MARPE Instructions for Patients

MARPE Instructions for Patients

Mini-implant Assisted Rapid Palatal Expander (MSE / MARPE Expander)

Welcome to the beginning of your palatal expansion journey! This guide will walk you through everything you need to know about your MARPE expander, including how it works, how to activate it at home, and what to expect during treatment. Palatal expansion is an important part of your orthodontic journey, and we’re here to support you every step of the way. If you ever have questions or concerns, don’t hesitate to reach out — we’ve got your back.
Dr. Phillips delivers MARPE appliance and delivers MARPE instructions to patient in his Encinitas Office.

Why Use The MARPE Appliance?

The MARPE expander (short for Mini-implant Assisted Rapid Palatal Expander) is a powerful tool used to widen the upper jaw by gently applying force through mini-screws anchored in the palate. At Phillips Family Orthodontics, we use a custom 3D-printed metal MARPE appliance with a Tiger Power Screw to ensure accuracy, efficiency, and comfort during treatment.

Palatal expansion through the MARPE can:

  • Improve how your upper and lower teeth fit together

  • Create space for crowded teeth

  • Reduce dark corners of the smile (buccal corridors)

  • Enhance your airway and potentially improve breathing

  • Support long-term bite stability and facial balance

Why Use The MARPE Appliance?​

The MARPE expander (short for Mini-implant Assisted Rapid Palatal Expander) is a powerful tool used to widen the upper jaw by gently applying force through mini-screws anchored in the palate. At Phillips Family Orthodontics, we use a custom 3D-printed metal MARPE appliance with a Tiger Power Screw to ensure accuracy, efficiency, and comfort during treatment.

Palatal expansion through the MARPE can:

  • Improve how your upper and lower teeth fit together

  • Create space for crowded teeth

  • Reduce dark corners of the smile (buccal corridors)

  • Enhance your airway and potentially improve breathing

  • Support long-term bite stability and facial balance

MARPE Activation Instructions

Activation Overview

Every patient’s expansion protocol is customized. At your appointment, we provided specific instructions tailored to your case. Please follow those directions exactly — including how many “faces” to turn each day and for how long.

We use a Tiger Power Screw with a hexagonal design. Each full turn (6 faces) equals 1 mm of palatal expansion. Each face is approximately 0.17 mm. This allows us to achieve extremely precise movement.

You’ll activate your MARPE appliance using a small wrench provided to you at your appointment.

Step-by-Step Activation Guide

  1. Use the wrench provided. Insert it into the hex slot in the middle of the Tiger Power Screw until it’s fully seated.

  2. Turn the wrench in the direction indicated by your orthodontist (typically toward the back of your mouth).

  3. One face of the hex = 0.17 mm. You may be instructed to turn one or more faces per day, depending on your specific plan.

  4. Only turn as instructed — more is not better, and turning incorrectly may cause discomfort or complications.

  5. Do not reverse the turn. Always remove the wrench carefully in the same direction of movement.

Watch An Activation Video Here ▶️

MARPE Activation Instructions​

Activation Overview

Every patient’s expansion protocol is customized. At your appointment, we provided specific instructions tailored to your case. Please follow those directions exactly — including how many “faces” to turn each day and for how long.

We use a Tiger Power Screw with a hexagonal design. Each full turn (6 faces) equals 1 mm of palatal expansion. Each face is approximately 0.17 mm. This allows us to achieve extremely precise movement.

You’ll activate your MARPE appliance using a small wrench provided to you at your appointment.

Step-by-Step Activation Guide

  1. Use the wrench provided. Insert it into the hex slot in the middle of the Tiger Power Screw until it’s fully seated.

  2. Turn the wrench in the direction indicated by your orthodontist (typically toward the back of your mouth).

  3. One face of the hex = 0.17 mm. You may be instructed to turn one or more faces per day, depending on your specific plan.

  4. Only turn as instructed — more is not better, and turning incorrectly may cause discomfort or complications.

  5. Do not reverse the turn. Always remove the wrench carefully in the same direction of movement.

Watch An Activation Video Here ▶️

Managing Discomfort and Oral Hygiene

Managing Discomfort and Medication

Some discomfort, tightness, or pressure is normal during MARPE activation. At your appointment, you may have received a prescription for anti-inflammatory steroids or pain relievers. Please take medications exactly as prescribed to reduce swelling, inflammation, and soreness.

Oral Hygiene During Palatal Expansion

Keeping Your MARPE Appliance Clean

It’s important to maintain excellent hygiene during your MARPE treatment to prevent irritation and inflammation around the appliance.

  • Brush around the appliance thoroughly 2x/day

  • Use an interdental proxy brush to clean under and around the expander

  • Rinse with mouthwash daily

  • A Waterpik is highly recommended to flush food from under the appliance

Discomfort and Oral Hygiene

Managing Discomfort and Medication

Some discomfort, tightness, or pressure is normal during MARPE activation. At your appointment, you may have received a prescription for anti-inflammatory steroids or pain relievers. Please take medications exactly as prescribed to reduce swelling, inflammation, and soreness.

Oral Hygiene During Palatal Expansion

Keeping Your MARPE Appliance Clean

It’s important to maintain excellent hygiene during your MARPE treatment to prevent irritation and inflammation around the appliance.

  • Brush around the appliance thoroughly 2x/day

  • Use an interdental proxy brush to clean under and around the expander

  • Rinse with mouthwash daily

  • A Waterpik is highly recommended to flush food from under the appliance

What to Expect with Your MARPE Expander

What’s Normal During Treatment

  • Speech changes (e.g., a slight lisp) are normal and temporary. Try reading aloud or singing to adjust faster.

  • Tooth and jaw soreness during the first few days of activation is common.

  • You may feel pressure or tingling in your cheeks, nose, or palate — a good sign that expansion is occurring.

  • Bite may feel “off” during expansion — this will stabilize later in treatment.

  • A gap between your front teeth may appear. This is expected and means the appliance is working well. Don’t worry — we’ll close the space as your orthodontic treatment continues.

When to Call Us

Please contact our office if you experience:

  • Pain that doesn’t improve with medication

  • Swelling or redness around the appliance

  • A screw (TAD) feels loose or shifts position

  • Bleeding, pus, or signs of infection

  • Intense nasal pressure, headaches, or sinus discomfort

What to Expect with MARPE

What’s Normal During Treatment

  • Speech changes (e.g., a slight lisp) are normal and temporary. Try reading aloud or singing to adjust faster.

  • Tooth and jaw soreness during the first few days of activation is common.

  • You may feel pressure or tingling in your cheeks, nose, or palate — a good sign that expansion is occurring.

  • Bite may feel “off” during expansion — this will stabilize later in treatment.

  • A gap between your front teeth may appear. This is expected and means the appliance is working well. Don’t worry — we’ll close the space as your orthodontic treatment continues.

When to Call Us

Please contact our office if you experience:

  • Pain that doesn’t improve with medication

  • Swelling or redness around the appliance

  • A screw (TAD) feels loose or shifts position

  • Bleeding, pus, or signs of infection

  • Intense nasal pressure, headaches, or sinus discomfort

Top Do’s and Don’ts for MARPE Activation

  • ✅ Do:

    • Follow the activation instructions given to you exactly

    • Use your wrench properly — one face at a time as directed

    • Keep the appliance and your teeth very clean

    • Take medications as prescribed

    • Use a Waterpik and mouthwash daily

    • Call us with any concerns — no question is too small!

    ❌ Don’t:

    • Skip days or “double up” without our direction

    • Turn more than instructed

    • Pull the wrench forward when removing it

    • Eat sticky, chewy, or crunchy foods

    • Ignore signs of irritation, swelling, or loose screws

Top Do’s and Don’ts for MARPE​

  • ✅ Do:

    • Follow the activation instructions given to you exactly

    • Use your wrench properly — one face at a time as directed

    • Keep the appliance and your teeth very clean

    • Take medications as prescribed

    • Use a Waterpik and mouthwash daily

    • Call us with any concerns — no question is too small!

    ❌ Don’t:

    • Skip days or “double up” without our direction

    • Turn more than instructed

    • Pull the wrench forward when removing it

    • Eat sticky, chewy, or crunchy foods

    • Ignore signs of irritation, swelling, or loose screws

  •  

Frequently Asked Questions (MARPE FAQs)

Will it hurt?

Mild pressure and soreness are common during activation. Most discomfort is temporary and improves with medication and time.

How long will the MARPE appliance be in my mouth?

Typically, the MARPE expander remains in place for 9–12 months total. This includes both the active phase of expansion and a stabilization phase where the bone adapts to the new width.

What if I miss a turn or do it wrong?

Please call us right away. We can guide you over the phone or schedule an in-office check. It’s important to stay on track.

Why do I feel pressure in my nose or cheeks?

This is a common effect of palatal expansion. Your upper jaw is connected to other facial structures, so changes in pressure are normal. If it becomes intense, give us a call.

Will the gap in my front teeth go away?

Yes! That gap is a sign that your expansion is progressing. We will close the space as we move into the next stage of treatment using braces or clear aligners.

Frequently Asked Questions

Will it hurt?

Mild pressure and soreness are common during activation. Most discomfort is temporary and improves with medication and time.

How long will the MARPE appliance be in my mouth?

Typically, the MARPE expander remains in place for 9–12 months total. This includes both the active phase of expansion and a stabilization phase where the bone adapts to the new width.

What if I miss a turn or do it wrong?

Please call us right away. We can guide you over the phone or schedule an in-office check. It’s important to stay on track.

Why do I feel pressure in my nose or cheeks?

This is a common effect of palatal expansion. Your upper jaw is connected to other facial structures, so changes in pressure are normal. If it becomes intense, give us a call.

Will the gap in my front teeth go away?

Yes! That gap is a sign that your expansion is progressing. We will close the space as we move into the next stage of treatment using braces or clear aligners.

Dr. Joseph Phillips consults with patient in his Encinitas orthodontics office. Contact us for a free consultation

Get started today with a complimentary consultation

ENCINITAS

PHONE
(760) 943-7770

ENCINITAS OFFICE
761 Garden View Court #101
Encinitas, CA 92024

OFFICE HOURS 
Monday 8:30 am – 5:30 pm
Tuesday 8:30 am – 5:30 pm
Wednesday 8:30 am – 5:30 pm
Thursday 8:30 am – 5:30 pm
Friday – By Appointment

MIRA MESA

PHONE
(858) 578-1822

MIRA MESA OFFICE
10737 Camino Ruiz #210
San Diego, CA 92126

OFFICE HOURS 
Monday 8:30 am – 5:30 pm
Tuesday 8:30 am – 5:30 pm
Wednesday 8:30 am – 5:30 pm
Thursday 8:30 am – 5:30 pm
Friday – By Appointment

ENCINITAS

PHONE
(760) 943-7770

ENCINITAS OFFICE
761 Garden View Court #101
Encinitas, CA 92024

OFFICE HOURS 
Monday 8:30 am – 5:30 pm
Tuesday 8:30 am – 5:30 pm
Wednesday 8:30 am – 5:30 pm
Thursday 8:30 am – 5:30 pm
Friday – By Appointment

MIRA MESA

PHONE
(858) 578-1822

MIRA MESA OFFICE
10737 Camino Ruiz #210
San Diego, CA 92126

OFFICE HOURS 
Monday 8:30 am – 5:30 pm
Tuesday 8:30 am – 5:30 pm
Wednesday 8:30 am – 5:30 pm
Thursday 8:30 am – 5:30 pm
Friday – By Appointment

Call or Text Us Now