A Patient-Friendly Guide to Your Palatal Expander & Activation

This guide will walk you through everything you need to know about your MARPE expander, including what it does, how to activate it at home, and what to expect throughout treatment.

Palatal expansion is often a common and important part of orthodontic treatment, and our orthodontic team is here to support you every step of the way. If you ever have questions or concerns, please reach out—we’ve got your back.

What Is MARPE?

MARPE stands for Mini-Implant Assisted Rapid Palatal Expansion. It is a specialized orthodontic appliance designed to widen a narrow upper jaw (maxilla).

Unlike traditional expanders that are used in growing patients and rely mostly on teeth for support, MARPE is anchored with small temporary screws (called mini-implants) placed in the palate. It can be used in patients who are done growing, such as odler teens and adults. MARPE can apply expansion force more directly to the bone, helping achieve true skeletal expansion rather than just tipping the teeth outward.

Why Might Someone Need MARPE?

A narrow upper jaw can contribute to several dental and functional concerns, including:

Crowded teeth (not enough space)
Crossbite (upper teeth biting inside the lower teeth)
A narrow or “V-shaped” upper arch
Dark spaces at the corners of the smile (buccal corridors)
Restricted nasal airflow or airway/breathing concerns

Your orthodontist determines whether MARPE is appropriate based on a full evaluation, including measurements of your smile and bite, photos, digital scans, and imaging.

Why We Use a MARPE Appliance

The MARPE expander is a powerful and precise tool for widening the upper jaw in teens and adults whose growth has slowed or completed.

Palatal expansion with MARPE can:

Improve how the upper and lower teeth fit together
Create space for crowded teeth
Broaden a narrow smile
Support airway health and breathing in certain cases
Improve long-term bite stability and facial balance

Understanding MARPE Activation

What Does “Activation” Mean?

Activation is the process of turning the expander screw using a small key (wrench). Each turn gently widens the appliance, which in turn slowly widens the upper jaw.

The goal of MARPE activation is to encourage opening of the midpalatal suture (a natural seam in the roof of the mouth), allowing the upper jaw to widen at the skeletal level—not just by tipping teeth outward. In other words, it “un-zips” and widens the suture in the middle of the upper jaw.

Your Personalized Activation Plan

Each MARPE plan is customized. At your appointment, you will be given specific instructions for:

How many turns to do per day
In which direction to perform the turns
Whether or not to use stretching turns
How long to continue activation

Always follow the instructions provided by your orthodontist exactly.

About the MARPE Tiger Screw

The MARPE appliance used at our office is designed with a Tiger Power Screw, which allows for precise, controlled expansion.

A full 360° turn of the screw equals ~1 mm of expansion
Each single turn of the screw equals approximately ~0.17 mm
You will be instructed how many turns to perform each day

This design allows gradual, predictable expansion while maintaining comfort and safety.

Step-by-Step MARPE Activation Instructions

Use the wrench provided at your appointment.
Insert the wrench fully onto the hex at the center of the screw.
Turn the wrench in the direction instructed.
Each face of the hex equals one turn, or one increment of activation.
Remove the wrench carefully by wiggling down to slide off the screw.

Important:

Only turn as instructed—more is not better.
Never force the screw.
If the wrench does not turn easily, stop and call our office.

Stretching Turns: Why We Use Them

For many adult patients, especially in the early phase of expansion, stretching turns are sometimes recommended.

What Are Stretching Turns?

Stretching turns involve an open/close technique, allowing your tissues to adapt more gradually. This protocol is sometimes done for up to three weeks prior to full activation turns. It is intended to disarticulate/mobilize sutures around the upper jaw, and to promote better response to expansion.

Why Stretching Turns Are Helpful

Improves comfort
Reduces pressure
Encourages controlled, consistent expansion

Example of Stretching Turns

A cyclic or stretching protocol intentionally alternates loading and unloading in opposite directions. This may look like:

Expand → reverse (constrict) → expand → reverse

This is often done over a period of one to three weeks.

Why Faster Isn’t Always Better

While MARPE is considered a “rapid” expansion technique, research and clinical experience show that activation speed should be personalized, and is often done at a slow, gentle pace.

In adults, slow and controlled protocols (often including stretching turns) may:

Improve comfort
Reduce stress on teeth and bone
Lower the risk of complications
Encourage more predictable skeletal response

This doesn’t mean faster activation is wrong—it means the best activation plan is the one designed specifically for you.

Managing Discomfort & Medications

Some pressure, tightness, or soreness is normal—especially shortly after activation.

You may feel pressure in the palate, nose, cheeks, or teeth
Mild headaches or facial tightness can occur
Your teeth and bite may become sore as they transition through new positions
Any prescribed medications should be taken exactly as directed to reduce inflammation and discomfort

If pain is severe or does not improve, please contact our office.

Oral Hygiene During MARPE Treatment

Keeping your MARPE appliance clean is essential for success, healing, and a healthy result.

Daily Cleaning Tips

Brush carefully around the appliance twice daily
Use an interdental or proxy brush under the expander
Rinse with mouthwash daily
Use a Waterpik or waterflosser to flush food debris from hard-to-reach areas

Excellent hygiene helps prevent irritation and inflammation around the appliance and mini-implants.

What’s Normal During MARPE Treatment?

You may notice:

Temporary speech changes (a slight lisp)
Tooth or jaw soreness during activation
Pressure or tingling in the nose, cheeks, or palate
A bite that feels “off” temporarily
A space forming between the front teeth (this is expected and a sign the appliance is working)

Don’t worry—these changes are temporary and will be addressed as treatment progresses.

When to Call Our Office

Please contact us if you experience:

Pain that does not improve with medication
Swelling, redness, or irritation around the appliance
A mini-implant that feels loose
Bleeding, pus, or signs of infection
Intense nasal pressure, headaches, or sinus discomfort
Difficulty turning the screw

MARPE Do’s & Don’ts

✅ Do:

Follow your activation instructions exactly
Use the wrench properly
Keep the appliance very clean
Take medications as prescribed
Use a Waterpik and mouthwash daily

❌ Don’t:

Double up on turns
Turn more than instructed
Eat sticky, chewy, or crunchy foods
Ignore swelling, pain, or loose screws

Frequently Asked Questions (FAQs)

How long does activation last?
Expansion can last from a few weeks to 4 months, depending on how much expansion is needed and how your body responds.

Will it hurt?
Most patients feel pressure rather than pain. Stretching turns help make activation more comfortable.

What if I forget a turn?
Do not perform extra turns if you miss a day. Call us so we can guide you.

What if it feels too easy to turn?
That can happen—but it may also indicate a mechanical issue. Let your team know.

Why do I feel pressure in my nose or cheeks?
The upper jaw connects to surrounding facial structures, so pressure changes in the areas of eyes, nose, and cheeks can be normal during expansion.

Will the gap between my front teeth close?
Yes! A gap between teeth is a sign the expansion is working. This will be closed it during the next phase of orthodontic treatment.

How long will the MARPE stay in place?
Typically 9–12 months total, including active expansion and a stabilization phase.

Final Thoughts

MARPE is a powerful, evidence-based treatment that allows us to safely and predictably widen the upper jaw, create space for teeth, improve bite function, reduce airway resistance, and support long-term oral health—especially in teens and adults where traditional expansion is less effective.

When combined with personalized activation protocols and monitoring, MARPE can be both comfortable and highly successful. Dr. Danielle Godley is proud to offer MARPE as a treatment option at Godley Family Orthodontics, using a customized patient-centered approach. If you’ve been told you have a narrow upper jaw—or you’re curious whether you might benefit from MARPE—schedule a consultation to learn more and explore your personalized treatment options.