Crossbites & Spacing

Crossbite refers to teeth that erupt and function inside or outside of the opposing dental arch. Anterior crossbites are when the upper front teeth bite behind the lower front teeth. Posterior crossbites are when the upper back teeth bite either inside or outside of the lower back teeth. Crossbites can be individual or groups of teeth. Posterior crossbites can be caused by narrowing of either jaw due to inheritance, oral habits such as tongue thrust, finger sucking and mouth breathing related to enlarged tonsils or allergies. The change in tongue posture that results from these oral habits results in narrowing of the upper jaw and the development of crossbites. Crossbites of anterior teeth can result from crowding of the teeth due to insufficient room, retained baby teeth causing deflection of the adult tooth or abnormal facial growth problems.

Crossbites can be very damaging to the teeth. They cause excessive occlusal wear of the teeth, lead to jaw joint discomfort (TMJ) and cause periodontal problems.

Crossbites are usually corrected as early as possible to minimize adverse consequences. In children and adolescents, expansion can be done with fixed or removable appliances whereas in adults, moderate crossbites can usually be corrected orthodontically and severe crossbites may require surgical expansion.

In adults, spacing can result from weakening of the supporting tooth structures due to periodontal disease associated with bone loss and gum recession. This is particularly noticeable when posterior teeth have been lost due to decay or gum disease resulting in excessive occlusal forces on the front teeth during function.

Spacing between the teeth can result in damage to gum and bone supporting tissue due to food impaction when chewing. Spacing can result in an unstable occlusion due to continued shifting of the teeth during function. Many people are self conscious and unhappy with their smile due to excessive spacing.

Treatment of spacing problems is successful with orthodontic treatment at any age. In children, once oral habits are controlled, spaces can be closed successfully. In most children, braces are used to close spaces but in adolescents and adults, Invisalign treatment is ideal for esthetic reasons.