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Palatal expansion and dental extractions are two options for reducing crowding and creating adequate space for all teeth to fit and align in the maxillary arch.

Palatal expansion is typically done using a bonded appliance. The appliance has a component that is turned using a key, and with regular turns, the archform is broadened over time. Palatal expansion is most effective in young patients who have not passed their pubertal growth spurt. Palatal expansion is only an option for the maxilla, as its mechanics rely on opening the mid-palatal suture. It will have no effect on the arch length in the lower jaw.

Dental extractions are another option for reducing crowding. Typically, the first or second premolars are extracted to create additional space along the arch to align the teeth. Facial and profile esthetics and airway competency will also be taken into account when considering extractions.

Your orthodontist will offer you options based on your individual case. In some cases, such as those with severe crowding, the orthodontist may recommend both palatal expansion and extractions. In young patients, palatal expansion may be able to create enough archlength in the upper jaw to avoid the need for extractions. In older patients with severe crowding, extractions may be necessary. Your orthodontist will review the best options for your case during the consultation appointment.

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