Starting with a Rapid Palatal Expander (RPE)

Kuhlberg - RPE 1A rapid palatal expander (RPE), is very commonly used in orthodontics as a means to gain space for crowded teeth, and to correct crossbites. This device may look a bit intimidating, but treatment with an RPE is actually very gentle and is usually quite comfortable for the patient. Here is what to expect if Dr. Dan recommends an expander for your child.

  • Placing separators: Dr. Dan will check if there is enough space between the upper molars to comfortably and accurately fit bands around these teeth. If the teeth are really tight together, we will place “separators” in between the back teeth to create a small space. Patients often describe separators as feeling like there is food caught between their teeth for several days. If the separators fall out with several days off being placed, let us know-you may need new ones placed. If it is only several days until the next appointment, you don’t need to call us!
  • Band fitting appointment:  Bands are like “rings” around the upper molars, and act as an anchor to keep things in place and stable. We will find the exact band that is the right size for your teeth. We will then take an impression of your teeth with the bands on them, remove the bands, and send everything to a lab where your expander is created. Your expander is custom for your mouth only, and it takes about two weeks make.
  • Appointment for placing the expander: At this visit, your expander will be delivered by cementing or bonding it to your upper teeth. We will teach parents how to turn the expander at home, and let them know how many turns are needed. We will also discuss hygiene and diet tips for keeping the expander secure and clean.
  • First expansion check appointment: After a week or two (depending on the amount of expansion Dr. Dan determines is needed) you will return, and Dr. Dan will check to make sure the amount of expansion is just right. Sometimes he will ask for several more turns to be made.
  • Your RPE will stay in place (without turning) for 6-9 months: This gives the maxilla, or upper jaw, time to remodel and make the changes remain after the expander is removed. We often slightly over-expand to account for relapse that usually occurs after the expander is removed.

Common questions and concerns

Kids are usually surprised that there is relatively little discomfort associated with the above appointments. Separators usually cause soreness for several days after they are placed, and there is a pushing sensation when we fit the bands. Patients most commonly report a “tight” sensation for several minutes after their parents turn the expander, but pain is relatively rare. Also, expect a small space to form between the front teeth (a sign that the upper jaw is expanding!).  If your “S” sounds are a bit slurred when speaking, read out loud as often as you can, and in several days your original speech will be very close! If you have any concerns at all, give us a call- we are always happy to answer any questions you may have!

Dr. Dan Rejman is the owner of Meadows Orthodontics, and is a board certified specialist in orthodontics and dentofacial orthopedics. Meadows Orthodontics serves patients from Castle Rock, Castle Pines, Franktown, Elizabeth, Larkspur, Parker, Highlands Ranch and Lonetree.