Rapid Palatal Expander (RPE)
Instructions and Care

Congratulations, your expander has been placed! This procedure allows for the creation of more space for the eruption of the permanent teeth and correction of your bite. This sheet is provided to give you information on how to activate your expander, what to expect and hygiene instructions. If you have other questions or problems, please call the office.

Your expander will be activated based on the specific instructions provided, typically starting with 1 turn every other night for a duration of 4 weeks.


I recommend activating the appliance at bedtime so by the next morning, the pressure from the turn is gone. If you forget one night, don’t worry, just turn the next night! Do not do more than 1 turn a day. Just keep track of how many turns have been completed.

1.) You will be given a key to activate the RPE.

2.) Place key in anterior hole of appliance, towards the front teeth. The white circle on key should be facing the patients right side. The key should feel secure in the appliance.

3.) There is an etched arrow in the appliance pointing down in the direction the key should be pushed, towards the throat


4.) Push key completely towards back of mouth until it stops. You will feel a slight click and the next hole can be seen fully in front of appliance.

5.) Remove the key carefully towards the back of throat and be sure not to pull the key up when removing. You want to be able to see the new hole at the front of the appliance.


Brush the appliance including the metal bars & screw in the same way you brush your teeth. When you are unable to brush after eating, use water swished around in your mouth to help dislodge any food particles. Must keep the expander and its parts clean and free of food. You should also use a Waterpik. Warm salt water rinses and use Orajel/Brace Relief gel if you have gum soreness.

What can I eat?

At first, eating will be more difficult; take small bites & eat soft foods until this is overcome (usually a few days to a week). After that, you should be able to eat almost everything you did before with some exceptions. Mainly sticky, hard, and crunchy foods. –Popcorn, ice, nuts, candy, and gum.

You will notice several things as the expander does its job.

Your speech will be slightly affected at first. This is not permanent & the best way to get used to this is to speak aloud as much as possible; try reading out loud or singing.

Your teeth may be sore for the first few days. To help with this you may want to take what you would normally take for a headache; however, chewing & talking are the best ways to get your mouth used to this new feeling.

Pressure or tingling of the mouth, tongue, cheeks & nose; your bite will feel off as the width of your palate changes and the palate expands. The teeth may not fit together properly, this is normal, for now.

Space between your front teeth
Although this is a good sign from the standpoint of your treatment, it can be disheartening from a cosmetic point of view. By the time you stop turning the expander, the space may look large enough to fit another tooth. This space is good and should close by itself within a short time.

Potential Trouble and Problems
Please turn the appliance as instructed. Do not do more turns than directed and stop after the directed number of weeks and turns. At your next appointment, you will be told if your expansion is completed or needs to continue. The most common problem we see with the RPE is an incomplete activation where the key cannot be seated for the next activation. You should see the next hole completely in the RPE when the key is removed. Please watch the video as well and we are here to help, if you need!

If the RPE ever feels loose or wiggly, the bands should be cemented and not moving on the teeth, please call to have the appliance re-cemented. You should carefully follow the food list and avoid sticky, hard foods. Yes, that means no gum!

Wires on the side look like they are in the gums
Please know that the gums respond to the wires by overgrowing, esp if the are is not kept clean. Use warm Salt water rinses, Orajel, keep the area clean and give it some time.

**If the appliance comes out completely, please bring it with you to your appointment.**