The day has finally arrived--it's time to remove my MARPE! In this video I take you along with me during my appointment to get the expander removed. There are some unpleasant surprises along the way...I share some learnings and advice on what to expect after having the expander removed! Full post below:
Removing the MARPE After the initial 1-2 week active expansion, the MARPE is left in for a longer period of time and acts as a retainer. In this time, the space between the now separated halves of the maxilla is filled in with new bone and solidifies. I had my MARPE in for six months before my orthodontists decided it was time to remove it. While the MARPE did not give me any discomfort or pain (in fact, I often forgot it was there!), I was still excited to get it removed and feel the roof of my mouth again. The first step of removal was to unscrew the four mini-implants that were anchoring the MARPE into my maxilla. I was given the numbing shots again so I wouldn't feel the pain of the screws coming out. There was still a lot of pressure and some discomfort. After the screws were out, my orthodontist started prying off my molar bands. They were cemented in so it took a LOT of force to tease them off my teeth. Once they were loose, the whole MARPE was remove from my mouth! It felt SO free and SPACIOUS! Especially because I have such a narrow maxilla AND a 'high'/'v-shaped' palatal vault, my tongue had never been able to comfortably fit into the roof of my mouth. Now, it had so much room! --Trigger warning for anyone prone to claustrophobia & panic attacks--- Installing the TPA I had barely started exploring my newfound freedom when my orthodontist immediately started fitting something new into my mouth - she said it was a trans-palatal wire. I hadn't looked this up at all but assumed since it was just now being introduced to me, that it wasn't that big a deal. When it was fully installed, I naturally relaxed my tongue, expecting it to rest against the roof. About halfway up, my tongue bit a thick metal bar. I noticed that this wire was actually traversing horizontally from molar to molar, completely blocking off access to the upper half of my mouth. Immediately, my body felt ice cold as my claustrophobia set in and I felt a trapping sensation all around me. I know this sounds like an overdramatic reaction, but it was really a huge surprise to me. This bar was preventing me from swallowing properly and my throat was filling up with saliva since I was leaned back in the patient's chair. I've had panic attacks before but this one was quite intense and I burst into tears and started blubbering. My orthodontist, the faculty supervisor and other student orthodontists around me started gathering over and just gawked at me as I fell into this panic. I was trying to tell them--I can't talk, I can't swallow, I can't do anything and I feel trapped. What is this thing in my mouth?! Here's a couple things that I think would have made this less traumatic. Even writing this post over a year later, I can still feel the same sensation of panic--that's saying something. 1) They should have told me before the appointment what exactly a TPA is, feels like, and when it would be installed. 2) Heads up on changes I could expect following the installation 3) How long they typically leave this in Once I had calmed down, the faculty doctor stayed to answer some of the questions I had. My first one was -- how long are you leaving this in? He said ideally for the rest of the treatment, or at a minimum 6-8months. My anxiety climbed. I asked, how long does it take for people to adjust to this and feel normal? He said about two weeks. I asked, are there ANY other options we can consider since I'm having such an intense reaction to it. They said not really. I asked, what happens if we just take it out? He said, there's a risk that we lose some of the width achieved with the MARPE. I told them -- I've been incredibly strong so far and didn't even flinch when they drove 12mm screws into my skull. I said I would give it two weeks to adjust but if it didn't work out we needed to have a plan B. I left in a shock that day. I wasn't able to swallow, chew, talk, or breathe normally because of this device that was inhibiting a basic human reflex (tongue to roof). I felt miserable but decided to do my own research (yet again) to find something that worked for me. I found a couple options with very little effort. 1) Get a custom TPA built using a longer wire that could contour to the shape of my palate 2) Get a removable TPA built that I could wear at night and take out during the day I scheduled a follow up appointment for a week later. During this week, I basically stopped talking because my tongue was so bruised and swollen from hitting the wire constantly. I actually had painful sores. I also lost about 10 pounds in two weeks just because I could barely eat or drink. At my follow up appointment I talked to my orthodontist about the two options. She said the removable TPA would not work as having it out for so long each day created a risk of losing width. She said we could go the custom TPA route but it would take a week to prepare, which I was more than fine with. So they took out the TPA and took a mold of my palate to send to the lab. Installing the custom TPA I returned the following week to have the custom TPA installed. After a few minutes of work, my orthodontist asked how it felt. I asked, how what felt? The new custom-contoured TPA fit my palate SO well that I actually could not feel it at all. I wanted to make sure that the functionality of this TPA was the same and they confirmed it was. I was so incredibly happy and relieved by this. At the same time, I was pretty angry. If this TPA was just as effective but so much more ergonomic and comfortable, why wouldn't they use this in the first place? Was it because of the tiny bit of extra work involved? The biggest takeaway here is that you should NEVER stop being proactive about your treatment. Any time something feels wrong or off, it's your responsibility to speak up. You are not a trained professional and can't tell them if something is the right approach or not, but you can tell them if it doesn't work for you. Ask all the questions you want to. It's your body, and your right to know what's going on.
6 Comments
Victor Gama Sabbithi
11/13/2017 08:01:38 am
Did you have two different orthodontists? Or maybe I misread. You started off my saying “he and then she”
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J
1/15/2018 01:19:51 am
She had it done at a university with orthodontic students and a faculty superviser
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Jenny Lewis
12/8/2017 10:38:06 am
Hi Divya! Thank you for doing this blog!! I just got my TAD supported RPE (sounds/looks like the same thing as your MARPE??) 4 days ago and I have been really curious about others' experiences with this. Do you remember how long it took for the roof of your mouth to stop hurting? I feel no pain when I turn the screw (just pressure), but I find that I still have to take Tylenol/Advil for the pain on the roof of my mouth. I'm wondering if that eventually goes away?? I don't want to have to keep taking pain killers because I'm worried about my liver lol..
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Divya
1/15/2018 06:56:42 am
Hi Jenny! The pain does subside pretty quickly once you stop turning. For me, I turned it for maybe five days total (a whole week less than anticipated), and my roof hurt on the fourth night which indicated to me the split happened. I did stick to Tylenol for the pain but just needed to take it once or twice.
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S
7/15/2020 02:14:48 pm
Came to see if they applied any anesthetic before removing the TADs (screws). Stayed because I recognized half the people walking around behind you at the beginning of the video, then realized, "That's my dental school!"
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Peachy
4/22/2021 04:14:11 pm
Thank you so much for this blog (albeit several years later, ha!). I had my Marpe installed today without much explanation of what to expect etc. My tongue and throat went number because of the local anesthetic and I almost had a panic attack in the chair since I did not know when or how to swallow. It was a bit traumatic fir be and I had to pause , sit up and take a moment to train my self how to swallow and breathe. I am reading this blog so carefully because this is the lost information I’ve come across! Thank you !
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