If you or your child has been told palatal expansion is needed, you may hear terms like RME, MARPE, TADs, and different types of braces. It can sound overwhelming but these tools all work together to create a healthier bite and a wider, more balanced smile.
So how do they work and why are some patients told they need more than just braces?
Let’s break it down in a question and answer format.
What is RME and MARPE?
What is RME?
RME stands for Rapid Maxillary Expansion. It uses a screw-based appliance attached to the upper teeth to widen the upper jaw. This works best when you or your child is still growing because the bones in the palate have not fully fused.
What is MARPE?
MARPE stands for Mini screw Assisted Rapid Palatal Expansion. It also widens the upper jaw but it uses small bone anchors called TADs to apply force directly to the jawbone. This allows expansion even when you or your child is a teenager or adult.
Why are braces used with RME or MARPE?
Expansion creates space but braces are what guide the teeth into their new positions.
Without braces, expansion alone could leave teeth flared outward, crooked, or unstable. Braces make sure that when you or your child’s jaw widens, the teeth move into a healthy and functional bite.
What brace combinations are used with RME or MARPE?
RME with Traditional Metal Braces
This is commonly used when you or your child is younger.
Metal braces are strong and precise, making them ideal for guiding teeth as the jaw expands. This combination is often used to correct crowding, crossbites, and narrow smiles.
RME with Clear Ceramic Braces
If you or your child wants a less noticeable option, ceramic braces can be used with RME.
They work similarly to metal braces but blend in with the teeth. However, they are not as strong, so they may not be recommended for more complex cases.
MARPE with Metal Braces
This is one of the most powerful combinations for teens and adults.
MARPE widens the jaw using bone anchored screws, and metal braces move the teeth efficiently into the new space. If you or your child has severe crowding, crossbite, or a very narrow upper jaw, this combination can often avoid the need for jaw surgery.
MARPE with Clear Aligners
Some adults prefer clear aligners after expansion.
In this approach, MARPE widens the jaw first, and then aligners move the teeth into their final positions. This can be a great option when you or your child wants a more discreet treatment.
What are TADs?
TAD stands for Temporary Anchorage Device. These are small titanium screws placed into the jawbone to provide a fixed anchor point. They are temporary and removed once treatment is finished.
In MARPE, TADs anchor the expander to the bone instead of just the teeth. This allows true skeletal expansion, especially in teens and adults.
TADs are also used to move difficult teeth, pull impacted teeth into position, close gaps, and correct bite problems that braces alone cannot fix.
Can I have MARPE or RME on its own?
This is a very common question.
In most cases, the answer is no. RME or MARPE by itself only widens the jaw. It does not straighten teeth, fix bite problems, or ensure that the teeth end up in the correct position after the expansion.
When you or your child has a narrow upper jaw, the teeth are usually already tipped, crowded, or misaligned. If expansion is done without braces or aligners, the teeth can flare outward, drift into unstable positions, or fail to meet the lower teeth properly. This can lead to an uneven bite and a higher risk of relapse.
RME and MARPE are designed to create the space. Braces or aligners are what organize that space and move the teeth into a healthy, functional bite.
In rare situations, very young children with a simple crossbite may have RME first and braces later. But for most teens and adults, and for most orthodontic problems, expansion and tooth alignment must work together.
That is why orthodontists almost always combine MARPE or RME with braces or clear aligners to achieve a stable, long term result.
How do all these tools work together?
RME or MARPE creates the space.
Braces or aligners guide the teeth into that space.
TADs provide the anchorage needed to move bone and teeth safely and predictably.
When these tools are chosen correctly, you or your child can achieve a wider smile, a better bite, and a more stable long term result.
