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What is a Crossbite?

Two children brushing their teeth

You want your children to have the best opportunity to reach their full growth potential with the most robust health. But a crossbite condition could potentially interfere and cause problems. What can you do to help your children avoid this? Here’s what you should know about crossbites, and why early treatment plays a key role.

Closeup of a child's mouth with a crossbite

What is a crossbite?

When your child’s teeth are properly aligned, their upper teeth will form a wider arch than their lower teeth. If they can close their jaw and feel an upper tooth (or teeth) fitting inside the lower teeth, that’s a misalignment known as a crossbite. A crossbite can occur in the front or the back of the mouth, and it might involve a single tooth or groups of teeth.

What causes a crossbite?

Various conditions can result in a crossbite:

Is a crossbite the same as an underbite?

A crossbite can occur in different parts of the mouth, and can involve as few as two teeth. In contrast, an underbite occurs when the lower jaw has actually grown in front of the upper jaw and the lower teeth line up in front of the top teeth. The upper teeth should be in front.

What’s the basic difference between correcting these two conditions?

“First, it’s important to remember that overbites are more common than underbites,” explains Dr. Gio. “But in the case of an underbite, the first phase of correction—depending on the patient’s age and stage of growth—might primarily involve dealing with a child’s jaws more than the teeth. In a young child, we can use the teeth to help ‘grow’ the jaws. When a patient has a narrow palate (the upper jaw), we can apply gentle, gradual pressure on the teeth to widen the palate. This happens in about 80% of cases. In rare cases, the lower jaw may be too far forward and then must be corrected with surgery.“

Why is it important to correct a crossbite?

Crossbites can change how a child’s jaws (and ultimately their face) develop. In adults, crossbites can increase the likelihood of future dental problems, including attrition and wear on teeth; receding gums; early loss of bone around the teeth; and earlier and easier formation of cavities and decay due to exposed tooth roots. When the teeth aren’t meeting at the correct angles, the excess force breaks down the teeth and their surrounding tissue, leading to early tooth loss.

How do dentists and orthodontists treat crossbites?

“Correcting a crossbite most frequently involves using some form of orthodontics to move the teeth into proper alignment. This can be with a Myobrace, palate expanders, traditional braces, or Invisalign. Whether the patient is a child or an adult, every situation is different, and we customize each treatment plan for each individual patient,” Dr. Gio says.

When is the best time to begin treatment?

The best time to correct a crossbite is as early as possible, ideally during a child’s growth period. Starting before age 8 is hugely advantageous, because by age 8, 80% of a child’s head and face have grown. But even adults can benefit from correction! You should not hesitate to consult a dentist if you believe you have a crossbite.

What is the best advice for pain-free patients who might be reluctant to begin treatment?

Dr. Gio explains, “Some patients have compensated for their crossbites, and might never experience other dental issues. Perhaps they don’t have any pain, or their crossbite isn’t visible. Maybe it only involves a couple of teeth. Even in these cases, the risk of future complications is always higher. If such issues occur, they often result in more pain and higher treatment costs that early correction could have helped them avoid. We always advise patients to consider these risks very carefully.”