Pre – orthodontics
What Is Pre-orthodontic Treatment?
It’s an early intervention in jaw development, before all permanent teeth have finished erupting. At this age (usually 6–11 years), the bones of the upper jaw are still pliable and can be guided towards proper growth with gentle, steady forces. The logic is simple: if the problem is lack of space, we increase the space before the teeth become crowded — instead of removing teeth or making large tooth movements later on.
What Are Palatal Expanders?
They are orthodontic appliances — removable or fixed — placed on the upper jaw that gradually widen the palate (the roof of the mouth). The best-known types are:
Rapid Palatal Expander (RPE)
A fixed appliance cemented to the molars with a special “screw” in the middle. The parents (or the patient themselves) turn the screw a small amount each day (or every few days), gradually widening the upper jaw over 4–12 weeks.
Removable Palatal Expander
A removable acrylic/plastic appliance the child wears for set hours per day (and at night). Milder expansion, suitable for smaller problems.
Functional Appliances
For cases where, beyond expansion, the upper-to-lower jaw relationship also needs correcting (e.g. when the lower jaw is set back). They guide the growth of both jaws simultaneously.
When Pre-orthodontic Treatment Is Needed
- Narrow upper jaw (the child shows “crowded” permanent teeth)
- Crossbite — when the upper teeth bite inside the lower
- Severe crowding of permanent teeth
- Impacted canine or other tooth that can't find space to erupt
- Children who breathe through the mouth (narrow jaw + breathing difficulty)
- Upper/lower jaw growth issues (overbite, underbite)
- Habits like pacifier use or thumb sucking that have affected the shape of the palate
The Procedure Step by Step
Initial assessment:
Clinical examination, digital photographs, digital impression and — where needed — a panoramic X- ray. We assess whether pre-orthodontic intervention is needed and what timing is ideal.
Appliance selection:
We choose the most appropriate appliance (fixed RPE, removable expander, functional) according to age, case and the child's cooperation.
Placement:
For fixed appliances, placement is done in a single appointment (30–45 minutes) and is completely painless. For removable appliances, the device is delivered with detailed instructions for use.
Daily use & activation:
Parents turn the expander screw according to the schedule we provide (e.g. 1 turn in the morning and 1 in the evening, or as per the plan). It's a simple 30-second procedure we teach you during the appointment.
Follow-up appointments:
Every 4–6 weeks, we check progress and adjust. When the desired expansion is achieved, we stop activation and keep the appliance in place for 4–6 months as a “stabiliser”.
Removal & transition to Phase 2:
After removal, there's usually a waiting period until the remaining permanent teeth erupt — and then, if needed, the 2nd phase of orthodontics (braces or aligners), which is significantly shorter and milder.
Benefits of Early Intervention
- Creates space for permanent teeth → less crowding later
- Avoid or significantly reduce extractions of permanent teeth
- Shorter and simpler 2nd phase (with braces or aligners) later
- Improved breathing (especially in mouth-breathing children)
- Correction of crossbite that, if left untreated, damages the joints
- Better chewing & speech
- Confidence: children develop a balanced smile from an early age
Ideal Age
The most effective period is 6–11 years, when the palatal suture is still open and bones respond easily to expansion. After ages 12–13, the suture matures and expansion becomes more difficult —in teenagers and adults, surgical assistance may be required.
Is It Painful for the Child?
No. Placement is completely painless. For the first 2–4 days the child may feel a sensation of pressure in the jaw or nose when you turn the screw — this passes quickly. They’ll also need 3–7 days of speech adjustment (a slight “distortion” of some sounds), which disappears as the child gets used to it.
Care During Treatment
- Brush after every meal — the appliance traps food
- Use a water flosser for cleaning around the appliance
- Avoid hard (ice, nuts) and sticky (sweets, chewing gum) foods
- Check-ups every 4–6 weeks
- Professional paediatric cleaning every 4 months
Cases
Everything You Need to Know
Frequently Asked Questions (FAQ)
At what age should the first orthodontic check be done?
Around age 7. At this age, enough permanent teeth have erupted for us to detect developmental issues, while the jaw is still pliable and favourable for intervention.
How long does pre-orthodontic treatment with an expander take?
The active expansion phase usually lasts 4–12 weeks. The appliance then stays in place for 4–6 months as a “stabiliser”. Total: 6–9 months.
Will my child still need braces later?
Not always — but often, the 2nd phase becomes much shorter and simpler. In some favourable cases, no braces are needed later at all.
Does the child feel pain?
No. There’s an initial pressure sensation in the first few days — not pain. Painkillers are rarely needed and only for 1–2 days.
Can I start this in a teenager or adult?
In teenagers up to age 13–14 it’s often still feasible. In adults, the palatal suture has closed and expansion usually requires surgical assistance (SARPE). That’s why ages 6–11 are ideal.
How much does it cost in Cyprus?
It’s significantly more affordable than a full orthodontic treatment and is an investment that reduces the cost of the 2nd phase. At Dentistar, you receive a clear quote after the initial check-up.
Ready to Book Your Appointment?
Contact us today to schedule your visit and take the first step toward a healthier smile.