Palatal Expanders for Kids on Mercer Island
Board-certified orthodontist Dr. Alissa Borda explains how expanders improve breathing, create room for teeth, and what to expect
Maybe your child's dentist mentioned a palatal expander. Maybe you've been reading about airway orthodontics and how widening the jaw can help kids breathe better, sleep better, and get more oxygen. Either way, you're here because you want what's best for your child — and that already says a lot about you as a parent.
Here's what we want you to know right up front: you're in the right place. At Islander Orthodontics, palatal expanders are one of the most common treatments we do for growing kids, and we're going to walk you through every step so you can feel completely confident in your decision.
Dr. Alissa Borda is a board-certified orthodontist who grew up right here on the Island and treats every family like her own neighbors. No stress, no guesswork, no needing to shop around. Just clear answers from a specialist you can trust. Schedule your free exam to get started.
Key Takeaways
What Is a Palatal Expander?
A palatal expander — sometimes called a rapid palatal expander (RPE) — is a custom-fitted orthodontic appliance that sits against the roof of your child's mouth and attaches to the upper back teeth. There's a small screw in the center that gets turned with a special key — usually once a day — to gradually widen the upper jaw.
Here's why that works: In kids and preteens, the upper jaw (the maxilla) is actually two separate bones connected by a flexible joint called the midline suture. That suture doesn't fully fuse until the mid-teen years. Before it does, an expander can gently push those two halves apart — a process called maxillary expansion — and new bone naturally fills in the gap.
It's the same principle as guiding a young tree to grow in the right direction — you work with the natural growth process, not against it.
Why Would My Child Need One?
A palatal expander can do a lot of good — from helping your child breathe easier to creating the space their permanent teeth need to come in straight. Here are the most common reasons Dr. Borda recommends one:
Better Breathing and Airway Health
The roof of your mouth is also the floor of your nasal cavity. A narrow palate can restrict airflow, leading to chronic mouth breathing, snoring, and sleep-disordered breathing. Expansion opens that airway up, helping your child breathe easier through their nose and sleep more soundly.
Crossbite Correction
This is when some of the upper teeth bite inside the lower teeth instead of outside them. When caught early, a palatal expander corrects the bite so the jaws grow together properly — avoiding more involved treatment later.
Room for Permanent Teeth
When the upper jaw is too narrow, permanent teeth can come in crooked, overlapping, or even get stuck beneath the gums. Widening the jaw creates the space those teeth need to come in right where they belong.
Foundation for Braces or Aligners
Sometimes the best path to straight teeth starts with creating the right framework. An expander gives braces or clear aligners a better starting point — often meaning shorter treatment time and better results.
What a Palatal Expander Can Do for Your Child
| Your Child's Situation | What Can Happen Over Time | How an Expander Helps |
|---|---|---|
| Narrow airway | Chronic mouth breathing, snoring, poor sleep quality, lower oxygen | Widens the nasal floor, opening the airway for easier nose breathing and better sleep |
| Crossbite | Jaw shifts to compensate, uneven growth pattern | Upper and lower jaws align properly — healthy, balanced development |
| Crowded teeth | Teeth come in crooked, overlapping, or stuck beneath the gums | Creates room for permanent teeth to erupt in the right position |
| Narrow jaw before braces | Longer treatment, possible tooth extractions | Gives braces or aligners a better foundation — often shorter, simpler treatment |
"Very impressed by the care here. Thoughtful and caring, patient with nervous kids."
Does My Child Need a Palatal Expander? Signs to Look For
You don't need to be a dentist to pick up on some of the early signals. If you're noticing any of the following at home, it's worth bringing them up during an evaluation with Dr. Borda:
If any of these sound familiar, you're not overreacting — you're paying attention. An early evaluation gives you answers and options while your child is still in the ideal window for treatment.
What Age Is Best for a Palatal Expander?
The sweet spot is typically between ages 7 and 12 — before the midline suture starts to fuse. This is one of the big reasons the American Association of Orthodontists recommends every child have their first orthodontic evaluation by age 7. Not because every 7-year-old needs treatment, but because catching issues like a narrow palate early makes early interceptive treatment — sometimes called Phase 1 orthodontic treatment — simpler, faster, and more effective than waiting.
Dr. Borda evaluates each child individually. Some kids are ready at 7 or 8. Others benefit from waiting a year or two. The goal is always to find the right window — when the jaw is still growing and responsive, but your child is old enough to handle the appliance comfortably.
If your child is older than 12, expansion may still be possible, but timing matters. The older the patient, the more likely the suture has started to fuse, which can limit how well a traditional expander works. That's why we always encourage Mercer Island and Eastside families not to wait on that first evaluation.
Does a Palatal Expander Hurt?
This is one of the first questions parents ask, so let's put your mind at ease: palatal expanders aren't painful.
Most kids feel some mild pressure across the roof of their mouth for a day or two after the expander is placed, and again briefly after each daily adjustment. Some notice a tingling sensation around the nose or under the eyes (because the upper jaw connects to these areas). But that's about it.
If any discomfort comes up, over-the-counter ibuprofen takes care of it. And here's what we hear from parents all the time: their kids adjust way faster than they expected.
Your child might talk a little differently at first (a temporary lisp is totally normal), produce more saliva than usual, and prefer softer foods for a couple of days. By the end of the first week, most kids forget the expander is even there.
A few tips that make the first week easy:
How Does the Turning Process Work?
You (the parent) will handle the daily turns at home. It's quick and straightforward once you get the hang of it.
Here's the basic process: Have your child tip their head back and open wide so you can clearly see the expander. Insert the special key into the small hole in the center of the appliance. Push the key gently toward the back of the mouth until you feel it stop and see the next hole appear. Remove the key. Done.
The whole thing takes about 10 seconds.
Dr. Borda will show you exactly how to do this at your child's appointment — and you'll feel confident before you leave the office. If you ever need a refresher or have questions between visits, our team is always just a phone call away at (206) 707-7650.
One important note: if you miss a day, don't try to "catch up" by doing extra turns. Just pick up where you left off. More turns doesn't mean faster results — it means unnecessary pressure.
What to Expect During Treatment
Palatal expander treatment happens in two phases:
The Active Expansion Phase (3–6 weeks)
This is when you're turning the screw daily and the jaw is actually widening. During this time, you'll probably notice a gap developing between your child's two front teeth. That's completely normal and actually a great sign — it means the expander is doing exactly what it should. We'll close that gap later when we fine-tune the alignment.
The Stabilization Phase (3–6 months total wear)
The expander stays in place, but you stop turning the screw. This allows new bone to fully form and solidify in the expanded space. Removing the expander too early can lead to relapse, so patience during this phase really pays off.
Throughout treatment, your child will come in for regular check-ups at our Mercer Island office so Dr. Borda can monitor progress. With early morning appointments starting at 7 AM, it's easy to fit visits in before school at MIHS, Islander Middle School, or any of the Island's elementary schools.
How Much Does a Palatal Expander Cost?
We're not going to dodge this one. Cost is a real concern for families, and you deserve straight answers.
Palatal expanders generally range from $2,000 to $4,000 depending on:
- •The type of expander
- •The complexity of your child's case
- •Whether expansion is part of a broader treatment plan (like Phase 1 treatment followed by braces)
Think about it this way: a palatal expander now can reduce or eliminate the need for tooth extractions, longer braces treatment, or even jaw surgery later. That's a significant savings — both financially and in terms of what your child goes through.
Making It Affordable
Free exams
Complete cost breakdown — no surprises
All orthodontic insurance accepted
We'll help you understand your coverage
In-house financing
Spread payments out over time
Pay-in-full discount
Save when you pay upfront
We believe every Mercer Island and Eastside family should be able to get their child the care they need without stressing about the bill. See all payment options.
Palatal Expander vs. Waiting for Braces
Some parents wonder whether they can skip the expander and just do braces later. It's a fair question — and sometimes the answer is yes, braces alone will work fine.
But when a child has a genuinely narrow upper jaw, there's a real advantage to acting while they're still growing. The midline suture is flexible now, which means expansion is gentle, effective, and stable. That window doesn't stay open forever — once the suture fuses in the teen years, traditional expansion becomes much more difficult, and what could have been a straightforward Phase 1 appliance might require extractions or more involved treatment down the road.
That's the value of early evaluation. When you know where things stand, you can make a confident, informed decision — and if an expander can set your child up for easier treatment later, that's a win.
Dr. Borda's approach is always honest and conservative — she won't recommend a palatal expander unless your child truly needs one. Her published research on orthodontic treatment outcomes and her board certification (ABO Diplomate) mean she's evaluating your child's case with the highest standard of clinical judgment. If an expander isn't necessary, she'll tell you.
"The consult was professional, clear, quick and efficient."
Why Mercer Island Families Choose Islander Orthodontics
When it comes to your child's jaw development, you want an orthodontist you can trust completely — someone who'll take the time to explain everything, answer every question, and make the whole experience as smooth as possible for your family.
Board-Certified Expertise
Dr. Borda is a Diplomate of the American Board of Orthodontics — the highest voluntary credential in the specialty. She's the only solo, board-certified orthodontist on the Island.
Hometown Roots
Dr. Borda grew up on Mercer Island — Pixie Hill through MIHS, class of 2002. After earning three graduate degrees (DMD, MPH, and MS) and completing orthodontic training at OHSU, she came home to open Islander Orthodontics.
Great with Kids
This comes up over and over in reviews: families describe Dr. Borda as "patient with nervous kids" and "thoughtful and caring." She takes time to answer every question.
Early Morning Hours
We open at 7 AM Tuesday through Friday and 8 AM on Mondays. Fit appointments in before school at MIHS, Islander Middle School, or any of the Island's elementary schools. And yes — there are video games in the waiting area.
"She answers all of our questions and takes good care of us. Her schedule is pretty flexible, which helps with my busy work schedule and my son's school schedule."
What Your First Visit Looks Like
We know a new orthodontic office can feel like a lot — especially when your child might be nervous. Here's what to expect so you can both walk in feeling relaxed.
Your first visit starts with Dr. Borda doing a thorough exam of your child's teeth, jaw, and bite. She'll take any needed records and then sit down with you to explain exactly what she's seeing — in plain language, not clinical jargon. If a palatal expander or any other treatment is recommended, she'll walk you through why, what the process looks like, and how long it will take.
Before you leave, you'll get a complete cost breakdown with all of your payment options laid out clearly. No surprises later. No pressure to decide on the spot. Just everything you need to make a confident decision on your own timeline.
The whole visit is free, and most families are in and out in under an hour. Our Mercer Island office is designed to feel comfortable and welcoming — and the video games in the waiting area don't hurt either.
"From the very first consultation, the entire team has been friendly, professional, and incredibly patient with my daughter. They make sure she feels comfortable and confident at every visit."
Frequently Asked Questions About Palatal Expanders
How long does a palatal expander stay in?
Most children wear their expander for about 4–6 months total. The active turning phase is just 3–6 weeks, followed by several months of stabilization while new bone fills in. Dr. Borda will give your child a personalized timeline during your free exam.
Will a palatal expander affect my child's speech?
Temporarily, yes. Most kids develop a mild lisp for a few days while their tongue adjusts to the appliance. Encourage them to read aloud or talk through it — the speech changes resolve quickly, usually within the first week.
Why is there a gap between my child's front teeth during treatment?
That gap is actually a great sign — it means the expander is doing exactly what it should. As the upper jaw widens, a temporary space opens between the two front teeth. It looks surprising, but it's completely normal. The gap closes during Phase 2 treatment when braces or aligners bring everything into alignment. You can see the kind of results we achieve when treatment is planned from the start.
Can my child still eat normally with an expander?
Mostly, yes. We recommend soft foods for the first few days while your child adjusts. After that, they can eat normally with a few exceptions — avoid sticky candy, hard foods like whole nuts or ice, and chewy snacks like caramels that could damage the appliance.
Is a palatal expander the same as braces?
No. A palatal expander widens the jaw, while braces straighten and align individual teeth. Many kids need an expander first (Phase 1) to create the right foundation, followed by braces or clear aligners later (Phase 2) to fine-tune alignment.
What happens if my child doesn't get an expander?
It really depends on the specific situation. For some kids, waiting is perfectly fine. For others — especially those with a crossbite, narrow airway, or significant crowding — early treatment makes a meaningful difference in how smoothly everything develops. Dr. Borda will give you a clear, honest picture of what she recommends and why.
Does insurance cover palatal expanders?
Most orthodontic insurance plans cover a portion of palatal expander treatment, especially when it's deemed necessary for proper jaw development. At Islander Orthodontics, we accept all orthodontic insurance and will help you understand your coverage before treatment begins. Learn about our payment options.
How do I know if my child needs a palatal expander?
The best way to find out is with an orthodontic evaluation. The AAO recommends every child be seen by age 7. During a free exam at Islander Orthodontics, Dr. Borda will assess your child's upper jaw development, bite, and incoming permanent teeth to determine if an expander or any other early treatment would be beneficial.
Schedule Your Free Exam
Whether you're exploring palatal expansion, curious about airway orthodontics, or just want to make sure your child's jaw is developing the way it should — we'd love to meet your family.
Or call us at (206) 707-7650
Islander Orthodontics
Mercerdale Professional Center
3236 78th Ave SE #102, Mercer Island, WA 98040
Phone: (206) 707-7650
Hours: Monday 8:00 AM – 3:30 PM | Tuesday–Friday 7:00 AM – 4:30 PM
Mercer Island sits right at the center of the I-90 corridor. Serving families from Bellevue, Renton, Newcastle, Seattle, and the greater Eastside.
Islander Orthodontics
Mercerdale Professional Center (lower level)
3236 78th Ave SE #102, Mercer Island, WA 98040