What is a Facemask & Expander?
A facemask is used in growing children to modify the growth of the upper jaw by moving the upper jaw forwards. A facemask is attached to an expander fixed in the upper jaw.
Orthopaedic protraction and expansion of the upper jaw is best achieved between 7 and 10 years of age, where the bones that make up the upper jaw are not fused. Protraction and expansion of the upper jaw can be done after 10 years of age, up until about 15 years of age, however, with increasing age there is less predictability of outcome and long-term stability. This is because the sutures connecting the bones of the upper jaw begin to fuse in the teenage years and may not separate. Once the sutures are fused at around 15 years of age, orthopaedic protraction and expansion is not possible and a surgically-assisted procedure would have to be considered.
The expander is fixed to the upper permanent 6 year-old molars with dental cement for a period of 9 to 12 months. During this time your child will not be able to remove the expander.
The facemask is attached to the expander with elastic rubber bands and ideally should be worn 12 to 14 hours per day over the 9 to 12 month period. Accordingly we recommend wearing the headgear at night whilst sleeping and for a few hours in the evening after school.
A facemask & expander is recommended in growing children with developing underbite problems (upper front teeth bite behind the lower front teeth) that are caused by deficient growth of the upper jaw, seen clinically as a flattened midface region or relative protrusion of the lower jaw.
In most underbite problems the upper jaw is narrower than the lower jaw and expansion of the upper jaw is required in combination with forward movement of the upper jaw.