Crossbite: types, causes, and treatments

13 July · 6 minutes

A crossbite is one of the most prevalent forms of dental misalignment (malocclusion) in the United States. Not only does it bring about physical alterations, but it can also give rise to complications involving chewing, gum health, and teeth grinding (bruxism). Within this article, we will delve into the definition of crossbite, its various types, what causes it, associated issues, and potential treatment options to fix it for both adults and children.

What is a crossbite?

To ensure clarity and prevent any misunderstandings, let us begin by providing a concise explanation of what a crossbite is and its meaning, differentiating it from other forms of malocclusion. Dental crossbite, alternatively referred to as reverse bite, denotes a specific kind of misalignment wherein the teeth in the upper arch overlap the teeth in the lower arch. In a proper bite, the teeth in the upper arch should slightly extend beyond those in the lower arch. Therefore, when the opposite occurs, it means there is a crossbite. This condition can impact a solitary tooth, multiple teeth, or even involve all of the teeth in the dental arch.

The different types of crossbites

There are a few different types of crossbites, distinguished by the specific location within the oral cavity where the occlusion issue arises or the origin of the malocclusion. Let us now explore the different classifications of crossbite malocclusion:

Types of crossbites based on the location in the mouth

The type of crossbite can be categorized based on the specific region of the mouth where the malocclusion is observed. This classification encompasses the following types: anterior crossbite, posterior crossbite, unilateral crossbite, and bilateral crossbite.

Anterior crossbite

The first type or classification of crossbite teeth based on its location refers to the anterior crossbite. This particular type of crossbite affects the region near the incisors, which corresponds to the front of the mouth. Due to its positioning, the anterior crossbite tends to be the most noticeable and visible form of crossbite.

Posterior crossbite

Another type of crossbite is the posterior crossbite, which entails the teeth located at the rear of the oral cavity, specifically the premolars and molars. Unlike the anterior crossbite, the posterior crossbite is less apparent since it occurs in the teeth positioned toward the back of the dental arch.

Unilateral crossbite

When the malocclusion impacts solely one side of the mouth, either the right or the left, it is identified as a unilateral crossbite. This particular type of crossbite has the potential to induce facial asymmetry as the jaw deviates toward the side affected by the crossbite.

Bilateral crossbite

A bilateral crossbite refers to a malocclusion that transpires on both sides of the mouth. In simpler terms, it involves a situation where the teeth in the upper arch are positioned inside the teeth in the lower arch on both sides.

3D rendering of an anterior crossbite. 

Types of crossbite according to the origin

Having examined the various types of crossbite based on their respective locations within the mouth, we will now shift our focus to exploring different classifications of crossbite according to the underlying causes of this malocclusion.

Skeletal crossbite

When a crossbite is attributed to an issue with bone development, it is known as a skeletal crossbite. In such cases, there is an inadequate development of the upper jaw, causing it to be smaller than the lower jaw. As a result, the upper teeth end up positioned inside the lower teeth.

Dental crossbite

In certain instances of crossbite, the cause of malocclusion is not related to jaw underdevelopment but rather to malposition of the teeth. Such cases, where the crossbite arises from dental malposition, are known as dental crossbites.

Mixed crossbite

Lastly, there exists a third type of crossbite in terms of its origin, where neither the jaw bones have developed properly nor the teeth have erupted optimally. In such cases, the malocclusion stems from a combination of factors, resulting in a mixed origin of the crossbite.

 Little baby sucking its finger. 

What causes a crossbite?

The causes of dental crossbite can exhibit variability, although they can generally be categorized into two primary groups: acquired habits and genetic factors.

Within the realm of genetic causes, maxillary hypoplasia and mandibular hyperplasia are the most prevalent in causing teeth to have a crossbite. In such instances, it is essential to conduct an evaluation of family members to determine the hereditary aspect.

Conversely, detrimental habits like mouth breathing, thumb sucking, or improper tongue placement can also cause crossbite, as they adversely affect both bone and dental development.

What problems can a crossbite cause?

Crossbites can give rise to a range of problems, resulting in physical and functional challenges for individuals affected by them. The following are some of the common problems a crossbite can cause:

  • Tooth wear: Crossbite can lead to uneven distribution of biting forces, potentially causing excessive wear and tear on teeth. If left untreated, tooth loss can be a consequence of crossbite.
  • Functional difficulties: Teeth with a crossbite can result in difficulties with speech articulation (phonation) and chewing, which can further lead to digestive problems if not properly addressed.
  • Temporomandibular joint (TMJ) problems: A dental crossbite can exert strain on the temporomandibular joint, potentially causing complications such as bruxism (teeth grinding) or discomfort in the jaw, head, or neck regions.

It is important to address crossbite promptly to mitigate these potential problems and maintain optimal oral health.

Crossbite correction: how to fix it and treatments

Crossbites can significantly impact the daily lives of those affected. Therefore, early diagnosis is crucial to initiate timely crossbite correction and treatment to prevent any adverse consequences. Now, let us delve into the various treatment options available for how to fix a crossbite.

How to fix a crossbite in kids

The optimal window for effectively treating and correcting crossbite in kids, while influencing bone growth and preventing future complications in adulthood, is typically between the ages of 6 and 12.

Interceptive orthodontics is the preferred treatment approach for addressing crossbite correction in children. During this stage, when the bones are more pliable, interceptive orthodontics can successfully rectify the crossbite. The use of expanders is a common orthodontic method in such cases. These devices facilitate modifications to the size of the maxillary bone and expansion of the palate.

It is important to note that this type of crossbite correction or treatment is only effective in children, as it capitalizes on the potential for bone growth modification. Once the bones have fully developed, intervention or alteration of their growth becomes unfeasible.

Crossbite correction in adults

Correcting crossbite in adults poses greater complexity compared to children since their bones have completed growth and development.

To initiate the process of crossbite correction in adults, the first step is to consult a dentist who will carefully assess the individual case and determine the most suitable treatment approach. There are two primary methods employed for correcting crossbite in adults: orthodontics and surgery.

Two doctors performing oral surgery on a patient. 

Crossbite surgery for adults

In instances where adults have severe crossbite or crossbite resulting from skeletal issues, surgery becomes necessary for correction. These cases may involve significant mandibular deviation or an excessively narrow palate, making it impossible to address the crossbite solely through orthodontic means since the individual's bone development is already complete.

Crossbite surgery aims to rectify the size and position of the jaw bones, thereby enhancing facial aesthetics and improving oral functionality. Often, crossbite correction surgery is followed by a subsequent phase of orthodontic treatment to address dental misalignment and achieve a harmonious, aligned smile. The combination of surgery and orthodontics offers a comprehensive approach to crossbite correction in these complex cases.

Crossbite correction for adults without surgery

In cases of crossbite in adults stemming from dental causes, orthodontic treatment, such as traditional braces or clear aligners, can serve as an effective means of crossbite correction without resorting to surgery for adults. These orthodontic devices facilitate the modification of malocclusion, enabling the correction of the crossbite. By applying gentle and controlled forces, orthodontic treatment can gradually shift the position of the teeth, resulting in the correction of the crossbite without surgery.

Impress orthodontic treatment for crossbites

At Impress, we specialize in providing orthodontic solutions to address crossbite problems in individuals of all ages, including children, adolescents, and adults.

For children, our team conducts a comprehensive analysis of the case and creates a customized treatment plan called Impress Kids. This personalized approach is designed specifically to correct crossbite in the youngest members of the family.

In cases of dental-origin crossbite in adolescents or adults, we offer a range of orthodontic solutions. Our treatments with Impress clear aligners are an effective and discreet option for efficiently correcting crossbite cases. These aligners are designed to fit comfortably and subtly align the teeth, providing an aesthetically pleasing solution.

If you would like us to assess your specific case and recommend the best treatment option for you, our team of experts is ready to assist you. Our goal is to help you achieve optimal oral health and achieve a perfect occlusion. Contact us today to begin your journey towards a healthier and well-aligned smile.

Visit an Impress clinic near you today to consult with one of our expert doctors about orthodontic treatment. Book your appointment now. Feel free to give us a call and we can assist you further.

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