by Macy in
and Stacy in Ohio
TPA (Trans-Palatal Arch) is a thin wire that goes across the
roof of the mouth from first molar to first molar. Most people
get a TPA to maintain arch width and aid in molar movement
that wires alone can't achieve. In my case, the orthodontist
was using the TPA to maintain the width between my first
molars and use the immobilized first molars to pull my
displaced bicuspid back into line (think of a lever).
The day I got my braces on,
the assistant took an impression of my upper arch before the
wires were put on. I noticed I had lingual tubes on my first
molar bands that would eventually be used to seat the TPA.
There are some who have the arch bonded directly to the bands.
my first adjustment, the TPA was sitting in a ceramic mold of
my teeth. It looked like someone got bored and started bending
one of those heavy gauge paper clips. The orthodontist came
over and snapped the ends of the device through the lingual
tubes and the assistant used metal ties to secure the arch
into place. I was given a slip of paper that instructed me to
rinse with salt water if I was in pain and warned me not to
play with it because it would only make the soreness wore. I
was also told to make sure I chopped long stringy foods (even
pasta) into bite sized pieces because trying to unwind
something that is wrapped in the roof of your mouth is not
attractive or easy. The orthodontist also told me to make sure
I brushed my tongue regularly as that is what would help keep
my arch clean and odor free.
At first, trying to talk was
difficult because this thing was stopping my tongue from
hitting the roof of my mouth. The worst for me was probably
the "K" sound. However, talking was the least of my
problems because the wire presses on your tongue and
eventually makes a running U impression (always a hit to show
off at family gatherings). The constant pressure caused my
tongue to be very sore and swollen. The feeling is like a bad
burn. Too bad most numbing gels aren't very tasty because that
seemed to be the only thing that gave me some relief while my
tongue adjusted to this torture the orthodontist's office put
After a couple weeks the pain
went away and I found that no one but me noticed the slight
slur of certain sounds. Then, two weeks before my next
adjustment, the soreness came back again and I noticed the
arch had changed positions just enough to make an impression
in a slightly different spot. After that bout of pain went
away, it was smooth sailing from there.
Eventually, I did play with
it a little just because it was there. I would push on the U
portion of the arch with my tongue just to feel the slight
pressure on my molars. When I was in the musical mood, I would
run my tongue across it just to hear the dull twang.
Sometimes food would get
stuck between the arch and the roof of my mouth, especially
the sides (thank heaven for proxy brushes). If I wasn't
careful, food would also get caught up under the arch and just
hang down the back of my throat that lead me to feel like I
could choke at any minute.
After four months, the
orthodontist hinted that my arch might come out at the next
visit if everything looked good. At my next visit, she changed
her mind and nothing was mentioned about removing it until I
had been wearing the TPA for eight months. I went in for an
adjustment the Tuesday before Thanksgiving and the
orthodontist looked at my bite up, down, and all around and
asked if I would like an early Christmas present. She clipped
the wire ties and with a yank on both sides, removed the arch
and put it in an envelope for me to keep as a memento of my
This is probably one of the
few cases where the orthodontist did understand about what I
was going through because she had a TPA as an adult as well.
Macy, for this excellent essay!
I am 33 yrs old, married 13
years. My son, Matthew,12 years old, encouraged me to get
braces with him. My other son will also be getting them soon.
I work at a bank, so I deal with public with this
expander. I am coping well. Nobody can see the expander
in my mouth, but they can see the bands around two of my
Getting the TPA in does not
hurt. I expanded for 2 weeks everyday. The first few times (3)
it was very tight and a bit uncomfortable after about an hour.
After taking Tylenol I was fine.
My tongue was very sore for a
few weeks. Food gets caught between the expander and the roof
of my mouth. So I would take my tongue to try and get it out.
Just having the expander in the roof of your mouth is not easy
because that is where your tongue belongs when you speak.
My speech -- well it's
been 10 weeks and it still sounds slurred and I can't get my
out very well. I can barely say my first name. I have to speak
slowly and softly.
And my mouth is very juicy.
Its hard to dry your mouth out. The expander keeps everything
all wet. I drool so bad at night I have to keep a towel on my
pillow. It's gross.
Eating is difficult because
of the food catching up inside the expander. I have to rinse a
lot while eating. I cover my mouth to chew because it's very
difficult and uncomfortable to chew and swallow. I eat very
small bites of anything.
The worst part of the
expander is my speech! I can handle not eating my favorite
foods. I just want my speech back although it is much better
than the beginning.
On a good note, I did not get
a huge gap between my two front teeth. It was a small slit and
I was very happy about that.
I hope this helps others who
have a TPA.
for sharing your experiences, Stacy!