Fixed Maxillary Expander Information and Instruction


Upper Superscrew Expander Instructions

Congratulations for being fitted with the superscrew Hyrax. Please read the instructions carefully for the best outcome.

What is a Maxillary Expander?

Our top jaw (Maxilla) is made of two separate bones joined together by a line (mid-palatal suture). When we are young the bones have not fused together, and therefore we are able to stretch the two bones apart. This forms a gap between the bones which with time fills up with bone.

When your top jaw is narrow, or if there is insufficient room for all your permanent teeth to fit into your top jaw, your dentist may prescribe a fixed or removable maxillary expander.

The expander sits around your six-year-old molars and can extend to some of your teeth further forward. The expander may or may not have a layer of plastic covering your upper back teeth.

1. It is normal to feel excess salivation during the initial few weeks.
2. Difficulty with speech that will improve with practice. Helpful exercises include tongue twisters such as repeating the words “Mississippi” or “sixty-six”.
3. A pressure sensation against the teeth and sometimes extending under the eyes following each turn. However if you are turning 1 turn per day as instructed the pressure should be very subtle or unnoticeable.
4. Toothbrushing needs to be done a minimum of three times per day with extra attention to the molar are as they will collect most food and plaque.

Foods to avoid include hard or sticky lollies such as minties, mars bars, fantales or gummy bears.

Expansion Instructions

Keep tongue and hands away from the screw at all times, as the tongue being a strong muscle there is a high chance for the screw to reverse if you push against it.

1. Lay your child on a flat sofa/ bed in a well lit room.
2. Insert the spanner onto the screw nut trying to fully engage the nut as the spanner must be stable if you let go as in Fig 2. Try both sides of the spanner first and choose the side that sits higher and almost touches the top front teeth.
3. Once engage and high, ask your child to open really wide and swing the spanner one full swing from top to bottom.
4. If the higher side of the spanner only sits in the middle of the mouth, that will be considered half position and you need to swing two half swings to equal one full swing.
5. After turning the screw, take a photo clearly depicting the number and position of the dots on the appliance. The expander needs to stay at that position for the following 24hrs. During the day, check the expander several times especially after brushing, after meals, after coming home from school to make sure it is in the same position as the last photo or note. The dots are there to help you reference the position. If the dots don’t match, use the spanner to bring it back to that position again only no extra turns.
6. When it is time to turn the expander again, cross reference the current dots position with last night’s photo or note. If they are the exact same, then you may turn one turn as instructed in steps 1-5. If the picture and current position don’t match, use the spanner to bring it back to last night’s dot position and THEN one turn as in steps 1-5 to make sure you progress forward one turn each day
7. If you do not follow the photo cross reference technique there is a high chance your child may turn back the expander without you noticing and all your forward effort may be in vain with your child reversing it
8. In order to ensure that your treatment progress on track, we expect to see you in 4 weeks time with 28 photos for the 28 days of turning.
9. If done properly, you will start seeing indicator lines resembling the model.

Fig 1. palatal Superscrew expander

Fig 2. spanner properly engaging the hyrax nut and touching the upper front teeth

Fig 3. Appearance of an expanded expander

How long do I have to wear the Maxillary Expander?

The RME will be worn at all times for a period of approximately 3 – 9 months. This period may vary depending on your tailored treatment plan, and progression of treatment once the expander has been fitted.

Will I need any further treatment?

After treatment with a Maxillary Expander, it is very likely that you will need to have further treatment such as braces to straighten your teeth. Treatment such as braces may also commence whilst you are still wearing your Maxillary Expander. Each case is different, and your dentist will inform you of your tailored treatment plan.