Palatal Expansion vs. Removal of Teeth: Which One Is Better?

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Elena

05/04/2023
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When teens are told they need to wear braces, there is often some work that needs to be done to the arch of their mouth beforehand. This is where an important decision comes into play: should the orthodontist install a palatal expander in the patient’s mouth or remove some of their teeth first? Both options have pros and cons.

Because each patient’s situation is different, what works for one patient doesn’t always work for the next one. The orthodontist has to take everything into consideration first, such as the patient’s age and numerous other things.

Which One Is Better: Palatal Expansion or Getting Teeth Removed?

At one point, orthodontists regularly pulled teeth before installing braces on a patient in order for the results to be what was best for the patient, but using a palatal expansion device is now an alternate option. Deciding between these two actions can be tough, but keep in mind that every patient is different, and therefore, the orthodontist has to make the decision on a case-by-case basis.

In these instances, the doctor usually considers the following:

  • What is the type of malocclusion (bite problem) that needs correction?
  • What is the jaw size of the patient vs. the number of teeth?
  • How far do the teeth need to move up so that they end up where they need to be?

Dentists also consider whether the problem is skeletal in nature, such as a narrow arch or dental. Many orthodontists believe that conditions such as a narrow arch need to be taken care of with a palatal expansion device, whereas extraction can work if the problem is dental in nature and it isn’t too severe.

The problem with the palatal expansion option is that you can only choose it before the ossification process—or the development of the bones—is complete. Ossification is normally completed in the late teens, but it can take until the patient is in their early to mid-20s to complete. After this has happened, palatal expanders are no longer an option.

Some of the things the orthodontist will consider when deciding between palatal expanders and extraction include:

  • The nature and severity of the malocclusion
  • Any medical conditions the patient might have
  • The preferences of the patient
  • The age of the patient

Of course, orthodontists examine the patient very carefully to make this decision, including the use of X-rays, models of the mouth, photographs, and exact measurements of the teeth and gums.

When Are Extractions Good for the Patient?

Extractions can be chosen for situations that include:

  • Severe crowding of the teeth when the upper and/or lower jaw simply isn’t big enough to accommodate the patient’s current teeth or the ones growing in
  • Front teeth that protrude out, especially if it prevents the patient from closing their lips properly
  • Severe issues when the teeth do not fit together the way they should, such as a severe overbite
  • Impacted teeth, especially if they are very far out of alignment
  • Missing teeth or gaps that result in an asymmetrical or uneven appearance

To be sure, tooth extractions are usually not chosen unless it’s the best choice for the patient, but in cases where a palatal expander simply won’t work, it may be the doctor’s only option.

Is It Possible to Choose a Third Option?

There is now a product called self-ligating braces, which are made out of the same materials as traditional braces but don’t use elastics. This results in fewer trips to the orthodontist and less pressure on the teeth. The main difference is the use of a specialized clip instead of the elastics, and the braces come in both active and passive models.

With self-ligating braces, the specialized clip helps the archwire guide the teeth into place, so they claim to be more comfortable as a result. The problem is that the reviews of these types of braces are very mixed at the moment, with many orthodontists not even considering using them on their patients.

If your orthodontist mentions the possibility of choosing self-ligating braces, it’s a good idea to do some heavy research into their pros and cons. These braces are certainly not for everyone, and many orthodontic specialists claim it’s impossible for the braces to do what the company claims they can do.

Can Facial Exercises Help in Enlarging the Jaw?

Facial exercises exist that help make the jaw look a lot more defined and much larger, so don’t hesitate to do a little research on this topic if this is something you’re interested in doing. Some of these exercises include:

  • Vowel exercises. These consist of opening your mouth wide and saying the letters “O” and “E” repeatedly in a very exaggerated motion.
  • Chin-up exercises. With your mouth closed, push your jaw forward and lift up the lower lip. Push up until there’s the feeling of the muscles in your jawline and chin being stretched.
  • Neck curl-up exercises. While lying down, press your tongue to the roof of your mouth and bring your chin to your chest. Next, lift your head roughly two to three inches above the ground and lower it slowly, then repeat.
  • Tongue twister exercises. Place the tongue on the roof of your mouth and behind your teeth. Press it down harder and hum. The vibrating sounds will activate the muscles.
  • Collarbone backup exercises. Sit down and bring your head back a few inches. Do this until the muscles on the side of your neck contract. Keep your chest still and your ears over your shoulders. Keep the chin parallel to the floor as you move.

Regular exercises such as these can easily give you a more defined and better-looking jawline, which is something both men and women will appreciate.

Conclusion

When your child needs braces, the orthodontist usually has to choose between tooth extractions or palatal expansion devices. The devices work better for younger patients, but the decision is also based on the patient’s individual circumstances, the condition they’re trying to improve, and numerous other factors.

When braces are needed, it’s smart to do your due diligence so you know what your options are and so you can work with your orthodontist to make the best decision in the end.

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