Typically, when a parent brings a young child to the dentist, the last discussion they’re expecting to have is one centered on braces and orthodontic appliances. Yet, even at ages three and four, a talk about braces, sagittal expanders, and retainers can indeed be front and center when a child is diagnosed with a crossbite. The question then is what to do about it, how soon should intervention take place, and what the complications are that can arise if nothing is done at all. Let’s get some answers.
What Exactly Is a Crossbite?
Imagine for a moment you’re sitting in front of a nice soup bowl with a wide flat brim, and inside that bowl is hearty chowder you’d like to keep warm until you’re ready to devour it. So, you grab another bowl designed exactly like the first, and hover it upside-down over the bowl containing the soup. As you slowly lower it, you try to line up the brims so when they rest together they form a nice even seal. Unfortunately, given the soup is hot, you don’t quite get the brims to line up perfectly, and the edge of the top bowl ends up resting just slightly to the left of the lip on the bottom bowl. The way these two bowls now rest unevenly atop one another is exactly what you would see in a person with a crossbite. A crossbite can affect several teeth, or a single tooth, and can occur on either one side of the mouth or both. Simply put, if any one tooth (or several teeth) lies nearer the tongue or cheek instead of coming together evenly, you’re likely dealing with a crossbite.
So, What To Do About It And When?
The dental community is split on when to initiate treatment for a crossbite, with some suggesting treatment should begin as soon as it is noticed (sometimes as early as age three), while others suggest parents should wait until a child’s sixth year molars have arrived. Despite the difference of opinion as to when treatment should begin, dentists and orthodontist are in agreement that the condition cannot be left untreated. Doing so presents a host of complications for the child later in life including gum and tooth wear, uneven jaw development that can lead to temporomandibular joint disorder (TMJ), and facial asymmetry – something no parent or child wants.
What Does Crossbite Treatment Look Like?
Crossbite treatment generally involves adjusting the spread of a child’s teeth with dental appliances so the bite pattern matches evenly on all sides. Depending on the type of crossbite a child has, this can be done with dental expanders that resemble orthodontic retainers, and include a screw that is tightened nightly to “spread” a child’s bite to the prescribed width. Additionally, dental facemasks, braces and clear aligners may be used – particularly when a single tooth is out of alignment.
Crossbites are generally regarded as genetic in nature, and they’re not overly common. It is, however, a condition that needs to be treated before permanent damage to a child’s facial and oral development occurs. So, if you find yourself at the other end of a discussion about having your little one wear a dental expander, be sure you listen and get however many opinions regarding that advice as you require. Your child, and your wallet, will thank you long into the future.
Dr. Perez has been in the private practice of Pediatric Dentistry and Orthodontics for almost 30 years. He has been educated in top universities around the world, receiving training in the United States, Spain and Mexico. He is currently a member of the American Academy of Pediatric Dentistry. Dr. Perez is fluent in both Spanish and English.