Can Palatal Expansion Avoid the Need for Extractions?

Can Palatal Expansion Avoid the Need for Extractions?

8 February 2026

Palatal expansion, whether performed with RPE, MARPE, or SARPE, is a powerful orthodontic tool used to widen a narrow upper jaw. A common question from patients and parents is whether expansion can remove the need for tooth extractions. The answer is sometimes yes, but often no.

RPE, or rapid palatal expansion, is typically used in younger children whose palatal bones have not yet fused. The expander is attached to the teeth and works by opening the midpalatal suture, producing true skeletal widening of the upper jaw. In this age group, expansion is often very effective.

MARPE, or mini screw assisted rapid palatal expansion, is used in older adolescents, and adults. It uses small temporary screws placed in the palate to anchor the expander directly to bone. This allows more reliable skeletal expansion when conventional RPE would mainly tip the teeth rather than widen the upper jaw.

SARPE, or surgically assisted rapid palatal expansion, is reserved for fully grown adults (specially males) where the palate is too rigid to be expanded orthodontically alone. It combines minor surgery with an expander to achieve skeletal widening.

When palatal expansion can avoid extractions

In cases of mild to moderate crowding, palatal expansion can often create enough space to align the teeth. This applies when the bite is otherwise favourable and the teeth are not protruded. By widening a narrow upper jaw, expansion increases arch width and perimeter, allowing the teeth to align without removing any.

Expansion works best when it corrects a true skeletal narrowness rather than trying to compensate for excessive tooth size or forward tooth position.

When expansion alone is not enough

Expansion has clear limits. When crowding is severe, or when moderate crowding exists alongside protruded teeth or an increased overjet, expansion alone cannot solve the problem. Widening the arch does not create enough space to both align the teeth and correct the bite properly.

Pushing teeth forward or outward to avoid extractions often compromises facial balance, long term stability, and the health of the teeth and gums.

Why expansion and extractions are sometimes combined

Some patients present with both a narrow palate and severe crowding. In these cases, the most predictable approach combines skeletal expansion and selective extractions. Expansion, often with MARPE, corrects the transverse jaw deficiency. Extractions then provide the additional space needed to align the teeth properly and finish the bite well.

Each treatment component addresses a different problem. Expansion corrects jaw width. Extractions manage tooth volume.

Orthodontics is not one size fits all

It is a common mistake to assume that palatal expansion can fix every crowding case. Orthodontic diagnosis is nuanced. Tooth position, jaw relationships, facial balance, bite function, and long term stability all matter.

The goal is not simply straight teeth. The goal is a healthy, functional, and stable result. Sometimes expansion alone achieves that. Sometimes extractions are necessary. In other cases, the best outcome comes from a carefully planned combination of both.

A thorough clinical assessment determines the right approach for each individual patient.