Crossbite correction

Bite or occlusion — this is the position of the teeth when the upper and lower jaws come together. Normally, the upper teeth overlap the lower teeth by one-third when the upper jaw is clenched. A deviation from the norm is called an occlusal anomaly or malocclusion.

Crossbite — is a bite pathology in which the overlap between the upper and lower teeth is disturbed so that in some sections or single teeth of the lower jaw cover the corresponding upper teeth. If the overlap is disturbed at least in the area of one tooth, it is already considered a crossbite or crossbite relationship in the area of one tooth.

Cross ratio in the lateral section

The cross ratio in the anterior section

Types of crossbites

Crossbite is classified according to several factors:

1. By location in the oral cavity:

   • In the side section

   • In the front section. The protruding lower jaw in the anterior part sometimes indicates a mesial bite.

   • A «scissors» bite in which the upper teeth overlap the lower teeth completely.

2. By overlapping the dentition:

   • Buccal occlusion, in which the lower jaw overlaps the upper one on one or both sides. The overlap is formed as a result of an abnormally large size of the lower jaw or an excessively narrow upper jaw.

   • Lingual occlusion, in which the upper jaw overlaps the lower one completely or partially as a result of insufficient development of the lower jaw or wide upper jaw.

3. By prevalence in the oral cavity:

   • Cross bite in the maxillary region;

   • The cross ratio is in the area of 1-2 teeth.

Signs of crossbite

An improper crossbite is primarily determined visually. When the jaws are locked together, individual teeth or groups of teeth in the lower dentition overlap the corresponding teeth in the upper dentition. The upper and lower teeth seem to «cross» each other.

Indirect symptoms of crossbite are facial asymmetry and chin displacement. These signs are not always apparent, and if they are, they do not necessarily indicate crossbite.

Crossbite is also associated with physical discomfort when teeth cling to each other. However, bite abnormalities usually develop gradually over a lifetime, so people get used to the discomfort and don't notice it.

Causes of crossbite

Most often, malocclusion pathology is formed from early childhood during the time of baby teeth or the change of milk teeth to permanent ones. The bite is formed both under the influence of factors beyond the control of a person: the peculiarities of the structure and development of the jaws and teeth, and because of the child's bad habits or improper dental care.

1. Abnormal jaw development due to heredity, lack of calcium, delayed eruption of permanent teeth, otolaryngological diseases (rhinitis, sinusitis).

2. Violation of the erasability of baby teeth. Normally, baby teeth gradually wear off and close evenly. If the milk fangs are not worn off, they interfere with the proper closing of the teeth: they slip off and mix the entire jaw behind them.

3. Early loss of baby teeth as a result of caries or natural loss provokes displacement of the remaining teeth, improper growth of permanent teeth and consolidation of improper closure. 

4. Вредные привычки ребенка. Иногда дети намеренно смещают челюсть в сторону или дотрагиваются языком до растущих зубов. Любые неестественные механические воздействия влияют на итоговое положение зубов и челюсти. 

In adults, a crossbite can occur as a result of facial trauma or poor-quality dentures. When restoring teeth with crowns or veneers, it is important to consider the anatomically correct position and size so that the prosthetic design does not interfere with the natural alignment of the teeth.

How to distinguish between forms of crossbite

The skeletal form of a malocclusion bite can be determined visually.

Assess the position of the jaws when the mouth is open. The midline of the upper and lower teeth should align. If the teeth are slipping and not in the correct position until they are clenched — this is a dental abnormality.

If the jaws and teeth are visually crooked in relation to each other, even when the teeth are not locked— this is an anomaly at the skeletal level. In this form of bite, there is usually facial asymmetry, a mismatched midline of the teeth, and a chin that is disproportionate to the face (protruding or underdeveloped).

How to prevent the formation of a crossbite?

It is possible to stop the fixation of malocclusion only at the beginning of its development, that is, in childhood, during the period of milk bite and the change of milk teeth to permanent ones.

First of all, you need to pay attention to the following habits of the child:

• regularly sits with his cheek propped up with his hand on one side;

• touches growing teeth with his hands/tongue;

• deliberately puts the jaw in the wrong position;

• sleeps on a pillow that is too high or low, which affects the position of the spine during sleep.

If the jaws are not closing properly — with a slope to one side, the child should be seen by an orthodontist. The doctor will select appliances to correct the bite, grind the deciduous canines to their natural level if necessary, and make recommendations for home exercises and habit management.

Crossbite is usually treated quickly and without braces in the early stages in children. Provided the child wears removable appliances and follows the recommendations.

Consequences of crossbite

At the initial stages of the development of crossbite, complications are usually associated with the speed and complexity of treatment: the longer the bite does not correct, the more difficult it will have to be treated in the future.

1. The bite is fixed in a skeletal form;

2. Permanent teeth grow incorrectly;

3. Uneven load on the joint, improper development of the joint and posture.

With crossbite of permanent teeth, teeth, gums and temporomandibular joint are subjected to constant uneven stress. The risk of complications requiring expensive treatment and the intervention of several specialists increases.

1. Tooth abrasion. The teeth touch each other unevenly, with irregular surfaces.

2. Caries and tooth decay due to too much stress on certain areas.

3. Chipped teeth. The teeth close in the wrong position, cling to each other.

4. Wedge-shaped defects — cracks in the enamel at the base of teeth.

5. Gingival recession — a decrease in gum tissue at the base of the teeth.

6. Injuries of the mucous membranes, which in a chronic form increase the risk of cancer.

7. Cracks, joint pain when opening and closing the mouth. In a neglected form - pain in the cervical spine, headaches in the temporal lobes.

8. Aesthetic disadvantages: uneven teeth, an asymmetrical face, a disproportionate chin, plaque and stone when crowded.

The above symptoms are individualized and do not necessarily occur in their entirety. However, any uneven stress on the teeth increases the risk of tooth decay. With a proper bite, the teeth and much easier to care for and maintain the health of the entire oral cavity.

How to fix crossbite

Bite correction for children

We have indicated above that the formation of an occlusion begins in childhood, so treatment in the early stages is much faster and easier.

The external manifestations of cross-occlusion can be determined visually, but the final diagnosis can only be made by an orthodontist. Therefore, if a child shows signs of improper closure, it is not recommended to self-medicate.

At the consultation, the doctor will conduct an examination, analyze the images and make an individual treatment plan.

Possible methods of bite correction in children:

• Grinding of milk canines;

• Orthodontic devices: plates, double-jawed and single-jawed, removable and non-removable.

• Partial braces;

• Devices and simulators for training muscles, lips, tongue;

• Children's aligners ;

• Exercises with a speech therapist.

To achieve the result, the orthodontist can prescribe a set of measures, including wearing devices, muscle training, and classes with a speech therapist.

Complications during crossbite treatment

During orthodontic treatment, the patient may show signs of joint dysfunction due to changes in the position of the teeth during clenching and changes in the load on the joint. Such patients are prescribed exercises or appliances to relieve joint pain and muscle training. Timely treatment of TMJ problems prevents serious complications from developing. 

Crossbite correction in the clinic «Konfidencia»

At «Konfidencia» we ensure patient comfort and a competent professional approach at all stages of treatment, including the retention period after braces are removed.

Diagnosis

We pay considerable attention to the very first and most important stage of treatment — diagnosis.

We use state-of-the-art diagnostic 3D tomography to obtain high-quality CBCT images.

During diagnosis and at all stages of treatment, orthodontists conduct a photo protocol: all changes in the oral cavity are carefully recorded and analyzed in order to trace the dynamics of treatment and eliminate errors.

Diagnostic cases are discussed at daily meetings of orthodontists to get the most complete picture of treatment with all the nuances.

Types of braces

Orthodontists are certified to work on different braces and aligners. Our patients can choose the most convenient orthodontic device for them:

• Classic ligature braces;

• Self-ligating braces Damon Q, Damon 3MX;

• Aesthetic clear braces Damon Clear;

• Lingual (internal) braces Incognito, WIN;

• Individualized braces Insignia, which shorten the treatment period by an average of 3-6 months;

• Transparent removable aligners.

Specialists

The orthodontic team «Konfidencia» — is 15 qualified orthodontists, three of whom are opinion leaders of Ormco Corporation — an American braces manufacturer. Orthodontist Petrova Elena Alexandrovna is a specialist in the treatment of the joint.

In difficult cases, the preparation of a treatment plan takes place with the participation of other specialists of the clinic (orthopedists, surgeons, therapists) to create a step-by-step plan for the improvement of the entire oral cavity.

We cooperate with a proven orthognathic surgeon and an osteopath, to whom we refer patients with indications for surgery or for more detailed work with the joint.