Expansion: The Earlier the Better 1

Expansion: The Earlier the Better

Why should expansion start as soon as it’s needed?

Expansion is done when a patient has breathing issues or narrow arches or both. Narrow arches can be treated and resolved at any age with general orthodontics, however breathing issues become much harder to treat with age. When a patient has breathing issues it is most likely related to a narrow airway. The airway size is determined by the width the of the roof of your mouth (upper palate) which is a bone with a suture down the middle. This suture/seam in the bone begins to fuse and harden during puberty making it a much more difficult process to treat breathing disorders in older patients. Expanding early means a retainer must be worn in order to maintain the space created. The retainer must be worn for 4-6 months until the teeth on each side of the two upper front teeth grow in. This means the patient will be wearing a retainer at night for longer than if we had waited to start expansion but it’s important that the breathing issues are addressed now. The patient will also have a wide “grown up, adult” smile that they will grow into as their permanent teeth erupt. Breathing issues can have a big effect a child’s development and overall quality of life so it’s important to help them breath better as early as

Before Expansion                                                                                            After Expansion

Expansion: The Earlier the Better 2Expansion: The Earlier the Better 3

The Invisalign Team! 4

The Invisalign Team!

“It takes a village”!
The Invisalign Team! 5

Most people don’t know how Invisalign is manufactured. It is NOT “done by the computer”. Dr. Jasmine Gorton recently met with our dedicated team of doctors and technicians in Costa Rica who work very hard to help provide our patients with the esthetic and functional excellence that Marin Ortho is known for. The Costa Rica team creates the aligners according to our Doctor’s specifications and is in constant communication with us so we can create the best outcome. Our hands on approach means that it can take longer for a case to be ready and we feel this extra effort is worth it.




What is it? What makes it different from a traditional expander?

As an orthodontic office that focuses on airway health, we are always looking for the most updated methods to better serve our patients. One of these advancements that has been proven effective in many journal articles is MARPE, or Mini-implant Assisted Rapid Palatal Expansion.


MARPE is a type of palatal expander that uses mini-implants, or mini anchors, to expand the upper jaw. The mini-implants are placed in the roof of the mouth using local anesthesia, a procedure that we do in our office. They are connected to a palatal expander that is used to widen the upper jaw by turning it at home. The process of expansion occurs at the suture, which is the “joint” where the right and left bones of the upper jaw meet.


How is MARPE different from traditional RPE? MARPE 8


Traditional RPE also widens the upper jaw by turning at home, but it is done using an expander that is connected to the teeth. RPE is most ideal for young children (5-9 years old). It can be used predictably anytime before puberty, however the amount of expansion at the suture can be limited in the older children.

MARPE, on the other hand, is connected directly to the roof of the mouth with four mini-implants. This allows for greater bone expansion at the suture, which can be beneficial for patients with airway concerns such as sleep apnea / sleep disordered breathing and difficulty nasal breathing / mouth breathing.


Night Guards 9

Night Guards

Night Guards

What You Should Know Before Buying

Night guards are widely recommended whether it’s for grinding, clenching, TMJ, etc. However the wrong one can actually cause damage when it should be preventing it!

As with all over the counter products it’s a good idea to be careful because night guards are often soft and your body can mistake them for food. After squeezing down on them like chewing every night, you can drive your back teeth apart, making it impossible to chew your actual food!

This change in the position of your back teeth can happen relatively quickly (a few months) or slowly over time (a few years) depending on how hard you are clenching your teeth together.

*Drs Jasmine Gorton, Diana Schron & Bill Schmohl at Marin Ortho recommend that you consult with a licensed dental professional prior to trying any treatments on your own! Yes, we can fix these issues for you if they arise, but it is more efficient to avoid them in the first place.

The patient below came to us when they realized they couldn’t bite down fully on their back teeth. They had started wearing a night guard and slowly it had shifted their teeth up making it difficult to chew properly.

                         Before Treatment                                                               After Treatment

Night Guards 10

Night Guards 11

Early Expansion 12

Early Expansion

Early Expansion 13Early expansion for children is only done for a few reasons; airway concerns, narrow bone structure, severe crowding of the teeth or dental crossbite. Airway concerns are best addressed when a person is still young as the bones are mailable and the process is much easier and more comfortable than when a person has gone through puberty. A narrow airway can have adverse health effects like trouble breathing and poor sleep. Narrow bone structure can make future orthodontics more challenging and can impact the final outcome. If the upper jaw is too narrow to the point where the teeth need to be tipped in order to correctly fit over the bottom teeth it can leave the teeth in a more vulnerable position. Severe crowding can be uncomfortable for the patient and impact the functionality of the teeth. It can also effect the over hygiene of the mouth as it can create food traps and make brushing, flossing and overall maintenance harder. Crowding also makes it hard for new teeth to erupt properly, increasing the chance of an ectopic eruption. An ectopic eruption is when a tooth erupts improperly either from the upper gums, or palatially through the roof of the mouth. Dental crossbite is when instead of the upper arch is slightly wider than the lower arch allowing the teeth to fit nicely over the bottom teeth the upper arch is narrow and the upper teeth fit inside the lower arch. This can cause problems with the bite and functionality.

Airway concerns and narrow bones structure require skeletal metal expansion (MARPE) which will widen the upper palatal bone to create more room for the tongue, teeth and airway. Severe crowding and dental crossbite can be treated with with dental expansion, Invisalign or braces. If a patient doesn’t have any of the above issues, we plan for dental expansion as a part of full treatment once all the teeth come in.

Invisalign for early expansion 14

Invisalign for early expansion

Marin Ortho orthodontic patients (including Dr. Gorton’s son Kai) were among the first worldwide to be treated with Invisalign for early expansion. We have found this technique to be effective, also more patient-friendly and hygienic than traditional expanders.

The demand for esthetic, comfortable orthodontic treatment appears to be on the rise across all age groups. Not surprisingly, parents’ perceptions of the types of appliances that are acceptable for their children
closely mirror their standards of esthetics for themselves. According to a survey by Rosvall and colleagues, clear aligners and lingual appliances are generally preferred, followed in order by ceramic appliances, ceramic selfligating appliances, and self-ligating stainless steel (including hybrid).

The same study found that esthetic appliances were acceptable to more than 90% of adults, while traditional stainless steel and metal self-ligating brackets were acceptable to only 55% and 58%, respectively.

Click the link below to see the full published article:

Phase 1 Invisalign Expansion

Should My Teenager Bring Their Retainer to Camp? 15

Should My Teenager Bring Their Retainer to Camp?

As we get further into summer, many patients have questions about traveling with their retainer. The most important thing is to always bring your retainer with you. 

A retainer ensures that your teeth stay in the position that your orthodontist left them. As time goes on, your teeth will try to move back into their original pre-treatment position. The longer you don’t wear the retainer, the more your teeth will move. It can take as little as two weeks without wearing your retainer for your teeth to shift enough to the point where they will no longer fit!

Life happens and a retainer can break or get lost. This is why we now provide patients with two sets of retainers (two upper arch & two lower arch). If anything happens to one retainer you can easily switch to your back up. If both sets of retainers get lost/destroyed ect. patients are always welcome to come back and get a new replacement retainer. A replacement retainer costs $410 per arch ($820 for a SET of upper and lower)

Should My Teenager Bring Their Retainer to Camp? 16

jasmine gorton sharing invisalign cases

Dr Jasmine Gorton joined Dr Drew Ferris in sharing Invisalign cases

Dr Jasmine Gorton was asked to join Dr Drew Ferris in sharing Invisalign cases with the west coast Schulman Group members. Her slides showed our treatment plans + results for young children with sleep apnea symptoms (age 7) with a combination of a Palatal Expander and Invisalign and young children (age 7) without apnea treated with Invisalign Only Expansion. She also presented a unique approach to non-invasive Invisalign treatment of adults with strong lower jaws who would traditionally be treated with jaw surgery and braces.

It's Women's History Month! 17

It’s Women’s History Month!

Happy Women’s History Month from Marin Ortho!

It's Women's History Month! 18

Future Women: What do you want to be when you grow up? Doctor? Business owner? Swimmer? Runner? Mom? All of those? None of the above? You do you 😊

Marin Ortho is a woman-owned and run business! Both Dr. Jasmine Gorton and Dr. Sona Bekmezian are UCSF-trained orthodontists and share the same philosophies in achieving your gorgeous, healthy smile.

NEW! Invisalign Stickables 19

NEW! Invisalign Stickables

New Invisalign Stickables!

Hi Marin Ortho Friends, Family, and New Patients! We are now offering Invisalign’s new product for Phase 1 and Teen patients called Invisalign Stickables. The stickers are a fun new way to accessorize your clear aligners and are easy to use. They are offered in a wide variety of shapes, colors, patterns, emojis, and more! Even better, they are made of a durable waterproof material so they adhere to the aligners.

How it Works

With your dry, clear aligner simply place the stickers where desired and peel off the clear film. The next step is to smile big! That’s it!

NEW! Invisalign Stickables 20

Ask a doctor or an assistant for Invisalign stickables at your next appointment!