PALATE EXPANDERS

Expanding the upper jaw (palate)

At Godley Family Orthodontics, our board-certified orthodontists provide personalized palate expansion treatment for children, teens and adults in Zionsville and nearby communities. A palate expander may be recommended to widen a narrow upper jaw, correct a crossbite, create space for crowded or impacted teeth, and improve how the upper and lower jaws fit together. Dr. Godley and Dr. Bradley carefully evaluate each patient’s age, growth, anatomy and treatment goals before recommending an expander. They are experienced with traditional expanders for children as well as advanced adult options, including MSE, MARPE and MASPE. Because expanders come in several designs and can produce different effects, our goal is to help each patient understand their options and choose the treatment best suited to their smile and bite.

How do expanders work?

Expanders are most predictable in kids when they are growing.  This is because the upper jaw starts with a split (suture) down the middle.  This split is OPEN during childhood, and becomes FUSED during puberty.  Fusion of this suture makes widening the upper jawbone difficult (often impossible) to achieve after puberty, without additional procedures or surgery.

Expanders are most predictable in kids when they are growing.  This is because the upper jaw starts with a split (suture) down the middle.  This split is open during childhood, and becomes fused during puberty.  Therefore, the midpalatal suture is generally more responsive to traditional expansion while a child is growing. As patients mature, the suture becomes more interlocked, so older teens and adults may require a different expansion approach.

Child holding a maxillary palatal expanders retainer in focus, smiling and standing indoors from Godley Family Orthodontics in Zionsville, Indiana.

Who can benefit from an expander?

Palatal expanders are particularly effective in children, especially between the ages of 6 and 12, when the jaw is still growing and developing.  Common dental conditions that may indicate a need for palatal expansion include:

  • Severe crowding
  • Crossbite
  • Narrow upper jaw
  • Impacted teeth (teeth are unable to erupt properly)
  • Certain sleep-disordered breathing conditions
  • Malocclusion (underbite, overbite, crossbite, open bite)
Early diagnosis and intervention are key benefits of using palatal expanders as they can address orthodontic issues before they become more severe.  By expanding the palate during childhood or adolescence, it can create additional space in the mouth, allowing permanent teeth to erupt properly, as well as correct breathing issues.  It also reduces the need for more invasive treatments in adulthood.

COMMON TYPES OF PALATE EXPANDERS

 Rapid Palatal Expander

The RPE (rapid palatal expander) or RME (rapid maxillary expander) is a common type of expander. It is bonded to the teeth and remains in place for at least six months.  The RPE is activated according to your orthodontist‘s prescription with an expansion key to gradually expand the jaw.

Hyrax Expander

The Hyrax is a common type of expander that can be used for rapid or slow palatal expansion. It is bonded to the teeth and remains in place for at least six months. The Hyrax is activated according to your orthodontist’s prescription using an expansion key to gently expand the jaw.

Bonded Expander

The bonded expander is similar in mechanism to the  RPE (rapid palatal expander) and Hyrax, however it is designed to have acrylic that covers the teeth.  This expander is typically used for severe open bites.

Haas Expander

The Haas expander works similarly to the RPE, though this type has large pads of acrylic.  The acrylic plate rests against areas of the palate.

Bone Anchored Expander

A bone anchored expander, sometimes called MSE (maxillary skeletal expander) or MARPE (maxillary anchored rapid palatal expander), is supported by small temporary anchorage devices (miniature implants) and is most often used for adults whose jaw growth is substantially complete. 

Invisalign® Expander

The Invisalign® Palatal Expander (IPE) is a removable plate that does not require turns.  This type of expander achieves a mix of dental (tooth) expansion/protrusion rather than jaw expansion.

Quad Helix Expander

The quad helix expander is bonded to the back molars, but does not require turns.  This type of expander achieves mostly dental (tooth) expansion/protrusion rather than jaw expansion.

MSE

The MSE appliance refers to a maxillary skeletal expander that is secured to the upper jawbone using TADS, which are small devices that act like miniature implants. This type of expander achieves upper jaw expansion in patients who are done growing, and is typically used for teens and younger adults.

MARPE

The MARPE appliance refers to a maxillary anchored palatal expander that is secured to the upper jawbone using TADs, which are small devices that act like miniature implants. This type of expander achieves upper jaw expansion in patients who are done growing, and is typically used in adults.

MASPE

The MASPE appliance refers to a maxillary anchored palatal expander that is secured to the upper jawbone using TADS, which are small devices that act like miniature implants. This type of expander achieves upper jaw expansion in patients who are done growing, and is typically used in adults.
A Godley Family Orthodontic palatal expander is displayed on a white plaster model of upper teeth from Godley Family Orthodontics in Zionsville, Indiana. Perfect for kids needing gentle orthodontic adjustments.

Do expanders work on the lower jaw?

Conventional lower expansion appliances can move and upright the lower teeth, but they do not widen the underlying lower jawbone in the same way that a palatal expander can widen the upper jaw. Without surgery, lower jaw expansion is anatomically impossible.  This is because the mandible (lower jaw) is not split down the middle.  The reason an expander is effective on the upper jaw is that the bones of the palate are separated by a split or suture that runs down the center.  If the suture is still open, these bones can be separated.​  The lower jaw, however, cannot be expanded.  The lower jaw is one solid bone and does not have a suture running through the center of it.  
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However, expanders might still be used to move and upright the lower TEETH.  This might be necessary to fix a misaligned bite and create space for crowding.​  There are some expansion appliances that can be placed on the lower arch, but these appliances are NOT meant to expand the bones of the lower jaw. They simply help to move and upright the lower teeth.

EXPANSION FOR ADULTS

Maxillary Skeletal Expanders (MSE, MARPE, MASPE)

In adult cases where the permanent teeth have erupted and the upper jaw is skeletally mature, a traditional palate expander may cause the teeth to tip or flare outward rather than producing true jaw expansion. In order to prevent this, adults typically require additional accessories to be used for expansion.​  MARPE / MASPE (maxillary anchored palatal expanders) and MSE (maxillary skeletal expanders) provide non-surgical palatal expansion for adults.  With custom MARPE, MASPE, and MSE treatment, we can help prevent the unwanted flaring of teeth and avoid invasive surgery (surgically-assisted rapid palatal expansion) that may otherwise be required to widen the jaws.

Who needs maxillary skeletal expansion?

MARPE, MASPE, and MSE appliances are suited for skeletally mature patients.  This refers to older teens and adults whose teeth and jaws are done developing, yet they have a narrow maxilla (upper jaw). For older teens and adults, bone-anchored appliances such as MSE, MARPE, or MASPE may provide a nonsurgical expansion option. The most appropriate approach depends on skeletal maturity, anatomy, asymmetry and the amount of expansion needed.

How does MARPE treatment work?

If Dr. Godley or Dr. Bradley determines that maxillary skeletal expander treatment is best for your case, we will walk you through the process.  This expander requires four small temporary anchors to support the appliance.  These mini screws are typically placed by a different specialist and implanted into the roof of the mouth.   The expander can then be activated by inserting a special key into the center and turning it (once or twice a day, depending on your treatment protocol).
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Each time the device is activated, it will expand slightly, which also expands the jawbone.  Expansion is gradual.  The MSE, MARPE, or MASPE appliance will typically remain in place for at least six months in order to solidify and retain your results. 
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During activation of the MARPE, MASPE, or MSE, it’s normal for the teeth to spread out a little and create spaces as the jaw is wider and now able to accommodate all teeth when straightened out.  A full treatment of braces or Invisalign typically follows this type of expander treatment to align the teeth and perfect the smile.

FREQUENTLY ASKED QUESTIONS

What age is best for a palate expander?

Palate expansion is often most effective while a child is still growing, commonly during childhood. The American Association of Orthodontists recommends an initial orthodontic evaluation by age 7 so jaw growth, tooth development and bite concerns can be evaluated and monitored, and treatment can begin at the most beneficial time.

How do I know if my child needs an expander?

A palate expander may be recommended if your child has a narrow upper jaw, crossbite, significant crowding, impacted teeth, airway concerns, or an upper jaw that does not fit properly with the lower jaw. Some signs are easy to notice, while others require an orthodontic examination and imaging. Our orthodontists carefully evaluate the teeth, bite, jaws, and facial development before recommending treatment.

Does a palate expander hurt?

At Godley Family Orthodontics, our expanders are custom-made, so they adhere well and fit comfortably. During expansion, palate expanders should not cause significant pain, although temporary pressure, tightness or mild tenderness is common after placement or activation. Some patients feel pressure near the upper teeth, palate, nose or cheeks, as the upper jaw is tall and extends to the upper nose area. These sensations usually improve quickly as the mouth adjusts, and our team is always available if your child experiences unexpected discomfort.

Why is a gap forming between the front teeth?

A temporary gap between the upper front teeth is a very common and encouraging sign that the palate expander is working. As the upper jaw widens, space may develop between the front teeth, as it gently widens the midpalatal suture that runs in between these teeth. The teeth often begin drifting back toward one another naturally, and any remaining spacing can be addressed with orthodontic braces or clear aligners when appropriate.

How long does a palate expander stay in?

The amount of time varies depending on the appliance and the patient’s treatment needs. Active expansion may take several weeks, but the expander usually remains in place for several additional months, acting similar to a cast or retainer while new bone forms and the upper jaw stabilizes. In general, expanders remain in place between 6 to 12 months. Your orthodontist will monitor progress and explain when the appliance is ready to be removed.

Will an expander affect speech or eating?

Speech may sound slightly different at first while the tongue adjusts to the appliance, but most patients adapt within several days. Eating can also feel unfamiliar initially, so softer foods and smaller bites may be helpful. Patients should avoid hard, sticky or chewy foods that could loosen or damage the expander.

How do you clean a palate expander?

Brush carefully around all areas of the expander using a soft-bristled toothbrush to remove trapped food and plaque. A water flosser, interdental brush or orthodontic flossing aid can make cleaning beneath and around the appliance easier. Rinsing with water after meals is also helpful.

Does an expander replace braces?

An expander and braces have different purposes. An expander widens the upper jaw and upper arch, while braces or clear aligners move and align the teeth more precisely. Some patients only need expansion, while many later receive braces or aligners to complete bite correction and create the best final smile.

Can teenagers or adults get palate expanders?

Yes. Teenagers and adults are often still be candidates for expansion, but the appropriate type of expander depends on skeletal maturity, anatomy and treatment goals. Traditional childhood expanders are generally more predictable in growing kids, while older teens and adults may require advanced options such as MARPE, MSE, MASPE or surgically assisted expansion.

What is the difference between MARPE, MSE and a traditional expander?

A traditional palate expander is usually supported by the teeth and is most commonly used while a child is still growing. MARPE stands for miniscrew-assisted rapid palatal expansion and uses small temporary anchorage devices to provide greater support from the upper jaw rather than relying only on the teeth.

MSE stands for maxillary skeletal expander and is a specific type of bone-anchored expansion approach within the broader MARPE category. MARPE and MSE are often considered for skeletally mature teens or adults, although the best option depends on each patient’s anatomy, age and expansion needs.

Is a free consultation available?

Yes. Godley Family Orthodontics offers free orthodontic consultations for all patients. Dr. Godley or Dr. Bradley evaluate your teeth, bite, jaw development, and smile, discuss whether expansion may be beneficial, and explain the treatment options available to you.

Do I need a dentist’s referral?

No referral is required. Parents and adult patients are welcome to contact our office directly to schedule a free consultation. We are also happy to collaborate with your family dentist and other healthcare providers whenever coordinated care would be helpful.

Questions about expanders?

Our team is here to answer any questions you may have and we want you to know your options!  Please don’t hesitate to reach out to us at any time.  Our orthodontists, Dr. Godley and Dr. Bradley, and our entire orthodontic staff are here to guide you, so you can have a positive treatment experience.
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Ready to get started?  Call or book online to reserve a complimentary consultation with our orthodontists at our convenient Zionsville office located close to Carmel and Indianapolis, IN.