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Malocclusion
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A crossbite is a form of dental malocclusion (misalignment). It occurs when the upper and lower teeth do not align correctly.
In a crossbite, some upper teeth sit inside the lower teeth. The misalignment can either appear at the front of the mouth or the sides of the mouth.
A crossbite is often confused with an underbite. However, the two are different malocclusions and require different treatments.
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There are two main classifications of crossbites, including:
An anterior crossbite is a lingual occlusion of the upper anterior teeth (incisors and canines) with the lower anterior teeth.
In this type of malocclusion, some or all of the upper anterior teeth are behind the lower anterior teeth. In some cases, the lower front teeth completely hide the upper front teeth.
A posterior crossbite is the opposite of an anterior crossbite. In this type of malocclusion, the top posterior teeth (upper molars) sit inside the bottom posterior teeth.
Between 8 and 16 percent of children have a posterior crossbite.
Posterior crossbites are usually due to the irregular narrowing of the palate and teeth in the upper jaw and can develop on one or both sides of the mouth.
In addition to abnormal alignment of the teeth, signs and symptoms of a crossbite include:
Without treatment, a crossbite can lead to tooth decay and gum disease.
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The cause of a crossbite can be attributed to various factors, including:
The primary cause of a crossbite is genetics. Some people are born with a larger lower jaw and smaller upper jaw.
Since narrow palates and teeth anomalies can run in the family, a crossbite may result once the teeth begin to grow in.
An orthodontist may recommend a growth modification device if this is the case. The device widens a child’s upper jaw early on to prepare for orthodontic treatment once the permanent teeth start to grow in.
Mouth breathing can alter facial growth.
Breathing through the mouth typically happens during sleep. If a child already has a small upper jaw and suffers from mouth breathing, they have a higher chance of developing a crossbite.
Over-retained teeth are baby teeth that do not fall out at the appropriate age. These baby teeth prevent the eruption of the underlying permanent teeth.
If the permanent tooth erupts and causes a crossbite, orthodontic correction may be necessary.
Sucking habits can alter jaw growth in children. These habits include:
Learn more about how to keep your kids' teeth healthy.
Common risk factors associated with untreated crossbites include:
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Crossbite correction typically involves orthodontic devices or surgical treatment. Several orthodontic appliances and procedures are available.
Clear aligners are a common orthodontic treatment for crossbites.
Invisalign is the most effective and well-known brand of clear aligners. Aligners cover the entire biting surfaces of the upper and lower teeth. This allows a tooth in a crossbite to move freely without being affected by the opposing teeth.
Braces are capable of treating most crossbite cases. If only a single tooth is in a crossbite, braces can correct it without help from additional orthodontic appliances.
If more than one tooth is in a crossbite, a dental expansion appliance or headgear may be used with braces.
An orthodontist may recommend dental expansion in combination with braces or clear aligners for severe crossbites. Rapid palate expanders (RPE) widen narrow dental arches and correct posterior crossbites.
The appliance fits over molars in the upper jaw, and a screw connects the device in the middle. To activate RPEs, you turn the screw a small amount every day.
Reverse pull headgear consists of pads that attach to the forehead and chin with a facemask frame in between.
Patients connect rubber bands from the anchorage device on the braces to the frame. Reverse pull headgear shifts the upper jaw forward. The goal is to align the teeth in the upper and lower jaws over time.
In the most severe cases, jaw (orthognathic) surgery may be recommended.
Surgery is used to treat underbites, overbites, crossbites, and advanced sleep apnea. During the procedure, an oral surgeon strategically moves the upper and lower jaws.
Jaw surgery costs anywhere between $20,000 and $50,000.
Veneers are capable of fixing mild crossbites in adults only.
If you have a stable bite and want to change the shape and color of your teeth, veneers might be an option.
However, veneers are more expensive and invasive than orthodontic treatment. Speak with your dentist or orthodontist to determine the best option.
Treatment time varies depending on age and severity of the crossbite. Crossbites that are diagnosed in childhood are typically easier to fix. This is because a child’s jaw isn’t fully developed and their bone is softer and easier to manipulate.
Orthodontic correction in adults is possible but may require more time and additional appliances.
Correcting a crossbite with metal braces typically takes between 6 months and 2 years. Very mild cases may only take up to 8 months. If you need jaw surgery, treatment will be longer, especially when you include recovery time.
The treatment cost for fixing a crossbite varies greatly, from a couple thousand dollars (braces) to $20,000 (jaw surgery).
Health insurance may help cover some expenses if the treatment is medically necessary, i.e. the bite causes problems that negatively affect your daily life.
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