Crossbite

CROSSBITE

Crossbite is a condition that affects both the upper and lower teeth. It is where theydo not align properly, vertically or horizontally. The development of this condition is typically earlier in life. Dentists advise parents of children affected with crossbite to have the issue addressed as early as possible, because it is much easier to treat the jaws and the teeth when they are still developing.

Your dentist will recommend a treatment option, usually involving braces, elastics, or surgery. Your dentist will consider your age, the complexity of the issue, and how it affects you when suggesting a course of treatment.

In this article, we will give an overview of crossbite and some of the methods of treating it.

TABLE OF CONTENTS

What is crossbite?

In simple terms,crossbite is where the upper and lower teeth overlap, and don’t meet properly, when they bite together. This condition may be the result of genetic factors, such as overcrowded teeth, or behavioural factors, such as thumb sucking. There are several different ways in which a crossbite can occur, and there are also different terms used to describe crossbite teeth.

What are the different types of crossbite?

There are different types of crossbite. Each of these types is classified by characteristics such as the number of misaligned teeth and their location.

Anterior crossbite

This is also called “underbite”. It occurs at the front of the mouth. When the teeth bite together, the lower teeth stay in front, hiding the upper teeth. Normally, the reverse is actually normal, and the upper front teeth should sit slightly in front of the lower teeth.

Why does it happen?

Some people are genetically prone to excessive tooth growth in the lower jaw- this forces the jaw to extend forwards.

At a very young age, some children start the habit of breathing through their mouth. This habit,in the long run, will affect the development of their upper jaw. When the mouth is left open, pressure from the tongue no longer applies to the upper jaw, making it lag (in growth) over time.

Children who maintain the habit of sucking their thumbs may also develop underbite, because their thumbs apply pressure to the roof of the mouth (the surface directly above  your tongue). This pressure causes the mouth to grow in a constricted path instead of the usual broad path. Continuing this habit will then keep the jaw misaligned when the child is older.

People who have undergone surgery to correct cleft lip or palatemay also have an increased risk of developing this condition.

Posterior crossbite

This type of crossbite occurs in the back teeth. The causes are similar to underbite’s.When children lose their milk teeth too late, they begin to develop permanent teeth besides their baby teeth, causing displacement which can cause a posterior crossbite.

Buccal crossbite

“Buccal” is a word that describes the region directly beside your cheeks. Buccal crossbite is a condition in which the teeth at buccal areas develop too close to the cheek. Due to the extra distance in between the two different sides of the posterior teeth, when the mouth is closed, the tongue is forced to rest on the chewing surface of the back teeth.

Lingual crossbite

Lingual crossbite is the inverse of buccal crossbite. The difference is that the distance in between the two sides of the posterior teeth is too small, also causing the tongue to lap on the chewing surface of the posterior teeth.

Bilateral and unilateral

The two terms above are used to differentiate crossbite conditions that impact both sides of the mouth (bilateral) or just one side of the mouth (unilateral). The treatments your dentist may suggest are usually similar in either case to correc the misalignment.

Single tooth crossbite

Well, just as the name implies, single tooth crossbite is the type that affects only one tooth. It may result from the late removal of milk teeth. One of the front lower teeth may be slowly driven forward, or one of the front upper teeth may be slowly driven behind. This creates a misalignment in the bite.

Segmental crossbite

This is where a small number of teeth in a row are misaligned, causing a crossbite.

How can cross bite be treated?

There areseveral medical terms used to classify the different characteristics of crossbite. In most cases, however, treatment is often similar. It is best to start working on realigning the teeth from as early as possible, because the jw bones and teeth are still developing so are much easier to move. Therefore it is usually much more straightforward to treat crossbite in younger children.

Research shows that people who start treatment for crossbite at a very early age report a  success rate of over 90%, even without additional treatment.

Treatmnt with braces

Braces are the usual treatment for re-aligning teeth, and are very effective for the treatment of both posterior and anterior crossbite. Braces can come with palate expanders which are made specifically to broaden the upper jaw until it properly aligns with the chewing surface of the lower teeth.

When using braces, you are required to have the palate expanders adjusted regularly. Doing this continuously over several months will, gradually, extend the teeth. To slightly speed the process up, additional methods designed to quicken the growth of the upper jaw can also be used. However, this typically only shortens the treatment time by a few months.

After a few months, once the teeth alignment has impoved, the upper and lower teeth may need additional horizontal re-arrangement. This uses an additional bespoke brace. After this,you will usually use a custom-made retainer to prevent the teeth from reverting to their pre-treatment position.

Treatmnt without braces

Many people are put off by the idea of metal braces, because they find them too conspicuous. Luckily, there are other options just as effective as braces but much more discreet; including invisible aligners or lingual braces. You should remember, however, the NHS will only coverconventional metal braces; other options are only available privately. Some milder cases of crossbite can be treated usin only elastics.

Invisalign aligners

Invisalign is a treatment usually used for treating mild to moderate crossbite. It is considered a very effective treatment for re-aligning teeth, and is extremely popular because it is very discreet.

If you are considering Invisalign, Chatfield is the place to come! Two of our dentists have a special interest in Invisalign, and hundreds of cases under their belts. This means you will be in excellent and experienced hands if you wish to improve the alignment of your teeth. We offer free consultations, so don’t hesitate to book in to discuss getting the smile you want.

Elastics

Elastics are used by professionals instead of braces to treat posterior crossbite. An orthodontist usually takes an elastic material with some dental characteristics and connects it to the posterior upper teeth firmly. They then extend the elastic material forwards, hooking it to the lower teeth.

The logic behind this is pretty obvious; the treatment is intended to push out the upper teeth, far enough so they lap directly on the chewing surface of the lower teeth. It’s easy and usually works in about four months.

There are very complex cases in whichcrossbite patients have to undergo surgery. Surgery may seem scary, but it’s nothing to worry about. The NHS is responsible for crossbite surgeries in children and in adults too, if deemed clinically necessary.

Before the surgery, patients are required to have used braces for up to eight months. They also need to have their wisdom teeth removed. The operation will happen at the back of your mouth; therefore patients are advised to take their pre-medication seriously and in line with any instructions in order to ensure the procedure is a success.

In both children and adults, the surgeon completely detaches the jaw and places it in a more practical position. They will hten insert some special plates and screws to keep the jaw firm. You don’t need to worry about scars, because all incisions are made inside the mouth, completely invisible from view.

Recovery

After surgery, patients are asked to stay on a liquid diet for 3- 4 days. They will then gradually return to their normal diet and recover fully in about twelve weeks. The last stage is to wear braces again for a few months, to ensure proper alignment.

The thought of an invasive surgical procedure can be worrying. But ask your surgeon to show some before and after style photographs to get an idea of the positive effect of having the procedure. It will greatly improve your tooth alignment, and how well you can eat, speak and smile!

How expensive is crossbite surgery?

Surgery is generally used for treating more complex cases inchildren, and this is covered under the NHS so is essentially free.

As an adult, if your surgery is deemed clinically necessary, you willusually only have to pay £269.30.

If you wish to undertake surgery privately, you should know that the overall cost  depends on a few variables:

  • Surgical procedure itself
  • Anaesthetist bills
  • Accommodation bills
  • Cost of surgical tools (screws, plates, etc)
  • Surgery planning bills. (The orthodontist prepares your surgery plan)

The final sum may cost in the region of £2,500 or more. It all depends on the individual case and the complexity of the treatment plan.

Does crossbite surgery work on adults?

Yes. You can realign your jaws and teeth at any time in your life, but the older you get without doing anything about it, the more complicated the process may become. It is possible to have buccal crossbite for a long period without being aware of it.

All the treatments mentioned here about the treatment of crossbite in children also apply to adults!

Conclusion

Cross bite does not need to negatively affect your life, your smile or the way you feel about yourself. There are many different options available for correcting a cross bite, or any other type of tooth misalignment. It is usually more straightforward to treat in younger children, but it is still perfectly possible in adults as well. Do not delay any further- call us at Chatfield and book in with one of our experience and renowned dentists to discuss your options. This is the first step on your journey to the smile you’ve always wanted!