If you are like many people, you probably won’t completely understand what a crossbite is until you experience it first-hand or have a family member who is diagnosed with one. Generally, there are two types of crossbites; anterior and posterior crossbites. Both can cause jaw pain, temporomandibular joint dysfunction, loose teeth, and receding gums (1).

The side effects of a crossbite can be excruciating, but the best bit is that they are treatable. As you’ll see later on, there are a couple of crossbite treatment and correction options you can explore. In this piece, we seek to help you to understand the condition and the options available to you.

What exactly is a crossbite?

The official definition of a crossbite is simply an abnormal relation of the teeth (one or more) of one arch to the opposite teeth on the other arch that is caused by an abnormal jaw position or tooth position.

In layman’s terms, it is a misalignment of the upper teeth with the lower teeth. Now, while crossbites can be hereditary, they have also been proven to be seasonal.

Crossbites in children can be caused by permanent teeth growing before the baby teeth fall out. When this happens, the permanent teeth sometimes cannot grow in the jaw socket properly. This leads to misaligned teeth. Other causes as we shall explore below include genetics and thumb sucking.

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Main causes of a crossbite


As we’ve pointed out above, a crossbite can boil down to your genes. This means that if any of your parents had a crossbite, there are high chances that you will too. However, some measures can be taken to reduce the chances of developing a crossbite.

Delayed and abnormal tooth eruption

For many people, when their milk teeth fall out, they are replaced by permanent teeth. Actually, the permanent teeth trigger the falling out of the milk teeth. Unfortunately, in some cases, the permanent teeth grow before the milk teeth fall out. When this happens, the permanent teeth become misaligned since there’s no space for them to take up. Once the baby teeth are removed, they usually find their place.

Thumb sucking

This is one of the leading causes of crossbites. If a child sucks their thumb too much, it could lead to the misalignment of teeth. Sucking on the thumb can, with time, reduce the width of the palate, and even cause a deformation of the bone on the upper palate.

Mouth breathing

When you close your mouth and breath through the nose, the tongue naturally rests against the roof of the mouth. In kids, the tongue helps in ensuring the upper jaw grows and develops normally. However, if a child insists on breathing through the mouth, probably due to problems such as swollen tonsils, the tongue rests on the lower palate and results in underdevelopment of the upper jaw.

Anterior crossbites vs. posterior crossbites

These are the two types of crossbites.

Anterior Crossbite

In the anterior crossbite, the top front teeth are behind the lower front teeth. It looks similar to an underbite. But the two aren’t the same thing (2).

Posterior crossbite

In a posterior crossbite, one or more of the upper premolars and molars meet the lowers more palatally. When one bites down, the upper teeth should be positioned slightly further out from the lowers in normal bites.

Crossbite problems

Crossbites can contribute to headaches and neck pains. Most people with crossbites often complain of migraines (3).

Crossbite correction and treatment options

Fortunately, many of the crossbite cases are easy to correct through the many treatments available. Below are some of the most common options you’ll come across. Your dentist might suggest any of them.


These are, by far, the most commonly used correction tools. They are used on both adults and children. Dental braces help to align teeth back into position by applying pressure and pushing them back into place.

A maxillary expander

options for correcting your crossbite savina dental clinics malta and gozo

In this treatment option, the dentist uses a palatal expander. The expander widens the upper jaw or the maxilla so that the lower jaw and the upper jaw can line up. The expander is attached to the upper jaw and is permanent (usually less than a year).

The maxillary expanders are perfect and highly effective. They cannot be used in post-pubertal patients as the bones of the palate would have fused and no longer have growth potential.

A removable expander

This is similar to a maxillary expander. The only difference is that you can remove it when you want. These are the perfect option for mild crossbites. They are also ideal for kids whose crossbite is in its early stages.


This is worn on the head and hugs the face and attaches to teeth with wires. The force on the jaw and teeth applied by the headgear slows down or increases jaw growth over time. It is effective for children and teenagers.

Teeth removal

When treating children or adults, we may advise removing teeth to create room to move teeth before using braces.

Dental restorations

Bonding, capping, and reshaping teeth can be used to improve mild crossbites for aesthetic purposes.


Surgery is used when the crossbite is extremely severe. It is usually done to expand the jaw bones. The expansion process is done before the facial bones fuse, which is usually at 19 for males and 16 for females. For this reason, surgery is best done in the early teenage years.

Oral care during treatment

Everything You Need To Know About Mouthwash

Caring for the teeth when receiving crossbite treatment involves preventing bacteria build-up and plaque. Tooth decay-causing bacteria thrive in hard-to-brush spaces such as between braces. During treatment, you should stay away from sticky and sugary foods and drinks. You should also rinse your mouth with mouthwash to get rid of bacteria and debris.

What happens if you don’t treat a crossbite?

When left untreated, a crossbite can cause cosmetic problems, a receding gum line, teeth grinding, jaw issues, and tooth loss.

Although crossbites can cause adverse effects, if taken care of immediately they surface, they are treatable. The treatment usually takes time, but eventually, the condition is corrected.

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Savina Clinic – Dental & Implantology Centres are friendly, state-of-the-art practices in Malta and Gozo dedicated to comprehensive quality dental care. Savina Dental is an innovative dental practice in Malta and prides itself on the high-quality customer service, low waiting room times, attention to detail and the advanced dental technology at its disposal.

Joseph Xuereb
Principal Dental Surgeon & Owner of Savina Dental Clinics, Dr Joseph Xuereb BChD (Hons), MFGDP(UK), MGDS RCS(Eng), FFGDP RCS(UK), FICD is a general dental practitioner with a special interest in Implant and Restorative Dentistry. Dr Joseph & the teams' full biographical information can be found here.