The palatal expander widens your upper jaw by putting gentle pressure on your molars each time a "turn" is made. It is recommended to make "turns" just before bedtime. The patient my feel pressure or a tingling sensation but should not feel pain. If experiencing pain, skip making a turn that night but never double up on a missed turn. Turns are typically made once an evening for 3-5 weeks. Avoid foods with small seeds (strawberries, poppy seeds, sesame seeds, etc.) while making the turns. At the beginning, sipping on water and reading aloud or talking will help you adjust. Food can get packed between the palate and your expander. Keep this flushed out by either sucking water through a straw or using a Waterpik. Don’t be surprised if a gap appears between your two front teeth. This is normal. When you achieve the desired expansion the turns will be stopped and the appliance "locked". You will continue wear of the appliance for about four months to solidify the expansion and to prevent regression. Typical length of wear is 5 months.
In a well-lit area tip the patient's head back.
Place the key in the hole until it is firmly in place.
Pushing the key towards the back of the mouth, you will notice the fender will rotate and the new hole will appear. The rotation stops when the key meets the back of the expander.
By pushing back and down towards the tongue, remove the key. The next hole for insertion of the key should now be visible.