A narrow palate can cause tooth overcrowding, crossbite, and even breathing problems. It’s something that should be addressed as soon as possible, because it’s easier to treat in children than adults. That’s because the two bones that make up the roof of the mouth don’t fuse together until the mid-teen years, which means they can be spread apart more easily. But it’s not impossible for adults. A certain type of palate expander (sometimes called a palatal expander) can fix the problem. 

Freeman Orthodontics knows all about palate expanders, including the maxillary skeletal expanders (MSEs) often used for adults. We can customize one to your mouth and expand your palate to make it easier to treat your orthodontic and breathing problems. 

What Is a Palate Expander?

A palate expander attaches to the two back molars or to implanted posts and sits against the inside of the back teeth. A small joint in the center of the device pushes the wires against the teeth. A small palate expander key is inserted into the joint and twisted once a day to push the wires out a little further, which forces the back teeth out.

There are three main types of palate expanders:

  • Rapid Palate Expander (RPE): This is used particularly in young patients with unfused palates to quickly widen the jaw. 
  • Maxillary Skeletal Expansion (MSE) or Miniscrew-Assisted Rapid Palate Expander(MARPE): This is more often used on adults whose palate bones are already fused together. It allows for palate expansion without major surgery. 
  • Surgically-Assisted Rapid Palate Expansion (SARPE): This requires full surgery and is only used on the most severe patients. 

For adult orthodontics, we prefer to use the MSE/MARPE expander, which involves placing two small posts into the palate under local anesthesia. The device then attaches to the posts and is turned daily to widen the palate. 

Does a Palate Expander Hurt?

It is likely that you will have some mild pain or discomfort immediately after the posts of your palate expander are implanted and the device is attached. But that usually goes away after a week or two. After that, there shouldn’t be any pain with the daily expansion; though there may be some mild pressure or discomfort, it should go away after a couple of days. 

If you continue to feel discomfort after a week or two, give Freeman Orthodontics a call. We can schedule an appointment to take a look. 

How Does an MSE Expander/MARPE Expander Work?

So how does a palatal expander work? The palate is actually made up of two bones in the maxillary, or upper jaw. Those bones meet in the center of the palate, but they don’t actually fuse together until a child’s middle teen years. That means it’s easy to move the bones apart when the child is younger. The palate expander does this by applying pressure to either side of the jaw. The steady pressure slowly pries the palate open.

It’s a bit trickier to use a palate expander for adults because the bones are fused already. That doesn’t mean it isn’t possible to expand the palate. On the contrary, our bones are very resilient, so as they’re expanded, they automatically stretch and grow to fill in the gap.

The device applies pressure because you use a hexagonal key to turn the joint, which puts pressure on the teeth and palate to widen it. You might feel a little pop when you turn the key. That pop or click means the joint was expanded successfully. 

It may be a bit tricky to clean your palate expander, but a soft-bristled toothbrush helps. A WaterPik or similar device is a great way to get around and under your MSE expander. 

How Long Will I Wear an MSE Expander?

An MSE expander will likely do the job within three months or so, but the process creates new bone that needs to “set,” or harden again. Otherwise, as soon as the MSE appliance is removed, the palate will go right back to being narrow. So the MSE expander stays in the mouth for another 3-6 months, on average so that the jaw can harden. 

In total, you can expect to wear a palate expander for 6-9 months. In rare cases, it could be in for up to a year. It depends on how wide the palate needs to expand.

Why Do I Need a Palate Expander?

Your narrow palate can lead to orthodontic problems, speech problems, and even breathing problems. An expanded palate, along with orthodontic treatment, can solve these problems.

Some of the problems a palate expander can solve include: 


A narrow palate can cause several orthodontic problems, including a crossbite. This happens when the upper teeth sit inside the lower teeth in the back instead of slightly outside as they should. An MSE expander helps push the teeth outside the lower teeth where they belong.


With a narrow palate, there may not be enough room for the permanent teeth to come in properly. Instead, they erupt in front of or behind the space they are supposed to occupy, or they may come in sideways. This is called teeth crowding. Over time, this can cause problems with your bite and chewing, which can lead to more problems, such as jaw pain and temporomandibular joint disorder (TMJ).

Impacted teeth

This is an issue that primarily affects younger patients. There is so little space that the teeth can’t come in at all because other teeth are in the way – these are impacted teeth. Giving them proper room allows them to erupt as they should. 

Speech problems 

With a narrow palate, the tongue doesn’t have room to move properly. This can cause a speech impediment. It can also cause the tongue to push forward on the front teeth, which can lead to an overbite and other speech issues. Widening the palate gives the tongue enough room to move and form words properly. 

Breathing problems 

A narrow palate can also mean narrow nasal passages, which can make it difficult for you to breathe through your nose. This can lead to you breathing through your mouth, which can cause dry mouth, halitosis (bad breath), and an increased presence of bacteria. It can also lead to sleeping disorders such as snoring and sleep apnea. Widening the palate can also expand room in the nasal passages, allowing you to breathe easier through your nose.  

MSE Orthodontics

Often, a patient with a narrow palate will have orthodontic issues as well. You likely need treatment with braces or clear aligners once the MSE palate expander is removed. The expander often causes a space to form between the front teeth. The teeth move closer together eventually, but braces or clear aligners will ensure they end up in the right place. Orthodontic treatment will also fix the crossbite and teeth crowding caused by your narrow palate.

Freeman Orthodontics can lay out a plan for orthodontic treatment in addition to your MSE expander treatment. You’ll be able to see how a wider palate and orthodontic treatment can transform not only your smile but your facial structure as well.  

MSE Expander Before and After

You will see a significant difference before and after a palate expander and orthodontic treatment with Freeman Orthodontics. Though there might be a slight difference in your facial structure, the biggest difference will be in your oral health and sleeping and breathing patterns. 

An MSE palate expander is an excellent tool to solve orthodontic, speech, and breathing problems and set you up for successful treatment with braces or clear aligners. It also avoids painful surgery to expand the palate.

If you’re in the San Jose, CA, area, visit Freeman Orthodontics and find out what we can do for you!

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