Crossbite: types, problems and treatments

Crossbite is one of the most common types of dental malocclusion. It can not only cause physical changes, but can also lead to problems with chewing, the gums and bruxism.

In this article we will explain what crossbite is, the different types, causes and problems, as well as possible treatments to correct it in adults and children.

What is crossbite?

Before we start getting into the subject, it is important to clarify what crossbite is in order to avoid confusion with other types of malocclusion. Crossbite, also known as reverse bite, is a type of malocclusion that occurs when the teeth of the upper arch overlap with the teeth of the lower arch. In a correct bite, the teeth of the upper arch bite slightly outside those of the lower arch. Therefore, when the opposite occurs we refer to it as a case of crossbite. A crossbite can affect a single tooth, several teeth or all of them.

Different types of crossbite

There are different types of crossbite, depending on the part of the mouth where the occlusion problem occurs or where the malocclusion originates from. Below we will look at the different types of crossbite malocclusion that exist:

Types of crossbite according to where it occurs

The first way that different types of crossbite can be classified is according to the part of the mouth in which the malocclusion is located. According to this classification it can be: an anterior crossbite, posterior crossbite, unilateral or bilateral.

Anterior crossbite

The first type of crossbite according to where the malocclusion occurs is anterior crossbite. This type of crossbite affects the area around the incisors (i.e. the front of the mouth) and is therefore the most visible.

Posterior crossbite

Posterior crossbite is a malocclusion that affects the teeth at the back of the oral cavity (i.e. the premolars and molars). This type of crossbite is less visible than an anterior crossbite, as it occurs in the teeth at the back of the dental arch.

Unilateral crossbite

In cases where the malocclusion affects only one side of the mouth, either the right or the left, we are talking about a unilateral crossbite. This type of crossbite can cause asymmetries in the face, as the jaw is deviated towards the side of the crossbite.

Bilateral crossbite

A bilateral crossbite is one that occurs on both sides of the mouth. In other words, the teeth of the upper arch are located inside the teeth of the lower arch on both sides.

Types of crossbite according to origin

After discussing the different types of crossbite according to where the malocclusion occurs, we will now look at the different types of crossbite depending on the origin of this malocclusion.

Skeletal crossbite

In instances where the crossbite is caused by a bone development problem, these are referred to as skeletal crossbite. In these cases, the upper jaw has not developed correctly and is therefore smaller than the lower jaw, allowing the upper teeth to remain inside the lower teeth.

Dental crossbite

There are some cases of crossbite in which the origin of the malocclusion is not underdevelopment of the jaw, but rather malposition of the teeth. These cases, where the crossbite is caused by dental malposition, are called dental crossbites.

Mixed crossbite

Finally, there is a third type of crossbite according to origin, in which neither the bones have developed correctly nor the teeth have erupted optimally. The origin of the malocclusion is therefore mixed.

What causes a crossbite?

The causes of crossbite can vary, although in most cases they can be classified into two main groups: acquired habits or genetic factors.

• Among the genetic causes of crossbite, the most common are maxillary hypoplasia and mandibular hyperplasia. In these cases, an assessment should be carried out on family members to find out the origin.

• On the other hand, bad habits, such as mouth breathing, thumb sucking or incorrect tongue placement, are also possible causes of crossbite, as they affect bone and dental development.

Crossbite consequences: physical or functional problems

Crossbites can have various consequences that can lead to physical or functional problems in people who suffer from them. Among the most common problems that can be caused by crossbite are the following:

• Tooth wear and, if left untreated, one of the problems caused by crossbite can be tooth loss.

• Functional difficulties, such as problems with phonation or chewing, which can lead to digestive issues.

• Problems in the temporomandibular joint (TMJ), which can cause bruxism or jaw, head or neck pain.

Treatments: how to fix a crossbite?

As previously explained, crossbites can cause problems in the daily lives of those who suffer from them. That’s why it is important to diagnose it in time so that crossbite correction can happen as soon as possible to avoid any negative consequences.

We will now discuss the different types of treatment for how to fix a crossbite.

Treatment for crossbite correction in children: interceptive orthodontics

The most opportune time for successful treatment to modify bone growth, correct crossbite in children and avoid problems in adulthood is between the ages of 6 and 12.

Interceptive orthodontics is the most suitable treatment for crossbite in children. At this stage, when the bones are much more malleable, treatment with interceptive orthodontics makes it possible to fix the crossbite. Expanders are the most common orthodontic device for these cases. They allow the size of the maxillary bone to be modified and the palate to be widened.

This type of treatment for crossbite is only effective in children, as once the bones are fully developed, we cannot intervene or modify their growth.

How to correct crossbite in adults?

Crossbite correction in adults is more complicated than in children, as the bones have finished growing and are fully developed.

The first step in correcting a crossbite in adults is to see a dentist, who will examine the case and determine the best treatment. There are two ways to correct crossbite in adults: orthodontics or surgery.

Crossbite correction surgery in adults

There are cases of severe crossbite in adults or those with a skeletal origin that require surgery to correct them. On these occasions, when there is a large mandibular deviation or a very narrow palate, surgery is the only effective treatment to correct the crossbite, as the person's development is complete and it would, therefore, be impossible to amend the position of the bones with orthodontics.

Crossbite surgery corrects the size and position of the jaw bones to balance the aesthetics of the face and improve the functionality of the mouth. In most cases, crossbite correction surgery is complemented with a second phase of orthodontics to fix the dental malposition and achieve an aligned smile.

Braces or invisible orthodontics: crossbite correction in adults without surgery

For cases of crossbite in adults with dental origin, orthodontics, whether fixed like braces or using clear aligners, can be an effective treatment for correction without surgery. These devices allow the malocclusion to be modified and the crossbite to be fixed.

Impress treatments for cases of crossbite

At Impress we can help to treat crossbite problems with orthodontics, whether in children, adolescents or adults.

For children, we analyse the case and design a personalised Impress Kids treatment plan to correct crossbite in the youngest members of the family.

If the case to be treated is of dental origin in adolescents or adults, we have various orthodontic solutions available. Treatments with Impress clear aligners are suitable for fixing cases of crossbite efficiently and discreetly.

If you would like us to examine your case and propose the best solution for you, our team of experts is at hand to help you achieve good oral health and perfect occlusion.

Get in touch with your nearest Impress clinic and book an appointment online, by phone at +44 20 3808 1072, or via WhatsApp.