Fixed Palatal Expander Guide

• You may need your parents’ help to activate the expander.
• Lie at the edge of a sofa or bed, with a pillow at your neck, and tip your chin up towards the ceiling. 
• Look for the keyhole closest to the front teeth and insert the key into this hole. 
• Follow the direction of the arrow and do a smooth, continuous push of the key towards the back of the mouth. 
• Remove the key from the back of the mouth. DO NOT pull forward to remove the key as this will close the expansion you just did. 

• Your Dr. will guide you on:
  • When to activate your fixed cemented maxillary expander.
  • The amount of expansion needed.
  • To follow a Rapid Maxillary Expansion Protocol or
  • To follow an Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC) Protocol.

Please download the following protocol timetables here:

• Rapid Maxillary Expansion Protocol at MyBracesClinic
• Alt-RAMEC Protocol at MyBracesClinic

• For the first 3-5 days, as you activate the expander, it is normal to experience discomfort and a dull ache when chewing.
• A soft diet and taking the prescribed painkillers will help.
• There may be a feeling of increased pressure from expander activation. This is a transient issue and will resolve with time. 
• Patients may get ulcers from new palatal expanders. Use braces wax on the expander to reduce ulcers from developing, but bear in mind that braces wax can block the opening of the expander keyhole!
• Applying the prescribed ulcer cream to the ulcer helps alleviate the symptoms. These ulcers gradually disappear as your mouth gets used to them.
• Use braces wax! Wrap up any ‘bulky’ areas with wax to buffer against ulcers.
• Drying the area first helps the braces wax stick better to the expander.
• Soft wax that is accidentally swallowed is ok. It will pass out when you go to the toilet (like fibre!).
• Remove any soft wax on the braces before brushing.
• Watch our Video on ‘How to use Braces Wax’.

• Your regular diet will not be affected; simply modify your eating habits.
• Apples, raw carrots, and meat should be cut into smaller pieces and chew slowly with your back teeth.
• Avoid crunching down on hard foods like peanuts, chewing ice cubes or crab claws. Repeated chomping on hard and crunchy food tends to crack and loosen the cement holding the expander in place.
• Avoid sticky foods like chewing gum and boba pearls as they may get stuck in the expander, making it harder to clean.
• Reduce the intake of soft drinks, as their high sugar and acidic content can cause tooth decay around the expander.

• Do brush your teeth, gums & braces at least twice a day.
• Start using the super-charged Fluoride mouth rinse designed for braces to prevent decay. Prevention is better (and cheaper!) than cure.
• Gargle with water often, especially after meals.
• Powered water flossers designed for braces, like the Waterpik, may be easier to for flushing debris out from the expander!
• End-tufted brushes with a long handle are designed to sweep over the hard-to-reach areas of the expander, helping to keep it clean.

  

• If one side of your expander is loose, DO NOT yank it out by yourself or by your parent. 
• Make an appointment with our clinics ASAP.
• If the whole expander is out of the mouth and you can replace it back onto your teeth, then brush the expander clean and replace it for 12 hours a day until you can see us.