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 one at an early age. They are likely to recommend fixing a crossbite 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.
Keep reading to find out more:
- What is a crossbite?
- All the different types of crossbite
- How is a crossbite corrected?
- Crossbite correction in adults and kids
- What happens if you don’t fix a crossbite
- Crossbite in kids and adults: How it's treated at different stages
- How much does jaw realignment surgery cost in the US?
Whenever you get told you or your child has a dental problem it is a cause for concern. We hope the information in this article helps you understand this condition better and seek the right treatment.
Table of contents
- 1 What is a crossbite?
- 2 Types of crossbite and classifications
- 3 Options for crossbite correction
- 4 What problems can a crossbite cause?
- 5 Conclusion
- 6 FAQs
What is a crossbite?
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 this condition can be an uneven or asymmetrical jaw.
This condition may be a result of genetic factors, such as overcrowded teeth, or behavioral 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 and classifications
There are different ways to classify this condition according to how many teeth are affected, where they are in the mouth, and what position they are in. Here is a brief overview of the different terms used to describe a crossbite:
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.
Crossbites in front teeth can be quite noticeable, causing the chin to protrude or the jaw to look uneven.
As opposed to an anterior crossbite, a posterior crossbite affects the teeth at the back of the mouth. The causes of these two types 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.
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 this if your tongue can feel the biting surface of the inner teeth with your mouth closed.
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 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, whereas a unilateral crossbite is on one side of your mouth. One of the more common diagnoses is a bilateral posterior crossbite with a functional shift. 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
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.
Options for crossbite correction
Dentists may have many terms to define this condition, 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.
How to fix 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.
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 permanent braces can be used for this. To continue to treat the crossbite after braces, retainers will be needed to help keep the teeth in place.
How to fix a crossbite without braces?
You may want to know if you need braces for a crossbite. 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 most likely require private treatment; Medicaid and CHIP will most likely only fund 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 anterior or posterior 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. This treatment may also be useful if you still have a crossbite after having braces. Crossbite treatment with Invisalign costs may be partially covered by your private insurance provider.
In the following video, a patient shares an update of her journey with Invisalign for crossbite and crooked teeth.
Another type of clear aligner that may be able to correct your crossbite is at-home clear aligners that don't require in-office dentist visits. Some people opt for these over Invisalign because they are cheaper and more convenient. However, keep in mind, that these aligners are only suitable for mild to moderate cases.
If you want to see if you're eligible for at-home clear aligners, Candid has created a super convenient and easy-to-use tool called a Smile Assessment. It lets you find out right away if you're eligible for this kind of treatment. Click the link below to get started, or read our Candid article for more information.
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 attaching 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
In more severe cases, surgery may be needed. Having an operation can be a worrying experience, but it is a reasonably common procedure. In cases where it is deemed medically necessary, Medicaid and CHIP will cover jaw realignment surgery for children, and in some states for crossbite correction in adults is covered as well.
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 a 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?
This condition is normally treated in childhood, in which case it can be covered by CHIP or Medicaid.
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 Medicaid depending on the state you live in. It is worth speaking to your dentist about your options. Most private insurance plans will also cover part of the cost, which is important because the surgery can cost anywhere from $20,000 to $40,000.
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)
What problems can a crossbite cause?
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 without treatment, if you notice a crossbite in the baby teeth of your child, you should talk to your child's dentist about treatment. It is likely that your child can qualify for free treatment on CHIP or Medicaid, and some adults will qualify on Medicaid. Our guide to Medicaid and Medicare has more information on who can qualify for Medicaid and what it will cover.
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.
Fortunately, this is a relatively straightforward dental problem to fix, and crossbite correction in children is a bit simpler to fix than adults. Listening to your dentist talk about crossbite fixes 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 that be 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. Check here to see whether at-home clear aligner braces would be a suitable treatment for you.
Does Invisalign fix crossbite?
In mild cases of crossbite, Invisalign is a good option for those who want a less conspicuous treatment.
Can you fix crossbite without braces?
You can fix this condition without braces using Invisalign or similar styles of invisible braces. Sometimes jaw surgery is required to fix severe cases, but this also may be preceded by braces.
How do you fix crossbite with braces?
Braces gradually reposition the upper and lower teeth so that they come together when you bite. If you have a mild crossbite, you may only need braces, but if your condition is more severe, jaw alignment surgery may be necessary.
What is anterior crossbite?
Anterior crossbite is when your upper front teeth sit behind your lower front teeth, caused by force from the palate. It is also known as an underbite. Anterior crossbite correction can involve braces and jaw surgery and anterior crossbite treatment in children is the same as for adults.