal expansion success. During this time, new bone forms and solidifies, ensuring the results are stable and permanent.

Total treatment time

Overall, expander treatment generally ranges from six to 12 months from start to finish. It might seem like a long time, but when you consider the lifelong benefits, it’s really quite brief.

Caring for the appliance and home activation

Maintaining oral hygiene

Keeping the expander clean is essential. Your child needs to brush carefully around the appliance after every meal. A water flosser can be a game-changer for dislodging food debris that gets trapped under the device.

Foods to avoid

To prevent damage to the expander, steer clear of:

• Hard foods (ice, hard sweets, crusty bread)
• Chewy foods (toffee, chewing gum)
• Sticky foods (caramels, certain sweets)
• Crunchy snacks (popcorn, hard crisps)

Turning the expander at home

Your orthodontist will teach you how to turn the expander using the special key. It might feel a bit awkward at first, but you’ll quickly get the hang of it. Most parents find it helpful to have good lighting and to let their child lie back with their head tilted.

Important reminders

If you forget to activate the expander one day, don’t double up on turns the next day. This can cause unnecessary discomfort and interfere with the treatment plan. Just continue with the regular schedule. Also, make sure each turn is complete by checking that the next hole in the screw is visible.

Palate expander before and after: long-term benefits

When you look at palate expander before and after pictures from UK patients, the changes can be quite remarkable. These include: 

Aesthetic improvements

Results often include a wider, more balanced facial appearance and a broader smile. Many parents notice their child’s profile looks more harmonious after widening the palate.

Functional benefits

The primary goal is creating space for permanent teeth to erupt correctly. This can prevent the need for extractions or jaw surgery later in life. Expansion also ensures the upper teeth correctly fit outside the lower jaw, establishing a healthy bite.

Health benefits

Beyond aesthetics, palatal expansion can improve breathing and reduce issues like snoring and sleep apnoea. Better nasal airflow contributes to improved sleep quality, which impacts your child’s overall wellbeing, concentration, and development.

Understanding costs 

Let’s talk about palate expander costs in the UK, because this is something parents want to know before committing to treatment.

NHS coverage

NHS treatment for children is typically free, but only if the treatment is clinically necessary. Free treatment is only provided if eligibility criteria via the IOTN scale are met and a referral is accepted. Children with mild or borderline cases usually don’t qualify. So while severe crossbites or functional problems affecting eating or breathing might qualify, most routine expansion treatments fall outside NHS coverage and are paid for privately. For example, Invisalign or clear aligner-based expanders are not commonly available under NHS and are usually private options.

If your case does qualify for NHS treatment, costs fall under banded treatment fees (Band 2 is approximately £75.30 as of 2025; Band 3, for complex orthodontic cases, is £326.70). That said, specific expander costs aren’t always clearly listed and eligibility criteria are strict.

Private costs in the UK

If you’re looking at private treatment, here are realistic price ranges for the Greater London area:

• Traditional expanders: £1,775 to £2,575
• Invisalign or clear aligner-based expanders: starting around £2,975
• Surgically assisted expansion (SARPE) for adults: starting from £7,500*

*Additional fees may apply.

These prices can vary based on the complexity of the case and the specific appliance needed.

Taking the next step

Palatal expansion offers significant benefits, including skeletal correction during the optimal growth window, space creation for emerging teeth and improved breathing function. If your child is around age seven or shows signs of a narrow jaw, crossbite, or crowding, an evaluation with a specialist orthodontist is a smart next step. Early orthodontic intervention can prevent more complex (and expensive) treatments later while taking advantage of your child’s natural growth patterns.

Ready to explore whether a palate expander is right for your child? Schedule a FREE consultation with Hampstead Orthodontic Practice today. We’ll assess your child’s individual needs and create a tailored early orthodontic plan that sets them up for a lifetime of healthy smiles.

FAQs about palate expanders

How much does a palate expander cost in the UK?

Private palate expander costs in the UK typically range from £2,959 to £3,950 for traditional metal expanders. Clear aligner-based expanders start around £3,250. NHS coverage is available only for clinically necessary cases, usually Band 2 treatment at approximately £75.30, though most routine expansion treatments are paid privately.

Will my child be in pain with a palate expander?

Most children experience mild pressure rather than severe pain. The sensation feels like tightness across the roof of the mouth or behind the nose, usually lasting only a few days after each activation. Over-the-counter pain relief and soft foods help manage any discomfort during the adjustment period.

How long does palate expander treatment take in the UK?

The active expansion phase, where you turn the key, lasts two to eight weeks. However, the device must stay in place for a retention phase of three to nine months afterwards to allow new bone to form. Total treatment time typically ranges from six to 12 months.

What age is best for getting a palate expander?

The ideal age is between seven and 12 years old, while the upper jaw bones haven’t fully fused. Early intervention works best because the jaw is still developing and responsive to gentle guidance. If your child still has some baby teeth, they’re likely a good candidate for treatment.

Can you see results from palate expander treatment?

Yes, palate expander before and after results show noticeable changes. You’ll see a wider smile, improved facial balance and proper tooth alignment. Functionally, the treatment creates space for permanent teeth, corrects crossbites and can improve breathing. A temporary gap between front teeth during treatment is normal and will close naturally.