The purpose of the expander is for maxillary development, airway development, palatal vault remodeling, and increasing tongue space. It can also help us with TMJ (temporamandibular joint) cases.

Epigenetic Orthodontics can open and protect the airway, enhancing breathing both during sleep and awake activities. Dr. Roca practices a philosophy that integrates airway into all diagnosis and treatments. Dentistry has traditionally not considered the airway when planning dental treatments. Fortunately, today there is a rapidly growing movement that now recognizes how dentistry can have an impact on the airway, which affects breathing during sleep. If dental treatments, including TMJ, orthopedics, and orthodontics are well planned, the result can be that the airway is protected or even enhanced. There is a clear link between underdeveloped and retruded jaws together with narrow dental arches that puts a patient at risk for sleep-breathing disorders.

Please visit this site for more information; Airway Health.

Example: Lower Expander


Example: Upper Expander








Fixed retainers are used when children around age seven or eight measure the roof of the mouth at 35 mm for their transverse measurement. Depending on the width, often we use 10 mm super screw on the upper expander.


There are seven sutures that connect the cranium to the maxilla and face that do not BEGIN to fuse until age 68 to 72. So the myth that adults are too old to expand is false. We use removable appliances on adults and turn once a week for adult cases.
Indications for Adult Removable Expanders

  • Unilateral posterior crossbite
  • Bilateral posterior crossbite
  • High-vaulted roof of the mouth
  • Sleep apnea diagnosis
  • Severity of medical symptoms
  • Beyond Invisalign capability

What is Orthotropics?

Orthotropics represents a new way of looking at crooked teeth. Instead of seeing them in isolation, they are viewed as part of the head and neck, and in relation to other problems in this system such as breathing, body posture, jaw joint problems, and most ENT.

Wider Airways
Healthier Jaw Joints
Stronger Profiles
Terrific Smiles

Orthotropics specializes in treating malocclusion by guiding the growth of the facial bones and correcting the oral environment. This treatment creates more space for the teeth and tongue. We use a variety of different fixed and removable appliances that help with expansion and correct posture. We also use myofunctional activities (exercises that teach correct swallowing and muscle function and help get the face to a symmetrical state).

Missing the bigger picture is a common problem within medicine, and orthodontics is no exception. Orthodontics was developed to make teeth straight. They do make teeth straight, but too many people need braces more than once, and finally we have learned why this is the case. Faces that grow correctly have straight teeth and are healthy, whereas faces that do not have crooked teeth and a list of other health problems. Attempting to force the teeth into alignment is ineffective in the long term and potentially damaging. However, attempting to redirect the growth pattern can align the teeth permanently, gain wide-ranging health benefits (especially for sleep apnea) and improving facial appearance.

Traditionally an orthodontist uses an expander at the age of 8 and places a Hawley Retainer for the patient to wear at night until the child loses the rest of their teeth and starts phase 2 treatment. As you can see in the photo the expander gives a lot more room for the patient to breathe but as soon as the Hawley retainer is placed in the mouth, now the tongue can’t live in the roof of the mouth and the habit of mouth breathing starts all over again. If the tongue was originally living in the roof of the mouth, they would not have needed an expander in the first place. Over time, we most usually see orthodontic relapse because it is common practice that the child stops wearing the retainer because either they forget one night or it starts to bother them due to the incorrect swallow during the day when they don’t have the retainer on in their mouth. Before we know it, the palate starts to move into its narrow shape again. In order for this not to happen the tongue needs be suctioned to the roof of the mouth 24/7, except while chewing and talking, which is why it is an essential part of our treatment to teach your child the proper use of all facial muscles.


There are many different methods of orthotropic treatment. It all depends on the patient’s chief complaint and the age. There is not one correct way; it depends on many variables. Here is a video talking more about this:
Many Available Options
We can use fixed expanders, removeable expanders, ALF (Advanced Lightwire Functionals), BioBlock…
ALF Expander


Below is an Upper Bioblock


BWS Upper Expander
Click the buttons below to watch videos about Bioblock:
Bioblock Video 1
Bioblock Video 2


Call for a consultation at (703) 237-7622 to determine if you or anyone in your family is a candidate for any of our orthodontic options.