Palatal Expander (Palate Expander) in Shelby Township, MI
*For new patients only. Patients transferring from another orthodontist: $250 consultation fee, credited toward treatment if they start here.
What Is a Palatal Expander?
A palatal expander is an orthodontic appliance that sits across the palate (the roof of the mouth). Orthodontic specialist Dr. Thomas Fredal Jr. uses palatal expansion in early (Phase 1) treatment for children, when early treatment is indicated. His aim is to address problems while a child is still developing.
In Dr. Fredal’s view, starting treatment before the timing is right is one of the biggest mistakes in orthodontics. He looks at growth, dental development, the way the jaws line up and the goals of treatment. That tells him how to treat, and also when to start. The youngest age he treats is 7.
Most Phase 1 treatments at Fredal Orthodontics combine a palatal expander with limited braces. For older teens and adults, the practice offers MARPE, an expander held in place with mini-screws.
How Dr. Fredal Decides on an Expander
For Dr. Fredal, where the teeth sit relative to the face, lips, smile, supporting bone and opposing teeth can change the decision to expand. He diagnoses every case in three dimensions with an i-CAT FLX V17 CBCT scan (a 3D X-ray) and an iTero digital scan.
Crossbite
A crossbite is when some upper teeth bite inside the lower teeth instead of outside them. Fredal Orthodontics treats crossbites. Dr. Fredal’s 3D diagnosis covers the bite and the way the upper and lower jaws relate.
Crowding
Crowding means there is not enough room for all the teeth. Fredal Orthodontics treats crowding. Crowding alone does not decide whether teeth are removed. Dr. Fredal also weighs the facial profile, lip support, front-tooth position, smile width, gum health, function and long-term stability.
Impacted Teeth
An impacted canine is an eye tooth that is blocked from coming in. Dr. Fredal uses the CBCT scan to assess the tooth, its root position and how it sits next to the other teeth. When the tooth needs surgical exposure (uncovering it), he coordinates with an oral surgeon or a periodontist (a gum specialist).
Airway & Breathing
At the consultation, Dr. Fredal uses the CBCT scan to evaluate the upper airway in three dimensions. He bases treatment decisions on the orthodontic and skeletal diagnosis. When sleep apnea is suspected or present, he decides together with the right medical providers.
Expander Types at Fredal Orthodontics
At Fredal Orthodontics, Dr. Fredal personally plans and oversees each patient’s care. The practice does not offer a quad helix expander.
| Type | What It Is | Who It Is For | Who Does What |
|---|---|---|---|
| Rapid Palatal Expander (RPE) | An expander for the upper jaw with an expansion screw. Parents turn the screw at home once per day for 28 to 42 days of active expansion, depending on the child’s age, skeletal development and treatment goals. The appliance then stays in place, passive, for at least six months while new bone fills the opened suture. | Children in Phase 1 (early) treatment. | Dr. Fredal plans and oversees it. |
| Invisalign Palatal Expander (IPE) | A removable, 3D-printed expander from Invisalign. | Dr. Fredal advises at the consultation. | Dr. Fredal plans and oversees it. |
| MARPE | An expander anchored with TADs (temporary anchorage devices), small mini-screws in the palate. MARPE stands for miniscrew-assisted rapid palatal expansion. | Older teens and adults. | Dr. Fredal plans it. For most cases, a trusted oral surgeon places the mini-screws. The surgeon may bill separately. |
| SARPE | Palatal expansion combined with surgery on the maxilla (the upper jaw). SARPE stands for surgically assisted rapid palatal expansion. | Dr. Fredal advises at the consultation. | An oral surgeon does the surgery. Fredal Orthodontics manages the orthodontic care before and after it. |
What to Expect During Expansion
Pressure & Discomfort
Most children describe a mild, gentle pressure across the roof of the mouth during activation rather than pain. This sensation is typically brief and well tolerated, and the pressure usually fades quickly as the mouth adjusts to the expander. If needed, over-the-counter acetaminophen can be used for temporary tenderness. Dr. Fredal advises following the recommended dosing instructions.
Palatal Expansion for Teens and Adults
MARPE (Miniscrew-Assisted RPE): For teens and adults who require skeletal expansion, MARPE uses temporary anchorage devices (TADs) to help transfer expansion forces more directly to the palate rather than relying solely on the teeth. The midpalatal suture is the joint that runs down the middle of the palate.
At Fredal Orthodontics, treatment is planned using 3D CBCT imaging to evaluate the palate, surrounding anatomy, and midpalatal suture. For most MARPE cases, Dr. Fredal coordinates TAD placement with a trusted oral surgeon, while Fredal Orthodontics manages the orthodontic planning, expander, activation protocol, and follow-up throughout treatment.
The dedicated MARPE and MSE expander page explains candidacy, the CBCT evaluation, and what patients can expect during treatment.
SARPE (Surgically-Assisted RPE): When the patient’s skeletal maturity or anatomy makes predictable expansion with MARPE alone less appropriate, Dr. Fredal coordinates treatment with an oral and maxillofacial surgeon. The surgical procedure assists expansion of the maxilla, while the orthodontic treatment before and after surgery is managed by Fredal Orthodontics.
The right approach is anatomy-dependent. 3D imaging and a comprehensive evaluation at the complimentary consultation help Dr. Fredal determine whether conventional expansion, MARPE, surgically assisted expansion, or another treatment approach is most appropriate for the individual patient.
The consultation is free for new patients. Patients transferring from another orthodontist pay a $250 consultation fee, credited toward treatment if they start here.
RPE Treatment for Children, Step by Step
-
1
Consult & 3D Imaging
The consultation includes a 3D CBCT scan and clinical photographs. -
2
Digital Scan
An iTero Lumina digital scan records the teeth in 3D, in place of impression material. -
3
Custom Fabrication
Fredal Orthodontics uses custom 3D-printed expanders. -
4
Placement
Once an RPE is in place, parents turn its expansion screw at home. -
5
Active Expansion
A typical case needs 28 to 42 days of turns. Dr. Fredal personally supervises the treatment. -
6
Retention Phase
Expander stays in place at least 6 months while bone fills the widened suture.
Palatal Expander Cost in Shelby Township
| Type | Price | Notes |
|---|---|---|
| Rapid palatal expander (RPE), upper | $2,980 | Phase 1 treatment with the expander only |
| Braces with MARPE (older teens and adults) | From $10,080 | Priced as one package, with $2,000 down. For most cases, a trusted oral surgeon outside the practice places the mini-screws. The surgeon may bill separately. |
For any expander, including the Invisalign Palatal Expander, you get the exact cost in writing at the consultation, based on the records review and 3D imaging.
Phase 1 and Phase 2 (comprehensive) treatment are not sold together. If your child goes on to Phase 2, $500 comes off the Phase 2 fee.
- In-house financing: 0% interest and no credit check. The down payment is $500 for Phase 1 and $2,000 for braces with MARPE.
- Monthly payments: starting as low as $179. Amounts vary with the treatment cost, the down payment and the financing terms.
- Cherry: down payments as low as $189.99. CareCredit financing is also offered.
- HSA and FSA: accepted.
- Insurance: Fredal Orthodontics is in-network with Delta Dental and files claims with other insurance providers as a courtesy.
Palatal Expander FAQ
How much does a palatal expander cost at Fredal Orthodontics?
At Fredal Orthodontics, an upper rapid palatal expander (RPE) costs $2,980, for Phase 1 treatment with the expander only. For older teens and adults, braces with MARPE are priced as one package from $10,080, with $2,000 down. You get the exact cost in writing at the consultation. In-house financing has 0% interest and no credit check.
Does my child need braces with the expander?
Usually, but not always. Most Phase 1 treatments at Fredal Orthodontics pair the palatal expander with limited braces. In some cases, Dr. Fredal recommends an expander alone as the most appropriate treatment. He bases every recommendation on your child’s individual growth pattern, bite and orthodontic needs.
What is MARPE, and is it done in the office?
MARPE (miniscrew-assisted rapid palatal expansion) is a palatal expander anchored with small mini-screws in the roof of the mouth. Fredal Orthodontics offers it for older teens and adults.
Dr. Fredal does not place the mini-screws himself. For most MARPE cases, a trusted oral surgeon places them, and Fredal Orthodontics manages the orthodontic planning, the expander, activation and follow-up. The surgeon may bill separately.
Does Fredal Orthodontics offer the Invisalign Palatal Expander?
Yes. The Invisalign Palatal Expander is a removable, 3D-printed palatal expander. In 2024, Fredal Orthodontics was selected as the first practice in Michigan to offer it.
The practice also offers the rapid palatal expander (RPE), with an expansion screw that parents turn at home. At the consultation, Dr. Fredal reviews the 3D records with you and gives his treatment recommendation.
Is there a charge for a MARPE consultation?
No. There is no charge for a consultation about MARPE or other skeletal expansion. The new-patient consultation includes a 3D CBCT scan, an iTero digital scan and clinical photographs. Dr. Fredal then gives you his recommendation and the exact cost in writing. Patients transferring from another orthodontist pay a $250 consultation fee, credited toward treatment if they start here.
Does Dr. Fredal check my child’s breathing before recommending an expander?
Yes. Airway screening is part of every comprehensive orthodontic consultation at Fredal Orthodontics. Dr. Fredal reviews the history for signs such as habitual mouth breathing, snoring and restless or disrupted sleep.
The screening does not diagnose sleep apnea. For concerning findings, he refers patients to an ENT (an ear, nose and throat doctor), typically Dr. Thottam.
Does Your Child Need an Expander?
Every new-patient consultation includes a free 3D CBCT scan. Dr. Fredal goes over the records with you. Then he tells you what he recommends, with the exact cost in writing.
*For new patients only. Patients transferring from another orthodontist: $250 consultation fee, credited toward treatment if they start here.