Crossbites are a common dental misalignment where the upper and lower teeth do not fit together correctly. This condition affects individuals of all ages. Many wonder if traditional braces can effectively correct a crossbite. This article explains how this misalignment occurs and how orthodontic appliances address it.
Understanding Crossbites
A crossbite is a dental misalignment where one or more upper teeth sit inside the lower teeth when the mouth is closed, rather than slightly overlapping them. This misalignment can manifest in different areas. An anterior crossbite involves the front teeth, with upper front teeth positioned behind the lower front teeth. This is sometimes called an “underbite” if it involves all front teeth or the jaw.
A posterior crossbite affects the back teeth, where upper back teeth bite inside the lower back teeth. This can occur on one or both sides of the mouth. Crossbites can involve a single tooth or multiple teeth, indicating a broader issue with the dental arch. The misalignment can stem from issues with the teeth (dental crossbite) or from an imbalance in jaw growth (skeletal crossbite).
Braces as a Crossbite Solution
Traditional braces are an effective method for correcting various types of crossbites. They apply continuous, gentle pressure to gradually move teeth into their correct positions. This process involves several components. Brackets, small attachments bonded to each tooth, serve as anchors for the archwire.
The archwire, threaded through the brackets, guides the teeth along a prescribed path. Orthodontists periodically adjust these wires to ensure continuous movement and proper tooth alignment. For crossbite correction, braces can facilitate arch expansion, widening either the upper or lower dental arch to achieve a harmonious bite. This expansion creates adequate space for teeth to fit together correctly.
Elastics, or rubber bands, are often used with braces to correct crossbites. These small bands connect to hooks on the brackets, spanning between the upper and lower jaws in specific patterns. Crossbite elastics commonly run from the inside of an upper tooth to the outside of a corresponding lower tooth, or vice versa, to exert targeted forces that shift teeth and adjust jaw relationships. This consistent pressure guides teeth into proper alignment and refines the bite.
For a single-tooth anterior crossbite, braces might be used with bite pads placed on the back teeth. These pads temporarily prop the bite open, preventing lower teeth from interfering with the forward movement of the upper tooth. In cases of mild posterior crossbites, a combination of braces and elastics can achieve correction, especially when only one tooth is involved. Braces can effectively address both dental and skeletal components of a crossbite.
Other Orthodontic Solutions for Crossbites
While braces are a common solution, other orthodontic methods also correct crossbites, often used with or as alternatives to braces. Palatal expanders are frequently employed, particularly for posterior crossbites, by gradually widening the upper jaw. These devices apply gentle outward pressure to the two halves of the palate, effective in children and growing teenagers whose jawbones are still developing.
Types of palatal expanders include fixed appliances with a screw mechanism for rapid expansion, and removable expanders for milder cases. For adults, whose palatal bones are fused, expansion with an expander alone may be limited; sometimes, surgically assisted expansion is required to facilitate widening of the jaw.
Clear aligners, such as Invisalign, offer a discreet alternative for certain crossbite cases. These removable plastic trays are custom-made and apply gentle, consistent pressure to move teeth into their desired positions. Clear aligners are effective for mild to moderate dental crossbites, especially when the issue involves tooth movement rather than significant jaw discrepancy. They may be used with elastics for more complex movements.
For severe skeletal crossbites, particularly in adults where jaw misalignment is pronounced and cannot be corrected by tooth movement or expansion alone, surgical options become necessary. Orthognathic surgery, or corrective jaw surgery, realigns the jaws to improve their functional relationship. This procedure is often performed with braces, which are used before and after surgery to position the teeth precisely for the newly aligned jaws.
Why Correcting a Crossbite Matters
Leaving a crossbite untreated can lead to complications that extend beyond cosmetic concerns, impacting oral health. One common issue is uneven tooth wear, where certain teeth bear excessive force during biting and chewing. This can result in enamel erosion, chipping, or fractures. Such abnormal wear increases the risk of tooth sensitivity and cavities, as compromised enamel is more vulnerable to decay.
Crossbites can also contribute to gum recession, particularly around affected teeth, exposing tooth roots and making them susceptible to decay and sensitivity. The misalignment can make it challenging to clean teeth effectively, leading to plaque buildup and an increased risk of gum disease. An untreated crossbite can strain the temporomandibular joints (TMJ), which connect the jaw to the skull. This strain often results in jaw pain, headaches, clicking sounds, and difficulty with jaw movement.
Crossbites can affect speech clarity, as improper positioning of teeth and jaws can interfere with sound formation. This can manifest as lisps or other articulation difficulties. In children, an untreated crossbite can even influence jaw growth, potentially leading to facial asymmetry. Correcting a crossbite is important for maintaining proper oral function, preventing long-term damage, and supporting balanced facial development.