A crossbite is a common type of dental malocclusion in which upper teeth are aligned improperly in relation to the lower teeth. The frequency of crossbite in children varies depending on several factors such as genetics, oral habits, variation in growth spurts, retained teeth/premature loss, mouth breathing, and multiple environmental factors.
What is a Crossbite?
Crossbite is an occlusal discrepancy in transverse teeth relation that can occur in both anterior and posterior teeth. It is also referred to as "poor bite," which can have a bad impact on oral health, its functions, and aesthetics.
Crossbites in children can be of skeletal or dental origin. Skeletal crossbite can occur due to improper jaw growth resulting from hormonal dysregulation or any growth disorders. At the same time, dental crossbites in children can be a result of oral parafunctional habits.
This condition should be corrected at an early stage during the growing ages of children to modify the dentition accordingly as it can lead to other problems such as tooth wear, TMJ disorders, cavities, jaw shifting, uneven facial features, chewing difficulties, speech problems, and others.
Types of Crossbite in Children
There are two main types of crossbites in children depending on the location in different areas of the mouth. Both types can be unilateral or bilateral, such as:
1. Anterior Crossbite
An anterior crossbite refers to the alteration in the position of upper front teeth (central and lateral incisors), which, instead of lying in front, positions behind the lower teeth and results in forming an 'underbite.'
2. Posterior Crossbite
A posterior crossbite occurs when there is a misalignment of one or more upper molars in relation to the lower teeth. It can be:
- Lingual Posterior Crossbite: When one or more upper teeth rest behind or on the lingual surfaces of lower posterior teeth. It is usually a common manifestation of a narrow maxillary arch.
- Buccal Posterior Crossbite: It occurs when upper teeth are excessively tipped buccally in relation to the opposing. At the same time, the lower ones are tipped towards the tongue, giving a condition known as "Scissor Bite."
What causes crossbite in children?
Several factors can cause crossbites, and the most specific ones include:
- Jaw Growth Alterations: by an alteration in the growth of the maxillary or mandibular arch, ending up being wider, narrower, prognathic, or retrognathic.
- Dental problems: premature loss of primary teeth, retained primary teeth, missing teeth, or delayed eruptions of permanent teeth.
- Oral Parafunctional Habits: such as tongue thrusting (abnormal tongue position, pushing it against teeth or lips during swallowing), thumb sucking, prolonged use of pacifiers, bruxism, nail-biting, mouth breathing, etc.
- Others, such as cleft lip or palate, genetic influences, poor chewing habits, or trauma to the face.
Treatment Options for Crossbite
There is a research study demonstrating that there is a self-correction of crossbite ranging from 12.2-77.1% during the primary to mixed dentition transition period and around 16% from mixed to permanent dentition. But what if it doesn't correct on its own?
That's why an orthodontist appointment for your child between the ages of 6 and 12 is so important to make a good differential diagnosis and should be treated as soon as possible. It is because, at this stage, your child is undergoing development at its peak and can be treated with ease. Otherwise, adult crossbites can also be corrected, but the options change as their growth has stopped.
Following are the crossbite treatment options available from an orthodontist's advice depending on the cause and severity of the condition:
1. Oral Habits Breaking Appliances:
There are multiple ortho appliances used to break bad oral habits and prevent or correct crossbites. It includes the use of a palatal crib to help finger or thumb-sucking individuals, a tongue crib for tongue thrusting, and a vestibular screen for mouth breathers.
A mandibular advancement device (MAD) is available to address mouth breathing-related sleep apnea, which keeps the lower jaw forward and prevents the tongue from obstructing the airway.
2. Palatal Expander:
This orthodontic appliance is used to treat maxillary deficiency in growing children. It is placed on the palate and upper teeth and activates to expand the jaw and accommodate teeth.
3. Braces or Clear Aligners:
Mild and moderate crossbites in children and adults can be corrected using clear aligners or dental braces. These devices reposition teeth to their correct positions and resolve malocclusion.
4. Reverse pull headgear:
Those who have anterior or reverse crossbite with type III malocclusion can benefit from reverse pull headgear. In this condition, a retrognathic upper jaw has been brought forward to align with the lower jaw.
5. Z-Spring:
Z-spring, or a double cantilever spring, is a removable orthodontic appliance that is usually used to correct one or two anterior tooth crossbites. It consists of helices that can be activated 2-3 mm at a time to move incisors forward and correct minor malalignments.
Conclusion
A crossbite is a common dental problem in children and adults that can lead to other complications if left untreated. Diagnosing it at an early stage can help children in many ways and avoid costly dental treatments in the future.
Make your child's first dental visit to the dentist or an orthodontist at the age of 6-7 for regular checkups or once to find a crossbite to make an accurate diagnosis and get the best treatment plan that fits your child's needs.
Make your child's first dental visit to the dentist or an orthodontist at the age of 6-7 for regular checkups or once to find a crossbite to make an accurate diagnosis and get the best treatment plan that fits your child's needs.
