What is crossbite? Causes and treatments

2024-04-11 20:00:23

Under normal conditions, the upper teeth are positioned in front of the lower teeth when biting. If the teeth are placed upside down, then problems will appear.

Last update: April 11, 2024

Crossbite is a condition that It alters the natural relationship between the upper and lower teeth. This dental discrepancy is also known as an inverted bite, since the mandible is positioned outside the upper jaw.

Reverse biting not only impacts oral functions, such as chewing and speaking, but also affects facial aesthetics. However, there are various dental treatments that can correct the problem.

What is crossbite like?

In normal occlusion, the upper teeth are not located at any point behind the lower teeth.

Crossbite is a type of dental malocclusion. Upper and lower teeth they do not align correctly when closing the mouth.

Under normal conditions, the top pieces should be placed slightly outside the bottom pieces when occluding. On the contrary, in a crossbite, this arrangement is reversed and Some upper teeth remain inside the lower teeth when you close your mouth.

The American Association of Orthodontists points out that this anomaly can affect one or more teeth, in the anterior or posterior sector of the mouth, on one or both sides of the jaw. In addition, this way of biting can be associated with other alterations of the jaw bones, such as the following:

• Narrow, ogival and deep palate.
• Very large and forward jaw.

In a crossbite, the normal relationship is lost and some upper teeth are placed behind the lower teeth when closing the mouth.

Types of crossbite

An inverted bite can present differently in each person. Depending on the area of ​​the mouth affected, the following types are distinguished:

• Anterior: The condition is concentrated in the front part of the mouth, on the incisors and canines.
• Posterior: It affects the back teeth of the mouth, that is, the molars and premolars.
• Unilateral: malocclusion occurs on only one side of the mouth, either the left or the right. In this situation, it is common for the deviation to cause asymmetries in the face and problems in the temporomandibular joint (TMJ).
• Bilateral: The disorder occurs on both sides of the jaw.

In addition to the above, crossbite can also be classified according to its origin:

• Skeletal: It arises from defects in bone growth. It may happen that the upper jaw has not developed enough or that the lower jaw is very large.
• Dental: It is due to incorrect positioning of the teeth.
• Mixed: The two previous cases are combined. There is a failure in bone growth and, in addition, the dental elements are positioned incorrectly.

For what is this?

The crossbite It can occur due to various causes, both genetic and environmental. It is considered a multifactorial conditionsince it can arise from the combination of different situations.

Genetic factors

Heredity plays a crucial role in the development of oral structures. The shape, size and arrangement of bones and teeth depends largely on genetics.

It is so It is quite common to observe the repetition of crossbite in several members of the same family.. Some underlying genetic causes, such as very narrow jaws, cleft lip or palate, crowded, abnormally shaped or extra teeth, are inherited conditions that can also trigger the disorder.

Environmental causes

In addition to genetic factors, there are environmental circumstances that They influence the way bones grow and teeth erupt and position. The following external situations can contribute to the development of crossbite:

• Oral breathing.
• Atypical swallowing.
• Trauma to the mouth.
• Habit of sucking thumb.
• Loss or absence of teeth.
• Crooked or malpositioned teeth.
• Prolonged use of a pacifier or bottle.
• Lack of space between baby teeth.
• Premature or very delayed loss of baby teeth.
• Restorations, crowns or dental appliances that do not fit properly.
• Functional problems, such as improper jaw posture when biting.

Symptoms of crossbite

A crossbite is usually quite obvious to the naked eye. A forward chin, a very small upper jaw or the deviation of the jaw to one side affect the appearance of the face.

However, beyond the aesthetic repercussions, suffering from this malocclusion affects both oral functions and oral health in general. The most relevant symptoms are the following:

• Tooth wear.
• Changes in the TMJ.
• Biting and chewing problems.
• Increased risk of suffering from cavities and gingivitis.
• Difficulty pronouncing some phonemes.
• Pain in teeth, jaws, shoulders, neck or head.

There are cases where A person can have a crossbite without experiencing noticeable symptoms. However, given the potential impact on quality of life, it is essential to seek advice from an orthodontist if malocclusion is suspected.

Treatments for crossbite

The orthodontist is the professional trained to diagnose and plan the treatment of crossbite. Your therapeutic approach will vary depending on various factors, with the patient’s age being one of the most important.

When is the best time to treat an inverted bite?

Treatment is most effective when addressed during childhood, taking advantage of the period of bone development and tooth eruption. During this stage, it is possible to guide the growth and position of the oral structures in a simpler, briefer and more successful approach.

Experts recommend correcting anterior and posterior crossbite early, during the first stage of mixed dentition, when baby teeth begin to change. This optimal moment allows correcting the occlusion of the permanent molars and incisors, as well as addressing maxillary deficiencies, narrow palates and mandibular displacements.

It is recommended that children visit the orthodontist from the age of 6. During the consultation, the specialist can identify any occlusion problems and take early steps to correct them before they progress and become serious.

However, although treatment is easier and more effective in childhood, it is not the only option available. There are also alternatives to correct it in adolescents and adults, although the procedures are more complex and take more time.

Treatment in children

Treatment of crossbite during childhood It is done through interceptive orthodontics. This therapeutic approach takes advantage of the child’s stage of bone growth and seeks to correct malocclusion with special devices that guide the development of the maxillary and mandibular bone bases.

The orthodontist can use different types of devices to expand the upper jaw, widen the palate or mobilize the teeth. Furthermore, if the case warrants it, the appliances are also used to treat dysfunctional oral habits that affect the development of the structures of the mouth.

Expanders, braces, removable appliances, myofunctional appliances, and clear aligners are some examples of devices that the orthodontist can use and combine to correct crossbite in children.

Once the child stops growing and an adequate relationship between both jaws has been achieved, It may be necessary to complement the treatment with corrective orthodontics. These appliances help align teeth precisely and improve the results obtained.

Treatment of inverted bite in adults

When the diagnosis is made in adulthood, The treatment may be more complex, because facial growth has already ended. The problem can have different degrees of severity and the approach will depend on the severity of the case.

If the crossbite has a dental origin, corrective orthodontics is usually used. Through fixed devices with bracketsarches and wires, or with invisible aligners, forces are generated capable of mobilizing the teeth until an adequate relationship between the upper and lower teeth is achieved.

Instead, When the discrepancies are very severe, it is necessary to resort to orthognathic surgery. This surgical procedure modifies the size and position of the jaws, achieving an adequate relationship between the structures of the mouth and face.

In general, before and after performing the operation, therapy is complemented with corrective orthodontics to align the teeth and achieve a harmonious bite. For this reason, The entire process can take several years.

In addition to these options, the treatment of inverted bite in adults may require other complementary practices, such as the following:

• Bone expanders.
• Reconstruction or remodeling of teeth.
• Tooth extraction to solve space problems.

A timely consultation makes a difference

Crossbite can impact both the aesthetics and the functionality and health of the mouth. However, The problem is treatable at any stage of life. The approaches will vary in complexity and duration.

The important thing is to seek professional help as soon as possible to prevent the malocclusion from getting worse. Your age doesn’t matter. Consult your orthodontist to obtain an accurate diagnosis and plan the most appropriate treatment for you.