When treating a narrow upper jaw (maxillary constriction) three commonly discussed approaches are RME, MARPE and SARPE. While they all aim to widen the upper jaw, they differ in how they work, who they are suitable for, and where the treatment is carried out.
In this blog we will discuss the differences between each option.
*PLEASE NOTE THAT RME AND MARPE PROVIDED AT ALIGNED ORTHODONTICS, IS NOT A STAND ALONE TREATMENT AND IS USED PRIOR TO A FULL COURSE OF ORTHODONTIC TREATMENT MARPE IS ALSO NOT AVAILABLE THROUGH THE NHS, WE CAN NOT PROVIDE THIS APPLIANCE PRIOR TO PRIVATE OR NHS TREATMENT IF TREATMENT IS BEING CARRIED OUT ELSEWHERE.
Please note this is only appropriate for patients under the age of 25 and if clinically necessary. If you are exploring this appliance due to breathing issues, we recommend that you speak with a ENT specialist beforehand to rule out any other issues. This appliance is used in conjunction with a comprehensive brace system such as a fixed brace or aligners which is charged additionally.
Invisalign First → early guidance and space creation (Ages 6-10 years with mixed dentition)
RME → younger children/early teens (Typically before the age of 14 years)
MARPE → older teens and some young adults (Under the age of 25)
SARPE → hospital-based adult cases (Over the age of 25)
These appliances are used alongside a brace, so their cost is in addition to the full cost of the brace you choose.
https://www.alignedorthodontics.com/fees
Invisalign First – Early Orthodontic Treatment for Young Children
Can my child have orthodontic treatment with baby teeth?
Invisalign First is a clear aligner system designed specifically for young children with a mix of baby and adult teeth. It focuses on guiding jaw development, creating space for adult teeth, and correcting early bite issues in a gentle and removable way.
Best suited for:
Young children in early mixed dentition
Typically ages 6–10 years
Key features:
Clear, removable aligners
More comfortable and discreet than traditional braces
Helps guide jaw growth and tooth eruption
Can reduce the need for more complex treatment later
Invisalign First is often recommended as the first step in orthodontic care before considering palatal expansion options such as RME, depending on the child’s growth and clinical needs.
Cost: £3500
RME – Rapid Maxillary Expansion
What is RME?
RME uses an expander fixed to the upper teeth. The appliance gently separates the mid‑palatal suture while a child or young teenager is still growing.
Best suited for:
Children and young teenagers
Typically before the age of 14 years of age (before the jawbones fully fuse)
Key features:
Non‑surgical treatment
Relies on natural growth
Expansion is achieved relatively quickly
Cost: £750
RME is usually the first‑line option for younger patients because it is effective, predictable and minimally invasive when growth is still ongoing.
MARPE – Mini screw Assisted Rapid Palatal Expansion
What is MARPE?
MARPE is a more advanced form of expansion that uses temporary orthodontic mini screws placed into the palate. These screws help anchor the expander directly to the bone rather than relying only on the teeth.
*Tooth extractions after this brace has achieved expansion are sometimes necessary to avoid gum recession in certain individulas.
Best suited for:
Older teenagers and young adults
Typically from around late teens and some young adults, depending on bone maturity
Key features:
Non‑surgical
Greater skeletal (bone‑based) expansion than traditional RME
Reduced unwanted tooth tipping
Often avoids the need for surgery in borderline adult cases
Cost:
£6,000
MARPE is an excellent option for patients who are no longer suitable for traditional RME but wish to avoid surgical treatment.
SARPE – Surgically Assisted Rapid Palatal Expansion
What is SARPE?
SARPE combines orthodontic expansion with a surgical procedure performed in a hospital setting. The surgeon releases the fused areas of the upper jaw so expansion can occur safely in fully grown adults.
Best suited for:
Adults with fully fused jaw bones
Usually 18 years and older when non‑surgical expansion is no longer possible
Key features:
Requires hospital‑based oral or maxillofacial surgery
Involves general or local anaesthetic
Orthodontic appliance is activated after surgery
Important note:
We do not provide SARPE at our practice
This treatment is carried out at a hospital under the care of a surgical team
Cost: Costs vary significantly and are determined by the hospital and surgical provider
Which Option Is Right for You or your Child?
The best expansion method depends on age, jaw maturity and clinical findings. A full orthodontic assessment, including X‑rays or scans, is essential before deciding on the most appropriate treatment.
If you or your child has a narrow upper jaw and would like to explore RME or MARPE, our practice will be happy to assess suitability and discuss options in detail. For cases requiring SARPE, we can advise and refer to the appropriate hospital specialists.
If you would like to book a consultation or have any questions, please get in touch with our team.
https://www.alignedorthodontics.com/contact
