This could vary from once a day to two or three times per day, depending on the degree of expansion required as well as on other orthodontic procedures that need to occur during the process, such as adding braces.


Be as consistent as possible.
If you find that your schedule is likely to be interrupted, or if you foresee the need to delay turning, always check with your orthodontist first.
 This is a tool, usually a small metal rod, that is inserted into the screw at the center of the gear and provides lateral torque to force the hard palate to expand.If the key doesn't have a safety string, secure the end with a long string or length of dental floss, which will allow for easy retrieval if you drop the key in your or your child's mouth.
 In most cases you will be inserting the key into a small angled hole facing the back of your upper teeth (i.e. the key will be pointing out of your mouth).


If you are performing this on yourself, do this in front of a mirror in a well lit room.
If you are performing this on a child or young person, have them lay down and open their mouth as wide as possible to prevent gagging in case you accidentally touch their uvula. Make sure you have enough light to see clearly - use a flashlight if needed.
 After inserting the key, and making sure not to hit the skin at the roof of the mouth, slowly and with consistent pressure turn the screw as far as it can go, towards the back of the throat.
 Clean it and put it in a safe place.
 Most orthodontists will have you come in one a week to gauge progress and address any concerns.


Keep a list of concerns as they occur for convenience.
Follow your orthodontist's instructions about how often to turn the expander.
Locate the "key" provided by your orthodontist.
Insert the key into the hole in the screw of the central gear.
Turn the key as far as it will go.
Remove the key carefully from your or your child's mouth.
Follow up with your orthodontic appointments as scheduled.
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