Crossbite Teeth: Treating an Uneven Jaw with Surgery or Braces

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A crossbite is a kind of dental misalignment where the upper and lower teeth don’t connect in the correct position when you bite. Dentists can usually spot a crossbite at an early age. They are likely to recommend fixing it because if left untreated, this condition can result in an uneven jaw and numerous oral health problems.

There are various crossbite treatments available, including elastics, braces and surgery. The recommended treatment for you will depend on whether you have a posterior or anterior crossbite, and how severe it is. 

crossbite braces
Braces are one possible treatment for crossbite

Keep reading to find out more:

  • What is a crossbite?
  • All the different types of crossbite
  • Crossbite correction
  • What happens if you don’t fix a crossbite
  • How it’s treated at different ages
  • How much does jaw realignment surgery cost in the UK?

Whenever you get told you or your child has a dental problem – crossbite or any other issue – it is a cause for concern. We hope the information in this article helps you understand this condition better and seek the right treatment.

What is a crossbite?

what is a crossbite teeth
This is just one of many misalignment problems that can occur

Put simply, a crossbite occurs when the top teeth sit on the inside of the bottom teeth or when the upper back teeth overhang the lower teeth too far. The outward appearance of a crossbite can be an uneven or asymmetrical jaw.

This condition may be a result of genetic factors, such as overcrowded teeth, or behavioural factors, such as thumb sucking. Because there are lots of different ways in which a crossbite can occur, there are also lots of different terms used to describe crossbite teeth.

Types of crossbite

There are different ways to classify this condition according to how many teeth are affected, where in the mouth they are, and what position they are in. Here is a brief overview of the different terms used to describe a crossbite:

Anterior crossbite

anterior crossbite
An anterior crossbite is also known as an underbite

An anterior crossbite, also known as an underbite, affects the front of the mouth, meaning the upper front teeth rest behind the lower front teeth. There are a few different causes, including:

  • Overcrowded teeth: When your teeth are crowded on your bottom jaw this can make them push further forward than they should be.
  • Mouth breathing as a child: Mouth breathing keeps the tongue from resting at the top of the mouth, so the tongue can’t help make the top jaw wider.
  • Thumb sucking: Sucking a thumb puts pressure on the roof of the mouth, pushing it up so that it gets narrower rather than wider.
  • Repairs to cleft lips: Cleft lip surgery can affect the development of the upper teeth.

Anterior crossbites can be quite noticeable, causing the chin to protrude or the jaw to look uneven.

Posterior crossbite

As opposed to an anterior crossbite, a posterior crossbite affects the teeth at the back of the mouth. The causes of this type of crossbite are similar to those that affect the front teeth. Another contributing factor can be milk teeth falling out late, and adult teeth appearing in the wrong order and position.

Posterior crossbites can be really simple to treat, especially if caught early.

Buccal crossbite

The buccal part of your mouth is the part next to your cheek; the outer face of the teeth. A buccal crossbite refers to teeth which are positioned too far out, towards the cheek. You might be able to tell you have a buccal crossbite if your tongue can feel the biting surface of the inner teeth with your mouth closed.

Lingual crossbite

A lingual crossbite is the opposite of a buccal one, meaning the teeth sit too far in, towards the tongue. Again, you can usually feel this type of crossbite by feeling the biting surface of your inner teeth with your tongue when you shut your mouth.

Bilateral and unilateral

A bilateral crossbite diagnosis means that both sides of your mouth are affected by the crossbite, whereas a unilateral crossbite is just on one side of your mouth. The treatment that you receive will probably look the same for these issues, but the mechanics of what your dentist does might be a little different.

Single tooth and segmental

singular anterior crossbite
A crossbite can affect a single tooth

These terms are a little bit easier to understand. A single tooth crossbite affects just one tooth. It can happen when a bottom tooth sticks forward too much (usually one of the front teeth or a canine) or when an upper tooth is pushed towards the inside of your mouth.

A segmental crossbite means that a few – but not all – of the teeth don’t line up. It will normally affect two or three teeth in a row, making them sit out towards the cheek, or inwards towards the tongue.

Type of crossbite What it means
Anterior Affects front teeth
Posterior Affects rear teeth
Buccal Teeth positioned towards cheek
Lingual Teeth positioned towards tongue
Bilateral Affects one side of the mouth
Unilateral Affects both sides of the mouth
Single tooth Affects one tooth
Segmental Affects just 2-3 teeth

Options for crossbite correction

Dentists may have many terms to define a crossbite, but the treatment options are similar in most cases. Crossbite teeth treatment is best started in childhood, when teeth and bones are much easier to move because they aren’t fused in place.

There is evidence which suggests that if crossbite braces treatment is started early, it’s up to 80% effective without other treatment being required.

Treating a crossbite with braces

A very common way to treat both posterior and anterior crossbites is with braces. An orthodontist will explain the exact treatment that you need.

palate expander
A palate expander is a common treatment

The most common type of crossbite braces use a palate expander. This is a device that works on widening the upper jaw so that the top teeth will sit properly with the lower teeth.

Palate expanders need to be adjusted regularly, and in small increments they push the teeth further apart. There is a rapid expansion method that can achieve the right results within the space of a few months.

After the palate has been expanded to the correct size, there may be further teeth straightening required. Various kinds of fixed braces can be used for this. Once all of this treatment is completed, retainers will be needed to help keep the teeth in place.

Can you fix crossbite without braces?

Not everyone likes the idea of fixed, metal braces. Fortunately, there are alternatives that can be just as effective for many cases, such as invisible aligner braces or clear braces. Do be aware that anything other than metal braces will require private treatment; the NHS only funds metal braces.

It may also possible to treat a posterior crossbite with just elastics, which you can read more about further down.

Can Invisalign fix crossbite?

For patients with mild to moderate crossbite, Invisalign clear aligner braces can be an effective treatment. This system has the benefit of being almost unnoticeable, with the added convenience of being able to remove the aligners for up to two hours a day.

In the following video, a patient named Kitty shares the start of her journey with Invisalign, treating overcrowding and crossbite:

If you’re interested in treatment with invisible braces like Invisalign, take a quick test to check whether you’re a suitable candidate. Visit Invisalign’s website for a free Smile Assessment and get your answer in minutes!

 

Alternatively you can book an appointment online with an Invisalign dentist near you to discuss your treatment options face to face.

Fixing a posterior crossbite with elastics

Crossbite teeth at the back of the mouth can sometimes be fixed with posterior crossbite elastics. This involves the orthodontist fixing a hook to the inside of the top tooth and the outside of the lower tooth, with an elastic band connecting them.

The point of this is to pull the back tooth outwards so that it will sit snugly over the lower tooth like it should. It is a pretty simple process that can take as little as three or four months.

Jaw realignment surgery

jaw realignment surgery
An uneven jaw can be quite noticeable

In more severe cases of crossbite, surgery may be needed. Having an operation can be a worrying experience, but it is a reasonably common procedure. The NHS covers jaw realignment surgery costs in the UK for children, and for some adults.

Crossbite surgery will normally be preceded by a year to eighteen months of braces, and the removal of wisdom teeth, if you have any. This is necessary since the surgery to fix your asymmetrical jaw takes place at the back of your mouth.

In jaw realignment surgery, for adults or children, the jaw is broken and repositioned. Once this is complete, the surgeon adds plates and screws to hold it in place. The cuts are all done inside your mouth so there shouldn’t be any visible scarring.

There are three stages to crossbite surgery recovery. A liquid diet will be required for the first three days. After that, it takes around six weeks for everything to heal and 12 weeks for full recovery. Crossbite braces will need to be worn for a further 4-6 months.

To help calm any nerves you or your child might have, you can ask your dentist to show you pictures of crossbites before and after surgery. Seeing these should help you understand what the crossbite treatment results will be like.

How much does crossbite surgery cost?

Crossbite is normally treated in childhood, in which case it is free on the NHS.

But there can be reasons why you make it to adulthood and still have a unilateral or bilateral crossbite. Because of the problems that are associated with not receiving crossbite correction, you may be able to still get this treatment through the NHS. It is worth speaking to your dentist about your options. If you are eligible for NHS jaw realignment surgery, the cost will be £269.30 in England (the Band 3 treatment charge). 

You may discover you are not eligible for NHS crossbite surgery as an adult, or you may prefer to be treated privately. Private jaw realignment surgery costs in the UK are based on a lot of variables.

These fees all contribute to crossbite surgery costs:

  • Surgical fees
  • Anaesthetic fees
  • Hospital fees (food, overnight stays etc.)
  • Consumables fees (implants, screws, plates etc.)
  • Orthognathic planning fees (paying the people who model your surgery)

The total cost can be anything from £2,500, and possibly much higher. Your dentist or surgeon will provide you with an accurate quotation.

What problems can a crossbite cause?

uneven jaw
It’s best to seek treatment at a young age

Crossbite teeth might not seem like a big problem aesthetically, but not getting the correct crossbite treatment can store up problems for later life. There are lots of problems associated with posterior and anterior crossbite, such as:

  • Increased risk of tooth decay
  • Gum disease
  • Excessive wear on gums and teeth
  • More chance of grinding teeth, or bruxism
  • Cheek biting when trying to eat food
  • Higher chances of headaches due to tension
  • An asymmetrical jaw

Because of the risks that come with an untreated crossbite, it is likely that NHS orthodontics will cover treatment. Find more information about what the NHS can offer here

Can you fix crossbite in adults?

It is never too late to get your teeth fixed and straightened. You may have been suffering the consequences of buccal crossbite for years and not known about it.

All of the procedures mentioned here – braces, elastics, surgery – can all be used in posterior and anterior crossbite treatment in adults too. If being treated with braces, many adults opt for clear braces or invisible aligners to make their treatment less conspicuous.

Conclusion

Crossbite is a relatively straightforward dental problem to fix, a little simpler in children than adults. Listening to your dentist talk about crossbite might seem intimidating, but if you don’t understand it’s ok to ask questions. The treatment will pretty much always require having something fitted in your mouth, whether it’s hooks for posterior crossbite elastics, braces, or metal plates during surgery.

Remember, getting crossbite braces doesn’t necessarily mean having metal brackets fixed to your teeth. Clear aligners are an effective treatment for many patients with a crossbite. To check whether you’re eligible for treatment with Invisalign invisible braces, take your free Smile Assessment now.

 

If you’d prefer an in-person consultation, find your nearest Invisalign dentist to book your first appointment.

Crossbite Teeth: Treating an Uneven Jaw with Surgery or Braces
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Sources

NHS: Orthodontics Overview. Consulted 27th May 2019

The Angle Orthodontist: Long-term Stability of Unilateral Posterior Crossbite Correction. Consulted 27th May 2019

Mayo Clinic: Jaw Surgery. Consulted 27th May 2019

Science Direct: Crossbite. Consulted 27th May 2019

 

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