DOMEzero™ palatal expansion in Kurri Kurri
A custom expander, anchored in bone, gently widens a narrow upper jaw while clear aligners straighten your teeth at the same time. Planned and placed here in Kurri Kurri by Dr David Ward, one of Australia's first DOMEzero providers.
- For adults 18+
- Anchored in bone, not teeth
- In the chair, under local anaesthetic
- Clear aligners at the same time
- Happy Gas (nitrous oxide) available if needed
Is DOMEzero right for you?
DOMEzero is designed for adults. It may be worth exploring if you have:
- A narrow or high-arched palate, crowding or a crossbite, even if your bite otherwise looks normal
- A wish to avoid removing teeth to make space, where widening is appropriate
It may not be the right first step if
- Your blockage comes mainly from soft tissue, such as enlarged turbinates, adenoids or allergies. An ENT surgeon may need to treat this first or alongside expansion.
- You have central sleep apnoea, which expansion does not treat.
- Your 3D scan shows the seam in your palate has fully fused. Surgically assisted expansion is then more predictable.
- You have significant facial asymmetry, which needs a surgical opinion first.
The roof of your mouth is the floor of your nose
Your upper jaw has a natural seam running down the middle, called the mid-palatal suture. In many adults the upper jaw is narrow and high-arched, which can crowd the teeth and narrow the floor of the nose above it.
DOMEzero slowly and gently opens this seam, and your body fills the space with new bone. The upper jaw becomes broader and the palate becomes dome-shaped. Because the palate is also the floor of the nose, widening it may create more room for air to flow.
Narrow. A narrow, high-arched upper jaw with crowded teeth
Widened. The same jaw widened along its seam, with a broad, dome-shaped palate
How DOMEzero works, step by step
Explore an interactive model of the upper jaw. Rotate it, step through treatment, and look beneath the gum to see the bone.
Anchors
Small titanium mini-implants are placed in the roof of the mouth, positioned with a custom guide from your 3D plan.
Expander
A custom expander is fitted onto the anchors. It is held by bone, not by your teeth.
Aligners
Clear aligners go on to guide your teeth through treatment.
Widen
Small, gradual turns widen the jaw along its natural seam while new bone fills in. The aligners keep your teeth in step.
Remove
Once the new bone has matured and the aligners have finished, the expander and anchors come out. Retainers are then worn at night, for good.
Interactive illustration. Loads about 1 MB.
Illustration only: a simplified model, not a real patient. Results vary.
How DOMEzero compares
There is more than one way to widen an upper jaw. Here is how the main approaches differ.
Traditional expander
- Held by
- Your teeth
- Where widening happens
- Partly the jaw, partly tipping the teeth
- Setting
- Dental chair
- Front-tooth gap
- Often large
- Teeth straightened
- Afterwards
Offered at Happy Tooth
DOMEzero
- Held by
- Bone, via mini-implants
- Where widening happens
- Mainly the jaw
- Setting
- Dental chair, local anaesthetic
- Front-tooth gap
- Kept small with aligners
- Teeth straightened
- At the same time
Surgical expansion (SARPE)
- Held by
- Your teeth, after a surgical cut
- Where widening happens
- Mainly the jaw
- Setting
- Hospital, general anaesthetic
- Front-tooth gap
- Often large
- Teeth straightened
- Afterwards
Your DOMEzero journey
Treatment runs over several months. We give you a personalised timeline and a written quote at your consultation, before anything begins.
Assess and plan
Consultation and screening
We discuss your breathing, sleep and smile goals, examine your bite and palate, and use short questionnaires on nasal breathing and daytime sleepiness. We may recommend a sleep study or an ENT review.
3D records
A CBCT (3D x-ray) shows the seam in your palate, your bone and your tooth roots. A digital scan of your teeth replaces messy moulds.
Digital planning
Dr Ward plans the mini-implant positions digitally, and a surgical guide is printed for you.
Expand
Mini-implant placement
In the chair, under local anaesthetic.
Expander fitted
A few weeks later your custom expander is attached to the mini-implants. Clear aligners start once expansion is confirmed.
Gradual expansion
You turn the expander at home on a slow schedule, and we monitor progress closely with check-ins and x-rays.
Retain
Bone matures
Once your jaw reaches its planned width, the expander stays in place while the new bone matures and your aligners finish.
Removal and review
The expander and mini-implants are removed (the gum heals in about a week) and final records are taken. You then wear retainers at night, indefinitely. Like all orthodontic treatment, retention is lifelong.
What to expect
Most people manage DOMEzero with simple pain relief. We explain everything that applies to you before you decide.
Common and usually short-lived
- Pressure or soreness in the palate, teeth, nose or between the eyes for a few days after turning starts
- A slight lisp and extra saliva while you get used to the expander
- A small temporary space between the front teeth, a sign the jaw is widening
- Occasionally a minor nosebleed or tingling around the nose
Less common risks
- Gum inflammation around the mini-implants, reduced with careful cleaning
- A mini-implant loosening and needing to be replaced
- Temporary numbness of the upper lip or nose
- Changes to the nerve supply of the front teeth
- Gum recession or thinning of the bone on the cheek side of the back teeth
- In some adults the seam does not open with the expander alone, and a minor surgical release may be needed
What the research says
Published studies by the developers of DOME, including groups of adult patients followed with sleep studies, have reported improvements in nasal airflow, nasal obstruction scores, daytime sleepiness and sleep apnoea measures for many patients after expansion. The research is promising but still growing, and individual results vary.
DOMEzero is not a guaranteed cure for snoring or sleep apnoea. Where your GP, sleep physician or ENT surgeon is involved in your care, we work alongside them.
DOMEzero was developed by Dr Stanley Liu, a sleep surgeon formerly of Stanford University, with orthodontist Dr Claudia Pinter and dentist Dr Gary Adams.
Costs and getting started
A written quote first
Your treatment fee depends on your plan. You receive a written quote at your consultation, before anything begins.
Health funds
If you have orthodontic extras cover, your health fund may contribute. Learn more about health funds
Payment plans
Spread the cost with Zip, Afterpay or Denticare, subject to eligibility. Learn more about payment plans
The first step
DOMEzero Consultation
$600
An extended appointment where Dr Ward assesses your bite, palate and breathing, explains whether DOMEzero suits you, and outlines costs before anything goes ahead.
Dr David Ward
Dr Ward is a general dentist (Bachelor of Dental Science, Charles Sturt University, 2014) with substantial experience in airway-focused orthodontics. He is one of the first DOMEzero providers in Australia and one of the most experienced.
- Planning, placement, adjustments and reviews all happen at our Kurri Kurri practice
- 3D CBCT imaging, digital scanning and guided mini-implant placement
- Our oral health therapist supports myofunctional care to help your result last
- We work alongside your GP, sleep physician or ENT surgeon
DOMEzero questions
Start with a DOMEzero Consultation
An extended appointment where Dr Ward assesses your bite, palate and breathing, explains whether DOMEzero suits you, and outlines costs before anything goes ahead.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. Individual results vary.
