Will palatal expansion help to achieve proper occlusion?

Patient's Query

Hello doctor,

I have a TMJ problem. My jaw cramps and can be painful while opening. I have had braces for two years to fix my crossbite. My lower right canine was over my upper right canine. That was fixed, but my bite is still uneven. When I bite down, my upper right canine makes contact with my lower premolar. My canine makes no contact on the left side, and only the molars and premolars bite together. I think this imbalance is causing me problems.

I have had two different opinions. My current orthodontist says I should wear an elastic from the upper left canine to my lower canine, so they get contact. Another orthodontist disagrees and believes my upper jaw is larger than my lower jaw, so I need to shave in between my lower teeth and fit inside the upper teeth.

I did my research online and thought maybe palatal expansion would be a good idea for me. I wanted to know if any orthodontist would agree with this. My upper molars seem to be uneven, and I thought palatal expansion would help my bite. I thought it made more sense than shaving in between my lower teeth. Would a device for the palate be an appropriate treatment? Do most orthodontists offer this treatment?

Answered by Dr. Disha Kandi Jain

Hello,

Welcome to icliniq.com.

I have gone through your query and images (attachment removed to protect patient identity).

I can see braces on the upper anterior teeth only. There are no braces on the posterior teeth in the upper arch. I want to know about the reason why braces are not there on the posterior teeth.

In my opinion, there is no major bone discrepancy when thinking about palatal expansion. Moreover, age also matters when thinking of palatal expansion.

In your case, a clinical checkup is necessary to know the exact cause of the TMJ problem, but when taking occlusal discrepancy as a cause, then in your case, if proper repositioning of bracket and bonding of all teeth, including molars, will help to obtain an appropriate occlusion. The remaining occlusal balance or plane can be obtained by using elastic bands.

It will be helpful if you upload the image of your teeth from the right and left side after occluding teeth tightly. I want to know do you have a habit of bruxism? Because jaw cramping maybe because of occlusal imbalance or bruxism.

Get back with the above details for further discussion.

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