The typical rate of activation is one (1) per day. Each RPE requires four (4) activations per 1mm. It is Not uncommon to double up with one turn in the morning and one in the evening. Going too fast may damage periodontal membrane or roots of the teeth. Going too slow may result in producing more dentoalveolar change and less sutural split than normally desired. This appliance should be cleaned every day with toothpaste and a soft toothbrush, morning and night. Encourage the patient to give sufficient time to clean thoroughly around the appliance, gums, teeth, and bands to maintain proper hygiene and prevent inflammation. 3 minutes is recommended.