One of the most common concerns among patients seeking orthodontic treatment is a narrow upper arch, often presenting as a crossbite on one or both sides of the mouth. For children under the age of 14, the treatment is usually straightforward, typically involving the use of a maxillary expander (RPE). This device can sometimes be supported by mini-screws. However, as patients get older, this method alone may not be sufficient to achieve the desired skeletal expansion. In these cases, surgically assisted expansion becomes necessary.
There is a lot of information circulating online about the relationship between breathing and maxillary expansion. Unfortunately, many of these claims exaggerate the impact of maxillary expansion on breathing. While skeletal expansion can be beneficial in certain situations, it’s essential to thoroughly assess each case before recommending maxillary expansion as a solution for breathing issues. Breathing problems are often multifactorial, meaning several other potential causes need to be ruled out before considering maxillary expansion. These could include a deviated nasal septum, mechanical obstructions in the nose, large adenoids, or tonsils, to name a few.
The idea of surgery can be daunting for many adult patients who need to correct a narrow upper arch or crossbite. Each year, I encounter several patients who have been told that surgery is their only option for correcting their jaw width discrepancy. However, many of these cases could be candidates for non-surgical dentoalveolar expansion, which is best delivered using a customized appliance, such as the Lingual Win Appliance.
A new approach was introduced by Professor Dirk Wiechmann, the founder of Incognito and the Win Appliance. He demonstrated that many challenging crossbite situations can be successfully resolved in a stable manner using expansion archwires in the upper jaw and constriction wires in the lower jaw. The customization and unmatched precision of these wires fitting into the brackets make this non-surgical crossbite correction highly predictable.
Despite the effectiveness of this method, many clinicians are hesitant to recommend it. This is primarily because few orthodontists are trained in lingual orthodontics, and many are unaware of the published research supporting this technique. The key to successful treatment always lies in an accurate diagnosis. While surgery may be necessary in some cases, a non-surgical approach is often a viable option.
If you are dealing with a similar issue and would like to explore all possible treatment options, please don’t hesitate to contact me for a consultation. Together, we can determine the best course of action for your specific needs.
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I recommend and prescribe orthodontic treatments to my patients as if they were my own family and I value meaningful relationships based on communication, confidence and trust.
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