Rapid maxillary expansion in kids: The process and its benefits

Rapid maxillary expansion (RME) is a common orthodontic procedure used to widen the upper jaw (maxilla) in children. This approach is highly effective during childhood because the maxilla is still developing, making it more responsive to treatment. RME not only corrects dental issues but can also address airway and breathing problems, improving overall health.

What is rapid maxillary expansion?

RME involves the use of a custom-designed appliance, such as a palatal expander, which is fixed to the upper teeth. The device applies gentle pressure to gradually widen the upper jaw over a specific period. This creates more space for teeth alignment, prevents overcrowding, and addresses jaw discrepancies. The procedure is most effective in children and preteens because their bones are still malleable. In adults, surgical intervention is often required to achieve similar results, or through using Mini-implant Assisted Rapid Palatal Expansion (MARPE).

When is RME recommended?

Orthodontists may recommend rapid maxillary expansion for:

• Crossbite correction: when the upper teeth are narrower than the lower teeth, causing misalignment.
• Dental crowding: to create more space for proper tooth alignment.
• Airway issues: to improve nasal breathing by widening the nasal passages.
• Sleep-disordered breathing: to reduce snoring and improve airflow, potentially aiding in obstructive sleep apnoea.

The process of rapid maxillary expansion

1. Initial consultation: The orthodontist evaluates the child's jaw structure, bite, and dental alignment using X-rays and impressions to determine if RME is suitable.
2. Appliance placement: A palatal expander is custom-made and attached to the upper teeth. It can be removable or fixed, depending on the case.
3. Activation phase: The appliance has a central screw that parents or caregivers adjust daily using a special key. This adjustment applies gentle pressure to the maxilla, encouraging it to expand.
4. Retention phase: Once the desired width is achieved (typically within one to three weeks), the appliance is left in place for several months to stabilise the bone and allow new bone to form in the expanded area.

Benefits of rapid maxillary expansion

1. Improved dental alignment: RME creates adequate space for permanent teeth to erupt, reducing the need for tooth extractions and future orthodontic treatments.
2. Corrected bite issues: it resolves crossbites and enhances the balance between the upper and lower jaws, promoting a healthy bite.
3. Better breathing: by widening the nasal passages, RME can improve nasal airflow and reduce symptoms of mouth breathing and sleep-disordered breathing.
4. Enhanced facial aesthetics: proper jaw alignment contributes to improved facial symmetry and aesthetics.
5. Boosted speech and oral function: a wider palate can help correct speech impediments and improve chewing and swallowing.

Does RME hurt?

Most children experience mild discomfort or pressure during the activation phase, but this is temporary and usually well-tolerated. Over-the-counter pain relief can help if needed.

Rapid maxillary expansion is a transformative orthodontic treatment that offers significant benefits for children. By addressing structural and functional issues early, RME can pave the way for improved dental health, better breathing and enhanced quality of life. Parents should consult with a qualified orthodontist to determine if this treatment is right for their child.