A Rapid Maxillary Expander (RME) is specially designed to widen your upper jaw (the maxilla). The most common use for the RME is to correct a posterior crossbite, when the top teeth fit inside of the bottom teeth. They are also widely used in cases of severe crowding.
In young and growing patients, the grown plate between both halves of the maxilla is still open. It is along this growth plate that we got our expansion. It is due to this midline separation that you should expect a “gap” between the two front teeth. Don’t worry if you see a gap. It just means the appliance is working properly. We will close the gap later – we promise!
The RME “expander’ has four main parts. They are the pre-fit orthodontic bands, the transpalatal arch, the lingual bars and the turn screw. The turn screw is the appliance’s only moving part and is the most important part of the whole apparatus. Each time you insert the key and turn until you see the next hole you have expanded both sides of the RME by ¼ millimeter.
When turning, insert the key in the hole facing the front. Gently push down towards their tongue until the next hole can be seen. Remove the key. YOU DID IT! Be careful when removing the key, to not turn the screw back.
You will be asked to turn once per day for 3-5 weeks or as directed by Dr. Streem.
Once we have adequate palatal width (Dr. Streem will let you know) we will ask you to stop turning. You will return approximately 8 weeks from that appointment to get your braces. The expander will remain along with your braces for 4 more months (6 months from when you stopped turning) unless otherwise directed by Dr. Streem.
As the maxilla widens you can expect symptoms ranging from a tickling feeling in the roof of the mouth to the floor of the nose to feeling no differently at all. Most patients are not usually uncomfortable throughout this process. Discomfort, if any, can be controlled with routine over-the-counter analgesics such as Tylenol or Advil.
You may feel the initial pressure on your teeth, in the middle of your palate, in your nose, in your cheeks, and you may experience a headache.
You should expect to see a huge space open between your upper front teeth. Although this is a good sign from the standpoint that this means the two halves of your palate are separating as they are supposed to, it can also be disheartening from a cosmetic standpoint. By the time I tell you to stop turning the screw, the space may look so large that you could fit another tooth in there. After you stop turning the screw, the space will close all by itself within a month or so. In fact the space may close so much that the two front teeth may cross over and overlap slightly. This will be corrected after the braces are on and is a normal reaction to the expander.
RME and braces have the same dietary restrictions. Stay away from STICKY and CHEWY foods. They will pull the bands loose and result in an emergency appointment. .