Sometimes, the upper jaw (maxilla) is too narrow, which can lead to crowding, crossbites, or even breathing issues. A Rapid Maxillary Expander (RME) is used to gently widen the upper jaw while a patient is still growing.

The appliance is fitted to the upper teeth and gradually expands the two halves of the upper jaw using a small central screw. This creates more space for adult teeth, improves the bite, and can even help improve nasal airflow. The active phase usually lasts a few weeks, but the appliance stays in place longer to stabilise the new arch width.

MARPE – Mini-screw Assisted Rapid Palatal Expander

In patients approaching the end of their growth phase—often in the late teens or even young adults—a standard expander may not be strong enough to separate the two halves of the upper jaw. This is where MARPE comes in.

MARPE (Mini-screw Assisted Rapid Palatal Expansion) uses small titanium screws (also called temporary anchorage devices, or TADs) placed in the palate to anchor the expander directly to the bone, rather than just the teeth. This allows for a more effective expansion even when the growth plates have begun to fuse.

MARPE can:

• Improve airway volume and nasal breathing
• Widen the upper jaw non-surgically in older teens and young adults
• Avoid or delay the need for jaw surgery in some cases

It’s a safe, well-researched technique and is a great option for patients who are too mature for traditional RME but still need expansion.

Functional appliances are used to correct jaw alignment issues, especially when the upper and lower jaws are not growing in sync. These appliances work best during periods of active growth. Common types include:

• Herbst Appliance
  A fixed appliance that connects the upper and lower jaws with metal rods. It helps the lower jaw grow forward and corrects an overbite. It works continuously without relying on patient cooperation.
• Twin Blocks
  Removable upper and lower plates that guide the lower jaw into a forward position. They are worn full-time, including meals, and are comfortable for most children to adjust to.
• Reverse Pull Headgear (Facemask)
  Used for children with an underdeveloped upper jaw (Class III bite). This appliance gently pulls the upper jaw forward using elastics attached to a facemask worn at home. It’s most effective before the age of 10 while the upper jaw is still growing rapidly.

When a baby tooth is lost early, the neighbouring teeth can drift into the empty space and block the eruption path for the adult tooth. A space maintainer is a small device that holds this space open until the adult tooth is ready to come in.

These appliances are simple, painless, and custom-made. They’re especially important for preventing crowding and avoiding more extensive orthodontic treatment later on.

The “E” space refers to the valuable space left behind when the second baby molars fall out (often labelled as “E” teeth). If this space is lost too early, the permanent molars may shift forward and cause crowding of the front teeth.

A Lingual Holding Arch is a fixed appliance that sits behind the lower teeth and connects the molars to hold them in position. It passively maintains space for the developing adult teeth and is especially useful during the transition from baby to adult dentition.

A deep bite occurs when the upper front teeth cover too much of the lower front teeth, sometimes even biting into the lower gum or causing tooth wear.

An anterior bite plate is a small acrylic appliance that covers the upper front teeth and prevents the back teeth from touching. This encourages the back teeth to erupt slightly, which helps open the bite and reduce the deep overlap in a controlled way. It’s a simple and effective way to begin correcting deep bites in growing children.