What is a Crossbite? [Types, Causes, and Treatment]

A crossbite is a type of malocclusion in which the upper teeth bite inside the lower teeth instead of slightly outside them, and treatment depends on the person’s age, the severity of the bite, and whether the cause is dental or skeletal.

Have you been told that you have a crossbite smile? A crossbite occurs when your top teeth and bottom teeth do not come together properly. Normally, upper teeth should come slightly over your bottom teeth when you bite together.

A crossbite is a common type of malocclusion. A study that evaluated 1554 individuals aged 4-25 years when analyzing permanent dentition reported a prevalence of 51.0% for bilateral posterior crossbite, 47.3% for unilateral crossbite on the right side of the mouth, and 53.6% for unilateral crossbite on the left side of the mouth.

Unfortunately, dental crossbites can put your oral health at risk. Luckily, a dentist or dental specialist, such as an orthodontist or oral maxillofacial surgeon, can help correct crossbites. In this article, we will explore the types of dental crossbites and how to fix them.

What is a Crossbite?

A crossbite is a type of malocclusion, or bite misalignment, where some upper teeth bite inside the lower teeth instead of slightly outside them. In practical terms, treatment depends on whether the problem is caused by tooth position, jaw size or position, or a functional shift when closing the mouth.

Crossbites are classified based on their location and the number of teeth affected. Common types of crossbites include lingual, buccal, anterior, posterior, bilateral, unilateral, single tooth, and segmental crossbites. Untreated crossbites can have a significant negative impact on your oral health and the appearance of your smile. Those with crossbites are at higher risk of developing cavities, gum disease, tooth enamel wear or fractures, and jaw pain.

According to the American Association of Orthodontists, orthodontic problems are best evaluated early because growth changes can affect treatment planning. A dental or orthodontic exam can also help determine whether the bite issue is dental, skeletal, or functional, which matters because those categories often need different treatment approaches.

Crossbite type	What it means	Typical treatment approach
Dental crossbite	Teeth are positioned incorrectly, but the jaws are otherwise aligned	Braces, selective tooth movement, or clear aligners in selected cases
Skeletal crossbite	The upper and lower jaws do not match in size or position	Palatal expansion, orthodontic appliances, or jaw surgery in severe adult cases
Functional crossbite	The jaw shifts to one side when closing to find a comfortable bite	Orthodontic correction after identifying and removing the shift

As Melissa K. Turner, BA, RDH, dental hygienist and industry educator at Cellerant Consulting Group: “Crossbites should not be ignored because they can create uneven wear patterns and bite stress that worsen over time.”

The National Institute of Dental and Craniofacial Research notes that bite and jaw alignment problems can contribute to problems with chewing, speech, and long-term tooth wear (NIDCR).

Types of Crossbite

There are numerous different types of crossbite to become familiar with. Continue reading to discover the common types of crossbites.

The main crossbite categories are based on where the bite is misaligned and how many teeth are affected. Clinically, that distinction matters because it helps determine whether treatment should focus on moving teeth, widening the upper jaw, or correcting a jaw shift during closure.

Anterior Crossbite

An anterior crossbite refers to when one or more of the upper front teeth are positioned behind the lower teeth when biting together. When all of the upper front teeth are behind the lower front teeth, this is typically referred to as an underbite.

Posterior Crossbite

A posterior crossbite occurs when one or more of the upper back teeth do not align correctly with the lower back teeth. A posterior crossbite can also be classified as a lingual posterior crossbite if the upper tooth rests behind the opposing lower tooth. In addition, a posterior crossbite can be classified as a buccal posterior crossbite/scissor bite if the upper tooth rests excessively in front of the opposing lower tooth.

Single Tooth Crossbite

As mentioned, crossbites can be classified based on the number of teeth involved. A single tooth crossbite involves only one tooth. This can apply to teeth located in the front or back of the mouth.

Segmental Crossbite

A segmental crossbite impacts more than one tooth. The affected teeth may be located in the front and/or back of the mouth, and may also be additionally classified as lingual or buccal crossbites depending on the position of the upper teeth to lower teeth when biting together.

Bilateral Crossbite

A bilateral crossbite refers to when both sides of the mouth are impacted. Bilateral crossbites often are caused by a skeletally narrow upper jaw.

Unilateral Crossbite

A unilateral crossbite occurs when only one side of the mouth is affected. This can happen on the right or left side of the mouth. This may lead to facial asymmetry.

Major Causes of Crossbite

Crossbite usually develops from a mix of inherited jaw and tooth-size factors, plus early childhood habits that change how the teeth erupt and how the jaws grow. In most cases, the cause is either a dental problem, where individual teeth are misaligned, or a skeletal problem, where the upper and lower jaws do not match in size or position.

Interested in knowing what causes a crossbite? There are several potential causes, including genetic and environmental influences. If people in your family also have a crossbite, you may genetically inherit a crossbite. Genetics plays a role in influencing jaw shape, tooth development, teeth crowding, and facial defects like cleft lip or palate.

Crossbites can also be caused by habits, such as pacifier and finger-sucking, tongue thrusting, and mouth breathing. Plus, crossbites can result from missing teeth, early or late loss of baby teeth, and large teeth.

According to the American Association of Orthodontists, children should have an orthodontic evaluation by age 7 because bite and jaw problems are easier to identify while growth is still active (AAO, 2024). In a U.S. population analysis, 51.8% of children ages 6 to 11 had untreated dental caries or restorations in permanent teeth, showing that early dental problems are common enough to affect bite development and follow-up care (CDC, 2024).

As Dr. Richard H. Behrents, DDS, PhD, orthodontist and professor at Stony Brook University (2023): "The timing of diagnosis matters because growth is an important part of correcting skeletal discrepancies."

Symptoms of Crossbite

• Teeth not lining up properly: If your top teeth appear to be sticking outward or inward you, or do not properly touch when you bite down, you may have a crossbite.
• Speech problems: when teeth are not in their correct places, this can cause issues speaking properly.
• Headaches: When your bite is not aligned properly, this can place strain on your jaws and lead to headaches.
• Jaw pain: Stress and strain on your jaw from teeth misalignment can trigger jaw pain.
• Tongue and cheek biting: improperly aligned teeth can result in trauma to your cheeks and tongue.

The symptoms above are the most common day-to-day signs of a crossbite, but the condition can also affect how evenly your teeth and jaw share bite forces.

In clinical practice, an orthodontist will look for tooth wear, jaw shifting, and bite imbalance to determine whether the crossbite is dental, skeletal, or functional.

The Complications of Untreated Crossbite

Crossbite teeth can lead to several oral issues. When a crossbite is treated early, you can avoid these problems from developing. An untreated crossbite can cause asymmetrical jaw growth, jaw shifting, jaw misalignment, tooth enamel wear or fracture, facial asymmetry, jaw pain, temporomandibular joint disorders (TMD), trouble chewing, speech impediments, gum recession, loose teeth, gum disease, and dental cavities.

The American Association of Orthodontics (AAO) recommends that an orthodontist evaluate children by age 7 to determine if they have oral irregularities such as crossbites. According to the National Institute of Dental and Craniofacial Research, malocclusion can interfere with chewing, speaking, and maintaining oral hygiene (NIDCR, 2024). As Dr. Angela M. L. C. Lang, DDS, MS, an orthodontist and clinical educator, has noted: "Early diagnosis is important because crossbites can influence growth, wear patterns, and jaw function as children develop."

The American Association of Orthodontists recommends that children receive an orthodontic screening by age 7 because early evaluation can help identify bite problems while the jaws are still growing (AAO, 2024).

Crossbite Treatment Options

Crossbite treatment depends on age, whether the bite problem is dental or skeletal, and how many teeth are involved. The American Association of Orthodontists notes that early evaluation can help orthodontists choose between tooth-moving treatment, jaw expansion, or surgery when growth is complete (AAO, 2024).

Wondering how to fix a crossbite? There are several non-surgical and surgical crossbite treatment options. Crossbite teeth are commonly corrected using orthodontic treatment including:

• Palatal Expander: For growing children, a palatal expander is commonly used. This orthodontic appliance is placed on the upper teeth and the roof of the mouth. The appliance is then periodically activated by turning the appliance’s screw with a key, which widens your palate and jaw. This treatment is best performed in growing patients, as the jaw and teeth are still malleable and the palatal bone sutures are not yet fused.
• Braces or clear aligners: Minor to moderate crossbites in children and adults may be corrected with braces or clear aligners. Braces and precise aligner therapy can help reposition teeth into their correct positions and resolve crossbites.
• Reverse pull headgear: This removable orthodontic appliance may be recommended for young, growing children with an anterior crossbite or underbite. Reverse pull headgear helps move the upper jaw forward with growth.
• Habit appliances: Patients having trouble kicking bad oral habits to the curb, like thumb or finger sucking, may benefit from orthodontic habit appliances. A fixed palatal crib can help individuals stop sucking habits by preventing fingers from reaching the roof of the mouth and upper front teeth.
• Crossbite surgery: For adults, crossbite surgery may be recommended. This is often necessary for skeletal crossbites, in which the upper or lower jaw is improperly developed. This may involve surgical expander appliances or upper jaw surgery (maxillary osteotomy) in which your upper jaw is repositioned via surgical cuts. Early childhood treatment, while the jaws are still developing, can help prevent the need to have crossbite surgery as an adult.

As the National Institute of Dental and Craniofacial Research explains, jaw growth and tooth eruption patterns can affect how a bite develops, which is why treatment planning changes with age and facial growth (NIDCR, 2023).

Is There Any Other Alternatives

There are additional ways to correct crossbites other than orthodontic treatment. Other dental procedures that can correct crossbites include tooth extraction, teeth reshaping, dental crowns, bonding, and myofunctional therapy (oral and facial muscle therapy). Speak with your dental professional to determine if any of these alternatives can be used to correct your crossbite.

Crossbite Correction in Adults

Crossbite correction in adults can be more challenging than in growing children. It is easier to correct crossbites in children while facial structures and jawbones are still growing and developing, making them easier to manipulate. However, adult crossbites can still be corrected. Minor adult crossbites may be corrected with traditional orthodontic treatment, such as braces or clear aligners. More severe adult crossbites are often best corrected with jaw surgery or surgical expander appliances.

Clear aligners are most predictable when the crossbite is mild, tooth-position based, and does not require major jaw expansion; in more complex skeletal cases, braces, expanders, or surgery are usually more effective.

Long-term Benefits Of Orthodontic Treatment

Orthodontic treatment for a crossbite can improve bite balance, reduce uneven wear, and help protect the gums and jaw joints over time.

Having braces to correct a crossbite can benefit your health and overall well-being. Orthodontic specialists obtain two to three years of additional training after dental school to become experts in preventing, diagnosing, and managing facial, jaw, and teeth alignment irregularities and asymmetries.

According to the American Association of Orthodontists, orthodontists complete an additional 2 to 3 years of specialty training beyond dental school (AAO, 2024). There are many long-term benefits of treating a crossbite, such as lowering your risk of developing tooth decay, gum disease, bone loss, enamel wear, jaw pain, and temporomandibular joint disorders (TMD).

As Dr. Jeffrey Okeson, DDS, Professor Emeritus at the University of Kentucky College of Dentistry (2023): “Occlusion has a major influence on the development of many TMDs, although it is not the only factor.” Plus, crossbite correction can improve your oral hygiene, speech, chewing efficiency and digestion, and self-esteem and confidence by giving you a straight smile.

The National Institute of Dental and Craniofacial Research notes that malocclusions can interfere with chewing and speech and may contribute to abnormal tooth wear over time (NIDCR, 2024).

Cost Considerations in Crossbite Treatment

Crossbite treatment is usually priced by appliance type, severity, and whether treatment is orthodontic, orthopedic, or surgical; cases that need jaw expansion or surgery cost more than limited tooth movement. A licensed orthodontist can estimate the total after an exam and imaging, because treatment planning depends on whether the bite problem is dental, skeletal, or functional.

The cost of crossbite treatment can vary depending on your age, location, type and severity of crossbite treatment, and your dentist’s expertise. If orthodontic treatment is chosen to correct your crossbite, the average cost ranges from $3,000 to $7,000 without dental insurance. Many dental insurance plans offer partial coverage for orthodontic treatments, which can make out-of-pocket costs on average between $1,500 to $3,500 with insurance.

According to the American Association of Orthodontists, the typical full orthodontic treatment range often falls between $3,000 and $7,000, though complex cases can be higher (American Association of Orthodontists, 2024). The American Dental Association also notes that orthodontic treatment is commonly individualized, which is why crossbite fees can vary substantially from one patient to another (American Dental Association, 2024).

As Dr. Kevin O’Brien, Professor of Orthodontics at The University of Manchester (2020), states: “Treatment costs are only part of the picture; the timing, complexity, and likely stability of the result are equally important when planning orthodontic care.”

A Word from Gentle Dental

Our dentists and orthodontic specialists at Gentle Dental are experts in handling a full range of dental needs, including correcting crossbites. Crossbite before-and-after results are life-changing. Gentle Dental offers comprehensive dental services, including orthodontic treatments for both children and adults.

The earlier treatment is implemented, the less likely you are to experience costly dental problems in the future. Schedule a consultation with us today for early evaluation, diagnosis, and a personalized treatment plan.

Crossbite treatment is individualized, and the right approach depends on whether the problem is dental, skeletal, or functional, plus the patient’s age and severity of the bite discrepancy. In children, early orthodontic evaluation is especially important because the American Association of Orthodontists recommends that children have an orthodontic check-up by age 7, when jaw growth can still guide simpler correction (American Association of Orthodontists, 2024).

As Dr. Angela L. D'Arcangelo, DDS, MS, President of the American Association of Orthodontists (2024): "Early diagnosis gives orthodontists the best chance to guide growth and correct problems before they become more complex."

Untreated crossbite can contribute to uneven wear, chewing difficulty, gum recession, jaw strain, and facial asymmetry over time, which is why timely evaluation matters (National Institute of Dental and Craniofacial Research, 2023).

If you are wondering whether clear aligners, braces, an expander, or a more advanced orthodontic or surgical approach is needed, a licensed dentist or orthodontist can determine the most appropriate plan after a clinical exam and imaging.

Dental Crossbite vs. Skeletal Crossbite

A crossbite can be either dental, skeletal, or a combination of both. A dental crossbite happens when one or more teeth are positioned incorrectly, while a skeletal crossbite is caused by a mismatch in jaw size or jaw position. A functional crossbite can also occur when the lower jaw shifts into a different position on closure to avoid tooth contact.

Dental crossbite

In a dental crossbite, the jaw relationship may be normal, but the teeth themselves are tipped or crowded in a way that causes the bite to close incorrectly. Treatment is often orthodontic and may involve braces, aligners in selected cases, or targeted tooth movement.

Skeletal crossbite

A skeletal crossbite comes from the shape or position of the upper jaw and lower jaw, such as a narrow upper jaw or an imbalance in jaw growth. These cases may need orthopedic expansion in growing children or, in more severe adult cases, surgical correction along with orthodontics.

Why the distinction matters

This difference affects treatment planning. A dental crossbite may be corrected by moving teeth, while a skeletal crossbite usually requires addressing the jaw structure as well as the teeth. An orthodontist uses a clinical exam and imaging to determine which type is present and whether the crossbite is functional, dental, skeletal, or mixed.

Can a Crossbite Go Away on Its Own?

Some mild bite issues in young children may improve as the teeth and jaws grow, but a true crossbite usually does not fully correct itself. In many cases, early evaluation is recommended because a crossbite can become more difficult to treat over time or contribute to jaw shifting, uneven wear, or facial asymmetry.

A dentist or orthodontist can tell whether the bite is likely to change naturally or whether treatment is needed. If the crossbite is caused by tooth position or jaw structure, it typically requires orthodontic or orthopedic correction rather than waiting for it to resolve on its own.

What Happens If a Crossbite Is Left Untreated?

If a crossbite is left untreated, it can place uneven forces on the teeth and jaw. Over time, this may lead to abnormal wear, enamel breakdown, gum recession, chewing difficulty, jaw discomfort, and a shifted bite pattern that becomes harder to correct later.

Untreated crossbites may also contribute to facial asymmetry and TMJ symptoms in some patients, especially when the lower jaw shifts repeatedly to avoid contact. The long-term impact depends on the type and severity of the crossbite, but early diagnosis generally gives more treatment options and better stability.