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A crossbite is a malocclusion where the upper and bottom teeth do not connect properly when biting down. This often results in an asymmetrical or uneven jaw appearance. It may result from genetic factors like Overcrowded teeth, thumb sucking, and other behavioural factors.

A dentist can usually identify a crossbite at an early age and will likely recommend fixing it. Different treatments are available for crossbite, including braces, elastics and surgery. The most suitable will depend on if you have an anterior or posterior crossbite and its severity. 

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Types of crossbite

Different ways to classify a crossbite are available, depending on the number of teeth affected, its position in the mouth and severity. The types of crossbite include:

  • Anterior crossbite

An anterior crossbite, also called an underbite, affects the front teeth. It causes the upper teeth to sit behind the lower front teeth. Its causes vary, including:

  • Overcrowded teeth
  • Repairs to the cleft lips
  • Mouth breathing in children
  • Thumb sucking

Anterior crossbite is often noticeable, causing an uneven jaw look, and the chin protrudes.

  • Posterior crossbite

A posterior crossbite affects the back teeth, making the lower teeth sit in front of the upper teeth. Its causes are similar to an anterior crossbite. Another factor that may result in a posterior crossbite is the baby teeth falling out later and the permanent teeth coming through in the wrong position or order.

Treating posterior crossbites is easy, especially if caught early when the permanent teeth are still erupting.

  • Buccal and lingual crossbite

These crossbites refer to if the teeth sit far out towards the tongue (lingual) or the cheek (buccal). They make you feel a lot of the inner tooth’s biting surface when closing the mouth.

  • Bilateral and unilateral crossbite

A bilateral crossbite means the crossbite affects both sides of the mouth, while a unilateral crossbite affects only one side of the mouth. The treatments for these crossbites may look the same, but the work your dentist will carry out may differ.

  • Single tooth and segmental

Single-tooth crossbite affects only one tooth. It can occur when a bottom tooth sits forward (usually a canine or one of the front teeth). A few of the teeth do not line up for a segmental crossbite. It usually affects 2 – 3 teeth in a row.

Below is a summary of crossbites and what they mean.

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Type of crossbite What it means
Anterior Affect the front teeth
Posterior Affect the back teeth
Buccal Teeth sit towards the cheek
Lingual Teeth sit towards the tongue
Bilateral Affect both sides of the mouth
Unilateral Affect one side of the mouth
Single tooth Affect one tooth
Segmental Affect 2 – 3 teeth

Treatment options for correcting a crossbite

Treatments for the different types of crossbite are similar in most cases. Correcting a crossbite is best in childhood when the bones and teeth are easier to move because they aren’t fused.

Evidence suggests that crossbite treatment with braces is up to 80% effective even without other treatments if started early.

What happens if the crossbite is untreated?

Misaligned teeth can cause oral health issues. If the teeth do not fit together properly, unusual wear and tear may occur in the affected teeth and jaw issues. The bone or teeth misalignment in a crossbite can affect one or more teeth and the jaw.

If left untreated, a crossbite can wear the enamel down as the jaw shifts to the side, resulting in uneven jaw growth. Depending on the severity of the crossbite, the dentist may recommend a palate expander, a removable or fixed orthodontic appliance used to widen the jaw. Some patients may recommend an appliance like clear aligners or braces to realign the teeth.

Brace treatments for crossbite

Orthodontic treatment is common for correcting anterior and posterior crossbites on the lower and upper teeth. Crossbite braces often use a palate expander to widen the upper jaw for the teeth to sit properly with the lower teeth.

Palate expanders need regular adjustments, and the small increments help push the teeth in the upper jaw apart. A rapid expansion method is also available to correct the position of the teeth within a few months.

Further teeth straightening may be necessary after expanding the palate to the correct size. You can use different types of fixed braces and a retainer afterwards to keep the teeth in place.

Can I correct crossbite without braces?

Some people do not like the idea of wearing braces, and several alternatives which are as effective as braces are available such as clear braces. Only metal braces are available in the public healthcare service.

You can also treat posterior crossbite with only elastics.

Can Invisalign correct crossbite?

Invisalign clear aligners can be effective for mild to moderate crossbites. Unlike metal braces, Invisalign aligners aren’t noticeable, and you can remove them for up to two hours daily.

Correcting posterior crossbites with elastics

You can fix crossbite affecting the back teeth with posterior crossbite elastics. This treatment involves fixing a hook to the outside of the lower teeth and the inside of the top tooth and connecting them with an elastic band.

This helps pull the back tooth out, allowing it to fit correctly over the lower tooth. The process is simple and takes about 3 – 4 months.

Jaw realignment surgery

In the more severe crossbite cases, surgery may be necessary. Undergoing this procedure may be worrisome, but it is relatively common. Children and some adults can undergo jaw realignment surgery at no cost to the public healthcare service.

Wearing braces may be necessary 12 – 18 months before crossbite surgery, including removing wisdom teeth. This is necessary as the surgery to fix the asymmetrical jaw is at the back of the mouth.

During jaw realignment surgery, the surgeon breaks down and repositions the jaw, then adds plates and screws to hold it in place. The incisions are inside the mouth, so no visible scarring will occur.

Recovery following crossbite surgery takes 6 – 12 weeks, then 4 – 6 months of orthodontic treatment. You may ask your dentist for before and after photos of people who have had crossbite surgery to help you understand the expected results.

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What is the cost of crossbite surgery?

Crossbite treatment is free on the public healthcare service if done in childhood, but some adults can still get free treatment. Due to the issues associated with not treating crossbite, you may still get treatment through the public healthcare service on the Band 3 treatment charge. You can consult your dentist to determine your suitability for treatment.

Jaw realignment surgery cost in the UK depends on different factors but starts at £2500. You can get an accurate cost from your dentist or surgeon.

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What problems can a crossbite cause?

A crossbite may not seem like a big aesthetic problem, but it can affect your oral health in the future. Common problems caused by anterior or posterior crossbite include:

  • Gum disease
  • Increased risk of tooth decay
  • Excess wear on the teeth and gums
  • Asymmetrical jaw
  • Increased risk of teeth grinding or bruxism
  • Increased chances of headaches from tension
  • Biting the cheek when trying to eat

Can an adult fix a crossbite?

You can always get your teeth straightened and fixed. The treatment options above for crossbites are also available for adults. If braces are the ideal treatment option, most adults choose invisible aligners or braces for a less conspicuous treatment.

A wide range of crossbite treatments is available at McKennell Dental Practice. You can visit us at 21 Churton Street, London SW1V 2LY, to have our dentist examine your teeth and recommend the best treatment. You can also call 020 7834 8802 to book an appointment with our dentist.

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Frequently asked questions

Genetic factors may cause a crossbite, but other factors such as mouth breathing and thumb sucking may be responsible. Overcrowding teeth is also a common cause of crossbites.

Crossbite treatment is usually available in the public health service due to the complications it causes if left untreated. Children and some adults may be eligible for free treatment, but private crossbite treatment costs vary.