A crossbite occurs when one or more upper teeth fit inside the lower teeth when the mouth is closed. This misalignment can affect chewing function and lead to uneven wear on the teeth, prompting patients to seek correction. While traditional braces are a common solution, many people explore less visible alternatives. Whether a crossbite can be fixed without braces depends entirely on its location, nature, severity, and the patient’s stage of skeletal development.
Defining Anterior and Posterior Crossbites
Understanding the location of the misalignment is the first step in determining the appropriate treatment. Crossbites are categorized into two primary types: anterior and posterior.
An anterior crossbite involves the front teeth, where the upper incisors or canines sit behind the lower front teeth when biting down. If the lower jaw is significantly positioned forward, this misalignment is sometimes referred to as an underbite.
A posterior crossbite affects the back teeth, occurring when the upper back teeth are positioned inside the lower teeth. This type can be unilateral (one side) or bilateral (both sides). The distinction between anterior and posterior involvement guides whether correction requires individual tooth movement or broader jaw expansion.
How Age and Severity Determine Treatment
The success of non-braces treatment is heavily influenced by whether the patient is still growing. In children and adolescents, the skeletal plates in the upper jaw are not yet fully fused, allowing for true skeletal correction. During this stage of active growth, specialized appliances can physically widen a narrow upper jaw, which often causes a posterior crossbite.
For adults, skeletal growth is complete and the sutures in the palate are rigid. This means that a crossbite caused by a narrow jaw structure (skeletal crossbite) is far more challenging to correct without surgery. Non-braces treatments for adults are usually limited to addressing dental crossbites, which involve only tooth misalignment, not the underlying bone structure. The severity of the crossbite also dictates the feasibility of non-braces methods.
Non-Braces Appliances and Methods
Several specialized orthodontic tools are used to correct crossbites without the application of traditional fixed braces.
For posterior crossbites in children, palatal expanders are a highly effective non-braces solution. These appliances are fixed to the upper back teeth and use a controlled force to gradually widen the maxilla, correcting the skeletal discrepancy. They work by gently separating the two halves of the upper jaw while the bone is still malleable.
Clear aligners offer a removable and aesthetic option for certain crossbites. These aligners are most effective for correcting mild to moderate dental crossbites, which involve moving individual teeth into proper position. They can successfully treat many anterior crossbites and minor posterior dental adjustments. Clear aligners are generally not capable of achieving the significant skeletal expansion required for severe posterior crossbites.
For minor corrections, particularly in the anterior region, removable appliances may be used. These custom-made plates often incorporate a spring or screw mechanism to push a single misaligned tooth into the correct position. These appliances rely on patient compliance, as they must be worn for a specific number of hours each day to be effective. Their use is typically limited to simple tooth movements rather than complex or skeletal corrections.
When Orthodontic Surgery is Required
When a severe skeletal crossbite is present in an adult, non-surgical methods are often insufficient to achieve a stable correction. These complex cases require orthognathic surgery, also known as corrective jaw surgery. This procedure is performed by a maxillofacial surgeon to reposition the upper jaw, lower jaw, or both, into an anatomically correct relationship.
During the surgery, the surgeon makes precise cuts in the jawbones, repositions the segment, and secures it with small plates and screws. This invasive intervention physically addresses the underlying bone discrepancy that no appliance alone can correct in a mature skeleton. Although surgery is the definitive fix, it is frequently combined with pre- and post-surgical orthodontics, which may involve short-term use of braces or aligners to ensure the teeth fit perfectly after the bones are moved.