Adult Nasomaxillary Expansion”
A non-surgical palatal expander for healthier jaws, better breathing, better sleep, and a stronger smile.
or call for a free consultation 905.829.1666
A Non-Surgical Approach to Correct Bites and Enhance Sleep Quality
At Olde Oakville Dental, we offer Adult Nasomaxillary Expansion, a gentle and innovative non-surgical treatment that helps widen the upper jaw (also called the maxilla). This treatment corrects crossbites and underbites, increases space in the mouth to address crowded teeth, and creates more space for the tongue to fit in the mouth.
Alongside these dental benefits, nasomaxillary expansion also expands the nasal cavity, which can help improve sleep-breathing difficulties, reduce snoring, and help you get higher-quality sleep.
The Problem: A Narrow Upper Jaw
Some adults have a narrow upper jaw, which dental professionals call Maxillary Transverse Skeletal Deficiency (MTSD). This means the upper jaw is too small compared to the lower jaw.
If you have MTSD, you might notice aesthetic and functional issues with your smile, such as:
- Crowded teeth, especially the bottom teeth
- A crossbite, which is where your upper teeth bite inside your lower teeth (also known as an underbite)
- Malocclusion, where your upper and lower teeth don’t fit together properly
- A narrow smile where your back teeth aren’t visible, leaving dark gaps on the sides
You might also notice that:
- You grind or clench your teeth
- You have difficulty breathing through your nose
- You often wake up feeling tired, even after a full night’s sleep
Remember, the roof of your mouth is also the floor of your nose. If your jaw is too narrow, your nasal airway may be too small as well, making it harder to breathe comfortably through your nose, especially during sleep.
Jaw alignment affects the whole skeleton
A narrow upper jaw
Crowded teeth
You can call our front desk at 905.829.1666
email us at info@oldeoakvilledental.com or fill the Contact Form
The Hidden Risks of a Narrow Upper Jaw
Without treatment, MTSD can lead to:
- Nasal congestion or mouth breathing
- Limited tongue movement
- Restricted airway
- Snoring or poor-quality sleep
- Damage to your teeth, like wearing down or cracking
In the long term, MTSD can contribute to more serious conditions such as obstructive sleep apnea and upper airway resistance symptoms. These conditions create chronic inflammation throughout your body, affecting your quality of life and longevity.
A diagnosis of sleep apnea can only be given by a sleep physician after an overnight sleep study (PolySomnoGram). Dentistry has a significant effect on airway health, tongue posture and the development of proper breathing and swallowing habits. We form part of a team including sleep physicians, family physicians, ENTs, OMTs, SLTs and oral surgeons.
The Solution: Nasomaxillary Expansion
Nasomaxillary Expansion does more than just create space—it sets the foundation for a healthier, functional, and more beautiful smile.
By gently widening the upper jaw, this innovative treatment helps properly position your teeth, correcting bite problems and setting you up for good long-term oral health.
Expanding your upper jaw will solve problems such as:
- Crowded teeth – Creates space so teeth can align naturally without extractions
- Crossbites – Corrects mismatched bites where upper teeth sit inside lower teeth
- Tooth alignment – Helps fix teeth that tip in or flare out due to lack of space
But the benefits don’t stop at your teeth. Expanding the upper jaw also improves how your whole face functions—especially when it comes to breathing and sleep.
Other life-changing benefits of nasomaxillary expansion include:
- Better jaw balance and facial symmetry
- More space for your tongue to rest comfortably
- A wider nasal airway, so you can breathe through your nose with ease
- Reduced snoring and deeper, more restful sleep
If any of these symptoms resonate with you, contact us today to find out if Adult Nasomaxillary Expansion is right for you.
Read on to learn more about the treatment!
The Treatment
How does Adult Nasomaxillary Expansion work?
For many years, dental and medical professionals believed that our bones stopped moving after puberty.
But newer research has shown that the cranial sutures—the joints where the bones in your skull meet—can
still respond to gentle pressure, even in adulthood. This discovery has made nasomaxillary expansion a
safe and effective option for adults.
Using a device called a Micro-Implant Expander, we apply gentle, controlled pressure
to the roof of your mouth. This encourages the bones of the upper jaw to gradually move apart,
creating new space as new bone grows in the expanded area.
Micro-Implant Expanders: A Key to Success in Adults
For teens and adults, we use micro-implant expanders to guide the expansion process. These devices use small pins
(micro-implants) that we place gently into the hard palate—the bony part of the roof of your mouth.
These pins are connected to a screw mechanism that is turned slowly over time.
Each small turn of the screw applies light, even pressure to your upper jaw, gradually encouraging the bones to move
outward. Because the device is anchored to the bone (not the teeth), it minimizes unwanted tooth movement and focuses
the expansion where it’s needed most.
This approach allows for predictable, stable results—even in fully grown adults.
Custom Expansion Appliances
At Olde Oakville Dental, your treatment is completely personalized—from start to finish.
We use custom-made expanders that are designed specifically for your unique anatomy.
Dr. De Souza personally designs each expander to control exactly where gentle pressure is applied,
accounting for factors like your age, gender, bone density, and the shape and size of your palate. Using advanced
3D scanning and printing technology, we create your expander from medical-grade metal to match your mouth exactly.
Compared to the premade micro-implant expanders used in other clinics, our custom expanders have been shown to:
- Deliver more accurate and consistent results
- Shorten treatment time
- Improve airway health and nasal breathing
- Create a more functional bite
- Enhance facial balance and symmetry
We are committed to using the latest technology and techniques to improve not only your smile, but also your overall well-being.
With over five years of hands-on experience in custom expansion therapy and a commitment to continuing education,
Dr. De Souza continues to refine this approach—bringing precision, care, and expertise to every case.
What Happens During the Expansion Treatment?
The information and graphic below explain how nasomaxillary expansion treatment works and how much time the process takes.
1. Initial Consultation and Imaging
We start by carefully examining your bite and facial structure using 3D imaging and digital scans.
This helps us design your custom appliance and treatment plan.
2. Placement of the Micro-Implant Expander
Your custom-designed expander is gently placed on the roof of your mouth and anchored with tiny micro-implants.
This procedure is done in our office using local anesthesia to ensure your comfort. Placement takes between 30-40 minutes.
3. Activation
Over the next 2-6 months, you will gently turn a small screw on the expander according to your treatment plan.
Once the suture has split, you will only turn the screw once a week. These slow, controlled turns guide your upper jaw
to expand gradually and safely.
4. Expansion
We will monitor your progress, make adjustments as needed, and ensure everything is moving as expected —
with weekly virtual check-ins and in-person visits every 2-3 months. Your expander will remain in place
for three months after the last turn to ensure the new bone is fully formed.
5. Forward Pull (if prescribed)
When we expand the upper jaw, we also assess whether it should be protracted, or repositioned forward.
If your upper jaw needs to be moved forward, we can do so with a metal protraction facemask.
This mask is connected to the expander with elastics and applies force to slowly move the upper jaw forward.
Protraction is generally effective in adults, but some male patients may require surgical options for optimal results.
Before and after protraction
6. Alignment
Once your cranial suture has split, we will start using clear aligners (Invisalign)
to straighten your teeth and move them into the optimal position for both aesthetics and function.
Overall, the active treatment time can be anywhere from 12-18 months.
This slow treatment protocol achieves more consistent and longer-lasting results than rapid treatments, and is something that Dr. De Souza has been continuously improving for over 5 years.
Continuous Improvement & Advancement
Working with you for a customized treatment, every step of the way.
We are committed to using the most cutting-edge technology and techniques to optimize your nasomaxillary expansion treatment.
Our slow turning protocols have reduced or eliminated many of the complications seen with non-custom designs and rapid turn protocols.
Our custom 3D-Printed expansion appliances are more precise and more comfortable for you.
Our advancements have allowed us to significantly reduce the need for Piezocision — a minor surgical procedure sometimes needed to split the cranial suture in male patients.
In cases where bone support over the lower teeth is inadequate, we identify and address these issues, often collaborating with periodontists for comprehensive care to assist with specific tooth movements. This may include SFOT, or Surgically Facilitated Orthodontic Therapy.
2025 Update: No Diastema Protocol!
A Seamless Transition to a Beautiful Smile
We are thrilled to introduce the No Diastema Protocol, a revolutionary approach that allows us to begin Invisalign aligners as soon as expansion is detected. This ensures that you never have to experience the discomfort or aesthetic concern of a visible gap (diastema) between your front teeth. The Invisalign appliance itself effectively conceals even the smallest 1mm gap while delivering simultaneous treatment to optimize upper and lower arch balance, functional bite improvement, and aesthetic alignment.
By integrating lower Invisalign treatment at the same time, this approach provides a smoother, more comfortable experience while promoting airway health and bite functionality. Tested at multiple centers worldwide, this protocol has shown exceptional success, and we’re excited to offer it to our patients immediately.
Summary
Nasomaxillary expansion is a revolutionary and life-changing procedure for adults with underdeveloped jaws.
It is a preventive treatment that can improve your quality of life and prevent future issues with sleep,
breathing, and overall health.
Contact us to learn more and find out if Adult Nasomaxillary Expansion is right for you!
Nasomaxillary expansion can help a wide range of patients — especially adults who were never treated
for a narrow upper jaw in childhood. You may benefit from this treatment if you:
- Have crowded teeth or a crossbite
- Experience difficulty breathing through your nose
- Snore or have trouble sleeping
- Have been diagnosed with or are showing signs of Upper Airway Resistance Syndrome or Obstructive Sleep Apnea
- Feel like your tongue doesn’t have enough room in your mouth
- Have had orthodontic treatment (e.g., premolar extractions) in the past but still experience bite or breathing issues
If you’re unsure whether this treatment is right for you, schedule a consultation with us and we can
evaluate your bite, breathing, and jaw structure.
Palatal expansion is much faster and easier in young children, whose facial bones are still developing and more flexible. For these patients, we use a technique called Rapid Palatal Expansion (RPE). Unlike the adult version, RPE uses the teeth as anchors instead of micro-implants.
Since a child’s jaw is still growing, RPE can widen the upper jaw more quickly and effectively. Fast expansion is important in children, because if it happens too slowly, it might only move the teeth without properly widening the jawbone.
As children get closer to puberty, their bones begin to harden and become less responsive to tooth-anchored expansion. That’s why, for pre-teens and teenagers, we evaluate each case individually to determine the best approach — whether that’s RPE or a micro-implant expander, depending on how far along their facial development is.
Visit our MSE Maxillary Expansion page to learn more about expansion options for children and teens.
While both treatments aim to create more space in the upper jaw, they work in different ways.
Dental expansion uses braces or aligners to move the teeth outward — but it does not change the shape or size of the jaw itself. Because of this, results may be less stable over time, especially in adults.
Nasomaxillary expansion, in contrast, gently widens the bones of the upper jaw. This creates lasting space for the teeth, improves bite and facial balance, and can also support better breathing. It is a more comprehensive and long-term solution for adults with a narrow upper jaw.
65-80%
OF STROKE PATIENTS HAVE OSA
17%
OF THE US POPULATION SUFFERS FROM OSA
95%
OF THE OSA PATIENTS ARE UNDIAGNOSED
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Appointment Online
Our dental office in Oakville uses the latest dental technology and provides personal patient care to solve dental problems that affect your overall lifestyle.
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Book Your Appointment Online
Our dental office in Oakville uses the latest dental technology and provides personal patient care to solve dental problems that affect your overall lifestyle.