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Old 09-18-2003, 12:12 AM   #1
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Post Upper Palate Expander...Now???

Hi,

My Son has a horrible bite...and for those of you that don't know me, he was in the middle of orthodontics when his problems began. (his braces were taken off prematurely due to this) We saw his Neuromuscular dentist last week for an adjustment and he said that if my Son saw no improvement within the next few weeks, he'd refer him to a fellow colleague of his (LVI graduate) that might help. It's been hard to get a splint to fit his mouth. A brief rundown:

His lower molars tilt inwards, the overcrowding is terrible, the 2 lower front teeth grew in behind the arch, also has impacted wisdom teeth. (thank goodness they aren't causing him grief as of yet) Also...underdeveloped lower jaw.

Upper arch is okay other than towards the back, the teeth are that of a roller coaster track, if that makes any sense.

Anyway, it seems that his upper palate became 'buckled' due to orthodontics. The dentist seems to think that if he wears an upper palate expander, it'll help out to make splint therapy more viable. I'm having a problem with this theory. Moving anything while in pain does not seem to be a good idea to me. Any thoughts?
Cheryl

Last edited by CherylLynn24; 11-02-2003 at 09:52 PM.

 
Old 09-18-2003, 05:21 AM   #2
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Cheryl,

Hi! It sounds like you have a lot going on right now. I know your fears about 'moving anything around' right now. It is a real worry.

All I really know about expanders is that they have Rapid Palatal Expanders, expanders that work more slowly, and functional expanders called ALF appliances I think. With the RPE, it works in usually about 6 weeks, but must stay in for up to a year or so to hold the expansion. The older the child is, the greater the chance that the bone sutures have already fused. Once the bones are fused usually the patient must have surgery to cut these sutures (or something like that) before they can have the expander. Some people have no problem with these expanders, but I have met an adult who had one as a child and said it was the most painful thing ever. The rapid ones may be more uncomfortable than the others. I'm not sure of the normal cut off date for 'needing surgery'. I think it can be anywhere from 12-18 depending on the sex of the individual, their growth, and who you ask. Just wanted to give you a heads up, as if this IS something he TRULY needs, you may want to look into it sooner rather than later.

Good luck Cheryl. I hope you are feeling well today. My monitor is giving me problems, so if I suddenly can't post you will know why I haven't gotten back to you.

Take care,
TC

[This message has been edited by totallyconfused (edited 10-29-2003).]

 
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Old 09-19-2003, 08:42 AM   #3
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hi, if you look under dental problems on this board and search under expander there are a couple posts on this topic. I wish the best for your son - I have a 14 year old son too and I can't imagine if he was in pain daily.

 
Old 09-19-2003, 10:25 PM   #4
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TC,

Thanks for the reply. How are you doing these days? As for the expander, I'm not so sure that I buy the surgery bit with age. I remember Marlene stating that she used an expander. Maybe she can clear this up if she sees this. This is something that I want to really read up on before committing to. Somehow, I don't agree with an expander of any sort while the patient is in pain.

Puzzled,
Thanks so much for the tip. I will go over to the dental board and read up on this.

Take Care,
Cheryl

[This message has been edited by CherylLynn24 (edited 09-20-2003).]

 
Old 09-19-2003, 10:49 PM   #5
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Hi Cheryl & TC:

How y'all doing? (don't I sound like I'm from the southern states I haven't been posting much lately as I haven't been feeling great. Hope you're both doing well, and Mike.

I hadn't heard about palate expanders before, but it's good you posted. My nephew has braces, and some weird tooth that the dentist is trying to yank down out of his palate bit by bit. I so worry about whatever is being done to him. A palate expander was mentioned as possible treatment for him in future. I'm already worried that the choices made on him are the wrong ones and going to cause him many problems in the future, so would certainly like to hear whatever anyone can offer about expanders - good or bad.

As I say, Cheryl, I don't know anything about them, but it never seems like a good idea doing something that sounds major while Mike's bite isn't somewhat stable and out of pain. Let me know what you decide.

Take care,
Arleen
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Old 09-20-2003, 08:02 AM   #6
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Everything I have read says that the earlier an expander is used, the better. As was explained above, the sutures fuse. It has worked in some adults, but doesn't in most. If there are structural problems, they have to be corrected sometime and likely the sooner the better. I know it concerns you that it will be painful. However, if you have a good dentist that you trust, and he has explained the rationale of treatment and it makes sense, some pain now is better than a lifetime of pain. You might try getting a second opinion from a functional jaw orthodontist.

 
Old 09-20-2003, 10:49 PM   #7
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GenDen,

Wouldn't expanding the upper palate while still in pain create more? I had taken him to a functional jaw orthodontist in late May and wasn't too impressed with him at all. I know this doesn't speak for everyone though. He said he'd make a splint, and if it didn't offer any relief, then long term pain management would be in store. It's hard weeding through all of them in the area, as I'm sure you can imagine. I'd be willing to travel a reasonable distance (as I know adjustments are in store) I know that you've gone the functional jaw route, any thoughts at all? To be honest with you, I just don't know who to trust anymore. I have a child in pain that I need to get well already. Thanks for responding to me.
Take Care,
Cheryl

Last edited by CherylLynn24; 11-02-2003 at 09:53 PM.

 
Old 09-21-2003, 06:06 PM   #8
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I offer my sincere sympathy. I know that I would willingly bear any of the pains of my children rather than see them suffer. It is doubly difficult to have them in pain and be stymied at every turn in getting treatment and relief for him. I know that you have done everything you know how to do.

The functional jaw orthopedic dentist I see works from the values that I think are essential. He always does what he thinks is the right thing to do and he works as hard as he can to do the right thing. He is also very bright and gifted at diagnosis and treatment. Perhaps the method isn't as important as the ethics and values of the treating dentist. The trick is to find such medical providers.

I can only tell you what I think I would do in your situation. Your concern now is that his structural problems--caused by the inept orthodontic work and developmental abnormalities--are contributing and/or causing his pain. If this is the case, then they must be corrected before he will be relieved of pain. I would see the best oral surgeon who deals with underdeveloped jaws that I could find. I would listen to his opinion and gather as much information as I could. I would also see a couple of orthodontists to see what they had to say. I trust my general dentist, so I would then go to him with all the information I had gathered and ask what he would do if this were his son.

My prayers are with you in finding help for your son.

 
Old 09-21-2003, 06:17 PM   #9
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You asked about Dr. Gerber. I have not heard of him.
When you say that your son's palate buckled with the orthodontic treatment, it makes me hurt to think about it. It seems to me that it won't correct itself and must be corrected and the sooner the better. Any correction will be easier while he is still growing, because the specialist can take advantage of natural growth in the correction process.

 
Old 09-21-2003, 11:28 PM   #10
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GenDen,

Thank you for your prayers and advice. This is so difficult watching him hurt, I'd rather it all be put upon myself. I looked into the AAFO site, and there are so many in my area, it's hard to choose who to see. I intend on setting up a few consultations in the near future. Speaking of an OS, I did take him to see someone reputable back in February. I mentioned his findings to Cymy Sue in a post to her, entitled "Cymy Sue". (If you have a chance, please read it over) I would like to hear your thoughts if you have any. He suggested Physical Therapy and splint therapy. Thank you again for responding to me and for your advice, I value it. I hope that you're doing well. What a mess this all is..
Take Care,
Cheryl

[This message has been edited by CherylLynn24 (edited 09-22-2003).]

Last edited by CherylLynn24; 11-02-2003 at 09:54 PM.

 
Old 10-12-2003, 01:03 PM   #11
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I am a 44-year-old who just went through the RPE surgery. Believe me, it would have been much easier to have it done as a child, before the bones fuse. That said, it was not so much "painful" as it was "uncomfortable" and you feel more "pressure" in the palate than pain as the expander does its work. I was sorry to read of your son's situation, but I agree with the previous poster, unless you correct the structural problem that's causing the pain, you can't realistically alleviate the pain. I also have an underdeveloped jaw and will be undergoing an additional surgery to correct that problem next year. In my case, none of this made sense until I found a top-rated oral surgeon, whom I trust enormously. He is coordinating everything among the "team" I need to achieve the best result, namely the orthodontist, the periodontist and my regular dentist. How did I get to the point of needing all this help, you might ask? Because as a child, my orthodontist didn't know enough to correct the underlying skeltal problems before using braces to move the teeth. Consequently, 30 years later I'm going through it all (and more....) again. Take it from me -- do it now!

 
Old 10-12-2003, 02:28 PM   #12
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Hi Cheryl,

It is so hard making decisions regarding our children's future health. I know you are doing everything you can to help your son.

We'll know more about the entire treatment plan for our son on Wednesday ...but, for now the Functional Jaw Orthodontist (that supposedly brought it to this country), that we consulted with on Saturday, mentioned braces and some type of an expander on my 12 yr, 10 month old son. He also treats TMJ and taught it for many years to doctors, so, he is very careful not to do anything to hurt the TMJ joints. I think he wants to expand his upper jaw. I know he doesn't use headgear or the herbst, because that only causes problems later on. I'm curious as to exactly what the treatment plan will be. You know I'm not sure about the circumstances, but, I would be making that orthodontist that contributed to your sons palate buckling answer to someone. That sure sounds serious to me! It's a shame what these orthodontists are doing to kids. Pretty soon they aren't going to be able to keep up with the lawsuits and from what I understand people have been suing them. Bu the way, what do they mean by an underdeveloped jaw? Anyone know? Does that mean no chin or what? My son has a nice jaw and good profile. I know that's what the TMJ dentist was looking at. He just said he was over closed (like me .

God Bless You in your journey for treatment for Mike!

velvetgrl

[This message has been edited by velvetgrl (edited 10-12-2003).]

 
Old 10-12-2003, 10:49 PM   #13
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DKSINAR,

I appreciate your words of experience. I'm sorry that you're going through all of this. Unfortunately, with my Son, we're not so sure that this 'palatal problem' is all that's wrong. He's got a lot of things that are 'wrong' in his mouth. I have someone better qualified to deal with this than who he's currently seeing, looking things over at this time. I hope to have some answers soon. Thank you for your response.
Cheryl

 
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