A palatal expaner, also known as a rapid palatal expander, rapid maxillary expansion appliance, palate expander or orthodontic expander, is used to widen the upper jaw so that the bottom and upper teeth will fit together better. It is thought this can only be done when the patient is still growing, unless surgery is used to separate the two halves of the palate, however there is evidence to the contrary. It is most often followed by braces to straighten out all the teeth now that room has been created. Patients who have just gotten expanders may experience extra saliva and talking lisps. Additionally, patients may also feel a sore on their tongue from contact with the expander's metal bars. The expansion process usually results in a large gap between the patient's front teeth although this does not always happen. This gap is closed naturally and the teeth may overlap so then subsequent orthodontics (braces)are needed. With expanders, the patient has to remember to turn the expansion screw themselves. For expansion that is not managed by the patient on the and lower jaw, a bionator may be a more suitable alternative.