Most orthodontic problems involve malocclusions, or the misalignment of the upper and lower teeth when biting or chewing.
Different variations of malocclusions are possible. This article examines crossbites, a malocclusion in which the upper teeth bite into the lower teeth.
Cross bites are often the result of nasal allergies that cause the patient to have mouth breathing. Chronically blocked nasal passages can lead to overgrowth of the nasal interior. Constant mouth breathing can also lead to dry mouth, several other types of malocclusions, and lung face syndrome (a longer, narrower face than normal).
A crossbite can also be caused by a narrow upper jaw, or a mismatch of jaw size and positioning between the lower and upper jaws. It can also result when teeth are reversed in position.
Finally, a crossbite can result from the delayed loss of baby teeth. Some patients retain their baby teeth so long that their permanent teeth come behind the baby teeth, giving the appearance of a second row of teeth.
In addition to mouth breathing, visual clues that a patient has a crossbite include snoring, an off-centered appearance of the chin; and sliding the lower jaw to the left or right to facilitate chewing.
If this problem occurs in a patient’s upper jaw, the permanent upper front teeth may become caught behind the lower front teeth during chewing. This can occur on one or both sides of the mouth.
Orthodontist Dr. Atoosa Nikaeen recommends treating crossbite patients as early as possible. This condition can cause:
Excessive tooth wear
Gum disease, including loss of bone around the tooth
Jaw deformity
Incorrect chewing patterns
Temporomandibular joint disease (TMJ)
An unattractive smile
Several treatment options are available. Dr. Nikaeen may recommend orthodontic treatment that begins with a maxillary expansion to widen the patient’s upper jaw. An expansion device is attached to the patient’s palate and dilated every night for one to two months. Once the expander has reached its maximum width, the patient will need to wear the device for approximately three more months to allow the bone to harden into position.
The next step may require the application of braces to the upper teeth, either during or after extraction. This treatment will close the usual “gap-tooth grin” that develops during upper jaw expansion. The patient may eventually need to continue wearing braces for one to two years after completing the expansion.
A cross bite can bite the teeth "Wrong side of the tracks"
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