MARPE Patient Instructions

Congratulations, your orthodontic treatment has started! The mini-implant assisted rapid palatal expander (MARPE), also known as the maxillary skeletal expander (MSE), is the first step to your new smile!

There are multiple benefits of the MARPE/MSE appliance. It will widen your upper jaw which may help the upper and lower teeth fit together better resulting in improved function. It will also create space which can help resolve minor to moderate crowding. In addition, a wider jaw may enlarge the airway resulting in improved breathing. Finally, this appliance can broaden your smile and reduce your buccal corridors.

Post-Appliance Insertion Instructions

After placement of the MARPE appliance:

  1. Take over-the-counter pain medication such as Ibuprofen or Tylenol® throughout the first day following the medication’s instructions. Do not wait for any discomfort to set in to take the pain medication.
  2. Perform warm saltwater rinses three times/day for the first three days. This will prevent any potential infections. Use water at roughly bathwater temperature, place a ½ teaspoon of salt, and swish and rinse your mouth for 10-12 seconds, then spit out.
  3. Activate/turn your expander based on your orthodontist’s directions.

How do I activate/turn the expander?

To turn your expander, use the activation key to turn the hexagonal nut from the front toward the back of the mouth. You should feel some resistance while turning it.

​Remove the key while it is toward the back of your mouth. If you turn the key back towards the front of the mouth, you will undo the activation.

To see what this looks like, please watch this YouTube video: MARPE Activation Video

How often do I turn the expander?

Our orthodontists will inform you on the frequency and number of times you should turn your expander. If you forget how many times to turn your expander or have any questions, please call our office to clarify.

How do I manage the initial discomfort?

Some initial discomfort is normal for the first few days after placement of the MARPE appliance. Over-the-counter pain medication such as Ibuprofen or Tylenol® is recommended to manage any discomfort.

What does it feel like when it is turned?

You will likely feel some pressure when you turn the expander, but minimal discomfort should be felt after the first few days of MARPE placement. Some patients may feel a “pop” which is often an indicator of successful expansion.

What should I expect to see?

A space may develop between your two front teeth. This is normal and should be celebrated if it occurs. If the space develops, it is a good indication that the expansion is a success and that you have just avoided needing a surgical procedure to achieve the expansion. We will close this space throughout your orthodontic treatment.

How do I clean my expander?

In addition to brushing your teeth as you normally would, you should also brush gently and carefully around the appliance. We also highly recommend using a Water Pik® and mouthwash daily.

How long will my expander be in my mouth?

The active phase where you will be turning the expander typically takes about one month. We will be monitoring you closely during this phase. The retention phase in which the expansion will stabilize typically takes another 6 months.

What are my options if the expansion does not work?

While MARPE has a high success rate, its success is dependent on several factors which include your age and bone density. We cannot guarantee that the MARPE will be a success, and we have alternative options that we can propose if the MARPE does not work.

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