Palate expanders are completely wrong

You cannot use mechanical force like this without deflating the skull and having lots of negative repercussions over the longer term

The youtube version

Back in early 2018 I was living in Boston and we were visited by some friends that had recently moved from Kiev to the US.

We knew them years before when we lived in Kiev back in 2013. The girl was a beautiful girl as many young Ukrainian women are (note my wife is also Ukrainian).

But when they arrived I was a bit shocked. The girl (who i’ll keep anonymous) looked very different. I almost didn’t recognize her.

Her face had a lot more assymetry, her profile had worsened and her body seemed like it had twisted.

Me being me… it wasn’t long before I popped the question… “Did you do something dental?”

Her answer.. “Yes I was using a palatal expander and it has been a nightmare.”

And this is something i’ve seen and heard on various TMJ-related facebook groups many many times over the past decade. With lots of different variations as to the negative effects.

But it has been so consistently negative that it kind of shocks me that they’re still being used.

Anyway, today i’m going to cover this in more detail.

What is a palate expander?

When dentists see narrow dental arches, their go-to solution is often a palate expander. It's basically a device that mechanically forces your upper dental arch wider, usually through some kind of screw mechanism.

They'll tell you it's necessary to make room for crowded teeth or improve breathing.

And so theoretically it works like the diagram above. It attaches to a couple of teeth and the screw is in the middle.

You return to the dentist every couple of months and he turns the screw, which pushes the appliance wider. Often it’s painful at first but then the palate and teeth adjust.

Common types of palate expanders

You've got your rapid palatal expanders (RPEs) that use a screw mechanism, removable expanders that use springs or screws, and hybrid types that combine different approaches.

Some will just have only the metal apparatus like the one at the top of the article whereas others will have a plastic plate like the one above.

The Biobloc, used by the Mews, is another variation.

But they're all working on the same flawed principle - mechanical force to push teeth apart.

An example of Biobloc treatment

The Biobloc is an appliance that was developed by John Mew sometime in the 1970’s and has evolved a bit since.

I figured i’d use it to show you an example of what the treatment approach looks like. This is what ChatGPT gave me to the prompt “How long does Biobloc treatment last?”

Active Phase (Phase 1 - Development and Expansion):

• Duration: Typically 12-24 months.

• This phase focuses on expanding the upper arch and correcting jaw alignment. Younger patients often complete this phase faster due to their growth potential.

Stabilization Phase (Retention):

• Duration: 12-36 months or more.

• Patients wear the appliance during nighttime to maintain the results achieved in the active phase. Some orthodontists recommend extended retention, even into adulthood, for long-term stability.

So in total it can last 2-4 years depending on a variety of factors.

What is their history of use?

Palate expanders have been around since the late 1800s. They started as pretty crude devices and have evolved into the fancy appliances we see today, with different types for different age groups and "problems" they're trying to solve.

These days, they're very common. Thousands of kids get them every year, often as a first step before braces.

It's become so normalized that parents don't even question it.

And so it’s not surprising that it is expected to continue growing at a 7.8% per year clip in the coming decade.

Why I think they are wrong

Here's the fundamental problem - they completely ignore how soft tissue works.

When you expand properly through natural biomechanics, teeth move in three dimensions like an airplane.

Visualize a tooth instead of the airplane above. And imagine that as you expand your skull it is constantly moving in all three of these planes of motion.

This is because multiple things are changing simultaneously: teeth upright, arches widen naturally, jaw repositions, skull expands, spine improves.

But palate expanders just push in one direction like a bulldozer. They're trying to force change instead of working with the body's natural mechanics.

This typically results in flattening the curve of spee (that natural curve where back teeth are higher than front teeth). And when you flatten that curve, you're basically deflating your skull.

See this article if you want to know more about that:

The Curve of Spee

What will typically happen from using them?

First, you're damaging the teeth. Forcing them sideways isn't natural and creates stress patterns that can lead to root problems later.

Second, as the curve of spee flattens, your skull starts to deflate like a balloon losing air. This often leads to neurological issues down the line.

Third, your spine typically deteriorates much faster than it would have naturally because the whole system is now compromised.

I've seen this pattern play out countless times over the years. The "expansion" might look good for the first year or two… just in time for the dentist to take a photo like the one above to put on his website.

But then usually when you check on this kid 5 - 8 years later you put a hand to your forehead and think… “My God…. they should put that dentist in jail for this.”

So why aren’t the courts full of parents suing dentists that do this to their child? Part of it is because they don’t associate the change in their child’s appearance (and health) to the palate expansion.

They just think that that is how the kid ‘got older’. And don’t have a good model to compare against for what the child should have looked like.

I’m not fooled as easily however. I follow these patterns for years on kids. Especially if it is a kid of a parent I am friends with. The minute that parent does something artificial to their child’s teeth… my mental tracker goes on.

And with many of those kids… i’ve unfortunately already been proven correct.

Closing thoughts

In my decade in this game, I've seen many people damaged by palatal expanders. Some realize it, others don't make the connection because the damage happens gradually over years.

But I have yet to see a single case where I thought a palatal expander actually helped someone long-term. Not one. This includes the Biobloc, which the Mews championed for years.

Look at what happened to Mike Mew in 2023 - he lost his dental license after a patient developed neurological symptoms during treatment. I wrote an article about that here:

Mike Mew's court case: why did it happen?

This isn't surprising to me at all. When you force mechanical expansion without accounting for soft tissue, you're asking for trouble.

The solution isn't to force the palate wider - it's to work with the soft tissue and let it guide natural expansion. This happens automatically when you add proper vertical height between the teeth without locking the jaw position.

But that's too simple for the orthodontic industry. They'd rather sell expensive expanders and create problems they can "treat" for years to come.

Remember - your teeth aren't meant to be forced apart like you're renovating a house. They're part of a complex biological system that needs to be worked with, not against.