hey it's dr amanda with straight smile solutions street smile solutions.com and today we're going
to talk about the side effects and a patient might see from paddle expansion either with an
rpe fixed or shorts and you tend to have more side effects if you do rapid versus slow expansion and
i do have some other videos on that and pretty much everything else you need to know about arch
expansion be it fixed or removable adults kids i don't do it in adults so but i have a video that
does explain why i don't do it in adults and why i don't think you should do it in adults
but i'd love for you to watch all those videos first before you watch this video and to access
those videos you can go to my youtube channel which you may or may not be on right now you might
just be in your channel and this kind of popped up so if you want to go to my channel which is called
straight smile solutions type those words into the search bar at the top of youtube it'll take you to
my channel which has over 7000 videos it has a green banner and if you scroll down on the home
page you're going to see a variety of different playlists towards the top you're going to see one
that says phase 1 interceptive airway omt habits or something like that a lot of stuff i kind of
lump all this growth tongue stuff airway stuff all into one because it's all really interrelated
you know little kids ortho um so watch those videos everything having to do with
expansions expanders expansion fix removable i probably have just 50 or 60 just on that alone
okay anyway so i'm assuming you've already watched those if you're listening to this now we're going
to talk about kind of random side effects what to expect like i said i'm more of a proponent of
slow expansion versus fix i'm not saying i don't do fix i did fixed all the time in my practice
but i also had the capacity the knowledge and the staff and the team and the emergency you know how
to to handle emergencies when they came up there's a lot more emergencies that come up and fix versus
removable you need to have the right kind of practice the right kind of people answering
the phone and i really don't think it's a great idea to do it in a gp or pedo practice unless
everyone's trained up on how to handle it because emergencies that can happen with expansion when
you do frap it are actually like real emergencies like can die emergencies like hemorrhage in the
brain emergencies okay so if you do slow and you check in on them you know gradually um
you're still going to get some skeletal expansion you know you're still going to get great outcomes
but just less side effects less discomfort less likely to have nose bleeding and big ugly gaps and
things like that yes it takes a little bit longer but it's a lot less dramatic and it's going to
stress you and the patient and the parent out less it's going to be an overall better experience you
still get fabulous outcomes so yes the scariest one would be when you get the nosebleeds and
usually it's a one or two time thing um if it keeps happening every time you do a turn i'd want
the patient to stop if it's just a one-time it's probably because the suture just popped you know
sutures are interlocking at one point when you put the pressure on it it's going to eventually pop
and then you'll get a gap sometimes they'll feel like they can breathe better it's usually
a positive thing um not all if you're doing slow you may not get a gap but the nose bleeding might
be as long as it's really limited and it's a one or two time thing only i'm not that worried if it
keeps happening or if i was doing rapid and it was happening i'd be much more worried and have
them pause and come in all right thanks so much remember the maxilla is in two different pieces
so all we're doing is popping those pieces okay it's no different than what we do in jaw surgery
in an adult when we have a constricted maxilla they take a saw and they cut it down the middle
and then they split those two pieces until they fill in um and kids we're just stretching it and
popping it because we can okay it's basically distraction osteogenesis so um billions of cases
i mean at least millions and millions have been done over the last century i mean it's so common
i'd say the very lot of kids have it done i mean i don't know the actual frequency
but there's a lot of kids who have expanders just because our mouths and our jaws are underdeveloped
from soft diets improper breastfeeding things like that and habits all right thanks so much