MARPE Instructions for Patients
MARPE Instructions for Patients
Mini-implant Assisted Rapid Palatal Expander (MSE / MARPE Expander)
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
Use the wrench provided. Insert it into the hex slot in the middle of the Tiger Power Screw until it’s fully seated.
Turn the wrench in the direction indicated by your orthodontist (typically toward the back of your mouth).
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.
Only turn as instructed — more is not better, and turning incorrectly may cause discomfort or complications.
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
Use the wrench provided. Insert it into the hex slot in the middle of the Tiger Power Screw until it’s fully seated.
Turn the wrench in the direction indicated by your orthodontist (typically toward the back of your mouth).
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.
Only turn as instructed — more is not better, and turning incorrectly may cause discomfort or complications.
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 will the rest of my mouth be affected?
Oftentimes, the MARPE appliance is used to create room for the tongue to function properly. Most patient’s will need an evaluation for a tongue tie along with this procedure. Our partners at Oral Tie Center are the best in the area to support these needs.
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 will the rest of my mouth be affected?
Oftentimes, the MARPE appliance is used to create room for the tongue to function properly. Most patient’s will need an evaluation for a tongue tie along with this procedure. Our partners at Oral Tie Center are the best in the area to support these needs.
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.
Ready To Learn More?
Visit Our Orthodontic Offices in
Encinitas & Mira Mesa for Expert Care
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