Phamily Orthodontics has a message for Main Line parents who quietly wonder if it’s “too late” for their own smile: it probably isn’t. Most parents know that kids should see an orthodontist by age seven, since early expansion can play a major role in healthy jaw development. What fewer people realize is that adults — including parents who finished orthodontic treatment decades ago — may also be candidates for expansion, often without surgery.

Each year, the Main Line Parent team asks readers who they love and why through a ballot that opens in December and runs through Valentine’s Day. Families don’t just vote; they share heartfelt, specific endorsements in their own words. Their stories make the annual LOVE List a sincerely trustworthy collection of referrals because every nomination reflects a real family’s real experience.

Members like Phamily Orthodontics collect endorsements year-round directly on their Main Line Parent Member Profile Page. Each endorsement counts toward the following year’s recognition. Phamily Orthodontics has now earned this recognition nine times — including the 2026, 2025, and 2024 LOVE Award for Best Orthodontist — a testament to how consistently, and how deeply, Main Line families trust this orthodontic practice.

It’s Not Just a Kids’ Treatment Anymore

If teeth have become more crowded over time, a bite feels off, a dentist has mentioned extractions, or a partner has started complaining about snoring, the width of the upper jaw could be playing a bigger role than most people think.

At Phamily Orthodontics, adult patients now make up more than 30% of the practice’s population. Many arrive looking for solutions to crowding — often after a few years without a retainer. Others come with bite concerns, TMJ discomfort, smile esthetics, or airway-related issues like mouth breathing, snoring, teeth grinding, and sleep apnea. For a meaningful number of these patients, expansion becomes part of the conversation.

But Doesn’t Adult Expansion Require Surgery?

It’s one of the most common questions the Phamily team hears and for a long time, the answer was yes.

The upper jaw develops from two halves that meet at the center of the palate. In children, that connection is still flexible, which is what makes early expansion relatively simple. In adults, the connection has fused and become much stronger, which is exactly why expansion was historically considered a surgical procedure.

Today, that’s changing. A treatment called MARPE (Miniscrew-Assisted Rapid Palatal Expansion) uses a specialized expander supported by small temporary anchors that apply force more directly to the upper jaw. For many adults who were previously told surgery was their only path to a wider smile, MARPE can create real skeletal expansion without it.

As with any orthodontic treatment, not everyone is a candidate — a comprehensive evaluation is the only way to know whether expansion makes sense for a particular patient.

“When you walk into our office, you become part of our Phamily — and that means we’re going to take the time to really understand what’s going on before we recommend anything,” says Dr. Debbie Parnes, who co-leads the practice with Dr. Courtney Rubin. “Expansion isn’t right for everyone, but for the right patient, it can completely change the conversation about what’s possible.”

Why More Adults Are Part of This Conversation Now

Many Millennials and older adults completed orthodontic treatment at a time when the options looked very different. Extraction-based treatment was commonly recommended for crowding, and expansion for adults was rarely discussed at all.

Orthodontics has evolved significantly since then. Today’s treatment planning looks beyond simply straightening teeth. It factors in facial balance, bite function, airway health, long-term stability, and periodontal health.

As a result, adults who were previously told extractions or surgery were their only options may benefit from a fresh look. Treatment is highly individualized, but today’s patients often have more choices available than they realize. Phamily Orthodontics walks through these options during a complimentary consultation.

Phamily Orthodontics offers a full range of treatment options for patients of every age, from early intervention for kids, to expansion, Invisalign, and braces for teens and adults.

What About the Gap Between My Front Teeth?

For many adults, the biggest hesitation about expansion isn’t the treatment itself. It’s the temporary gap that can form between the front teeth while the jaw widens.

Phamily Orthodontics takes a proactive approach to this. As soon as space begins to form, Invisalign aligners are introduced to begin guiding the teeth while expansion continues. This helps manage the appearance of the gap early in the process — and may shorten overall treatment time as well.

It’s a detail that matters for adults balancing professional, social, and family responsibilities, who may feel more self-conscious about visible changes than a teenager would.

Treatment Coordinated Under One Roof

Because expansion requires close monitoring, communication between patient and doctor matters. At Phamily Orthodontics, Dr. Parnes and Dr. Rubin place both the expander and the temporary anchors in-office, so treatment stays coordinated under one roof rather than being split across multiple specialists. Patients can learn more about the team on the Meet the Doctors page.

Patients also get access to a secure, HIPAA-compliant app to communicate directly with their doctors throughout the active expansion phase. This makes it possible to monitor progress and get guidance without constant office visits. For busy adults juggling work and family schedules, that combination of convenience and comprehensive care often makes the difference between starting treatment and putting it off another year.

“Phamily Orthodontics has not only changed my smile, they have changed my life! Before starting my Invisalign treatment, I was not confident in my smile — I would avoid showing my teeth in photos. From my first consultation to my final visit, Phamily was top notch. Drs. Parnes and Rubin took the time to explain each step and make sure I was comfortable throughout treatment. They even offer virtual monitoring, which reduced my time in the office and made life so easy.”

— Charles P., Main Line Parent

Curious whether expansion could help? Families can schedule a complimentary consultation online to get started.

What Patients Are Saying

Every patient’s experience is different, and results depend on diagnosis, anatomy, and treatment goals. But the feedback the Phamily team hears most often centers on comfort, confidence, and quality of life. Partners noticed less snoring, patients breathed easier, and more than one person mentioned, with a laugh, that they’ve gained “new cheekbones.”

One adult patient came to Phamily after years of being told that extractions would be necessary to address her crowding. After a comprehensive evaluation, the team used expansion to create the space she needed — without removing healthy teeth. Today, she has a broader smile, more confidence, and a result that finally aligns with what she’d been hoping for all along.

That kind of outcome is part of why families come back to Phamily again and again — sometimes for every member of the household.

“Our whole family has received treatment from Phamily Orthodontics and we could not be happier. Dr. Parnes and Dr. Rubin, along with their whole team, are smart, kind, and really take their time with patients.”

— Katie F., Main Line Parent

Could Expansion Be Part of Your Treatment Plan?

Have you been told you need extractions? Have you noticed crowding creeping back over time? Do you struggle with a narrow smile? Are you dealing with bite concerns or breathing issues? Or maybe you simply wonder whether today’s options differ from what was available years ago. If you have any of these concerns, it may be worth exploring whether expansion belongs in the conversation.

A complimentary consultation with Dr. Debbie Parnes and Dr. Courtney Rubin can help determine whether adult expansion is appropriate for a specific set of goals and anatomy. As one Main Line parent put it after relocating to the area and visiting Phamily Orthodontics for the first time:

“Dr. Rubin caught something with my son’s alignment plan that our previous orthodontist had missed and was able to fix the issue and set his smile up for perfection. I could not recommend Phamily more — from the warmth of the front desk to the expertise of the doctors, Phamily is the best orthodontist on the Main Line.”

— Chelsea F., Main Line Parent

Treatment options exist today that simply weren’t available when many adults first explored orthodontics. For many Main Line families, a single consultation has been the first step toward a better night’s sleep, a more comfortable bite, or a smile they finally feel good about.

Ready to find out more? Phamily Orthodontics walks new patients through what to expect on their first visit page, making it easy to know what to bring and what happens during a complimentary consultation.

---

Photos courtesy of Phamily Orthodontics, as seen in the Best for Families Guide.

This story supports the Main Line Parent Community. Collaborate with us.