- ALF (Alternative Light-wire Functional): a very light wire appliance that exerts a subtle force over time, attracting the tongue to the roof of the mouth, and encouraging a stable swallow pattern. The ALF is adjusted both by the action of the tongue during the swallow, as well as by the dentist every 3-6 weeks.
- RPE (Rapid Palatal Expander): a rigid semi-customized appliance frequently bonded to a right and left molar, with hardware in the palate space, often blocking the tongue. These are expanded by the patient or parent weekly using screw-turns or occasionally directly by the dentist.
- MSE (Maxillary Skeletal Expander): similar to RPE, the hardware is bonded to molars and activated in a similar way, but the MSE also requires implants to be screwed into the patient’s hard palate (and sometimes the hard palate itself is surgically punctured to speed up the process)
How can a palate be expanded?
There are three main options for expanding a palate: