An RPE consists of side components that can be metal or acrylic, and are connected in the middle of the palate (roof of the mouth) by an expansion screw. They are cemented in place on the upper posterior teeth, and cannot be removed by the patient, ensuring compliance.

Initial Placement

Initial placement requires three different appointments over a period of 10-14 days.

• The first appointment takes no longer than 5 minutes and can be done at the consultation appointment. Separators or small rubber bands are placed between the back teeth. They are used to make space between those teeth and allow for the band fitting at the second appointment. It is important to avoid flossing the areas with the separators. As they begin to move, the back teeth will be sore for a few days.
• The second appointment consists of a band fitting around the molar (back) teeth, and taking the mold of the upper arch. The mold is used to fabricate the custom appliance for each individual patient.
• The third appointment is the delivery appointment, meaning the expander is ready to be cemented in the patient’s mouth. It is also time to educate the patient or parent on how to activate the appliance at home.

Activations

The expander is activated at home by turning the expansion screw in the middle of the palate as instructed. In most cases, one turn a day for a period of two to three weeks will achieve the desired maxillary expansion.

The appliance will need to be checked periodically until removed.

Holding Phase

The expander remains in place for an additional 6 months for passive maintenance. During this time, it helps stabilize the expanded maxillary bones and teeth while the body forms new bone at the expansion site.

Hygiene

Patients are encouraged to brush carefully around the appliance with the toothbrush and toothpaste. Use of a Waterpik may help rinse out bigger food particles that may block the expansion screw, or get wedged under the side components.

Helpful Tips for Your Expander Appliance

The first week to two after the initial insertion of the expander, the inside of your cheeks, lips and tongue may be slightly irritated.

Over the counter pain medicine may help with the initial discomfort and wax or gooshy goo have proven to be useful against soft tissue irritation.

Chewing and speaking may also be difficult and awkward at first. Cutting food into smaller pieces and avoiding sticky or hard foods will help you eat more comfortably and avoid breakage of the appliance.

Limit carbonated beverages (soda) as they have tendency to dissolve the cement holding the appliance in place and are more likely to cause dental cavities.

Practice reading aloud and your ordinary speech will return quickly. More you speak and practice, faster the speech will normalize.

You may also notice more saliva than normal, but this will decrease as you become accustomed to the appliance.

If the appliance comes loose, call the office immediately.

An Invisalign aligner palatal expander consists of a series of 3D-printed, removable expanders that gradually increase in size.

The thickness of an Invisalign aligner expander is specifically designed to fit each patient’s unique anatomy and deliver the precise force needed for effective expansion. This customization ensures both optimal results and enhanced comfort, making each expander uniquely tailored to the individual.

Initial Placement

Initial placement requires two different appointments over a period of 10-14 days.

• The first appointment takes no longer than 5 minutes. A 3D iTero scan is taken. This can be done at the consultation appointment.
• The second appointment is the delivery appointment, during which the patient and parent are instructed on how to use and clean the appliance.

Activations

The expander is activated by wearing each aligner sequentially for one to three days before progressing to the next. It is crucial to wear them full-time (22–23 hours per day), removing them only for meals and cleaning. Each expander is individually packaged and numbered, making the process straightforward and easy to follow.

This active expansion phase typically lasts 4 weeks.

Holding Phase

The holding phase lasts six months unless the patient transitions to Invisalign aligners. In that case, after a minimum of four to five months in the holding phase, the teeth will be scanned using the iTero® scanner to prepare for the next phase, Invisalign First.

During the holding phase, the patient wears retainers full-time. These retainers look identical to the expanders but are no longer active and remain the same size as the final expander used. Each retainer is worn full-time for 1–2 weeks. Do not worry – we will provide multiple retainers, so you will have plenty of replacements if one is lost.

Hygiene

Patients are encouraged to remove and brush their appliance with the toothbrush and toothpaste at least twice per day, morning and before bedtime. Avoid hot water, as it can warp the material.

Helpful Tips for Your Expander Appliance

• Manage Discomfort: Mild discomfort or pressure is normal when switching to a new expander. Use over-the-counter pain relievers if needed and stick to soft foods for the first few days.
• Stay Hydrated: Drinking water can help with any dryness or soreness caused by wearing the expander.
• Chewies Are Your Friend: Use Invisalign aligner “chewies” to help seat the expander properly and minimize discomfort.
• Practice Speaking: If the expander affects your speech, practice talking or reading aloud to adjust more quickly.
• Be Patient: It may take a few days to get used to the feeling of the expander in your mouth.
• Monitor Progress: Check for any signs of damage or wear on the expander and inform your orthodontist immediately if issues arise.
• Attend Appointments: Stick to your scheduled orthodontic visits to ensure the treatment is progressing as planned.

By following these tips, you will maximize the effectiveness of your Invisalign aligner expander and make the process smoother and more comfortable!