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A crossbite occurs when upper teeth sit inside the lower teeth instead of outside. We correct crossbites with palatal expanders, braces, and clear aligners — with early treatment producing the best results.
A crossbite is a bite misalignment where one or more upper teeth sit inside the lower teeth instead of outside, affecting either the back teeth (posterior crossbite) or front teeth (anterior crossbite). Untreated crossbites can cause the jaw to shift to one side, leading to asymmetric facial growth and uneven tooth wear. Early treatment with a palatal expander between ages 7 and 10 is highly effective because the jaw is still growing, often correcting the crossbite completely and preventing the need for more complex treatment later.
A crossbite is a type of dental malocclusion where the upper teeth are positioned inside the lower teeth when biting down — the reverse of a normal bite. It can affect one tooth or an entire group of teeth on one or both sides of the mouth.
There are two main types: a posterior crossbite, where the upper back teeth sit inside the lower back teeth, and an anterior crossbite, where the upper front teeth sit behind the lower front teeth. Posterior crossbites are more common and are often caused by a narrow upper jaw. The condition is primarily genetic, though habits like thumb-sucking, prolonged pacifier use, and mouth breathing can contribute to upper jaw narrowing during childhood development.
When left untreated, a crossbite forces the lower jaw to shift laterally to achieve a comfortable bite. Over time, this functional shift can become a skeletal shift — meaning the jawbone actually grows asymmetrically. This can lead to facial asymmetry, TMJ problems, uneven tooth wear, and gum recession on the affected teeth. Crossbite is one of the top reasons orthodontists recommend early interceptive treatment, because correcting it during childhood — while the palate is still developing — is far simpler than treating it in adulthood. Treatment options include palatal expanders for children, braces, and clear aligners for teens and adults.
When you bite down, one or more upper teeth sit inside the lower teeth instead of slightly outside them.
The lower jaw slides left or right when closing to find a comfortable bite — a sign of a functional shift from posterior crossbite.
Abnormal contact between upper and lower teeth causes certain teeth to wear down faster than others, damaging enamel over time.
Chronic jaw shifting from an untreated crossbite can cause one side of the face to develop differently, creating visible asymmetry.
Crossbite makes it uncomfortable or inefficient to chew on the affected side, often causing patients to favor the other side.
Teeth in crossbite receive abnormal forces that can push them toward the cheek or tongue side, causing gum tissue to recede over time.
Dr. Brandon Zipper develops a customized treatment plan based on the type of crossbite, the patient's age, and whether the issue is dental, skeletal, or both. Here is our typical approach to crossbite correction.
We use 3D digital scans, panoramic X-rays, and a clinical bite analysis to determine whether the crossbite is dental (tooth position only) or skeletal (jaw width discrepancy). This distinction is critical because it determines the treatment approach.
For growing children with a narrow upper jaw, a palatal expander is the gold standard treatment. This appliance gently widens the upper jaw over 2 to 4 weeks, correcting the crossbite at its skeletal source. This is the primary reason crossbite is one of the top conditions for early Phase 1 treatment.
For teens and adults, or cases where the crossbite is primarily dental, braces or clear aligners move the affected teeth into their correct positions. Braces offer the most precise control for complex crossbite cases, while aligners work well for mild to moderate corrections.
After correction, custom retainers maintain the new bite alignment. Dr. Zipper monitors the results over time to ensure the crossbite does not return, particularly in growing patients where jaw development is still ongoing.
Crossbites affect patients at every age, but early detection and treatment during childhood produces the most predictable and efficient results.
The cost of crossbite treatment at Zipper Orthodontics depends on the type of crossbite, the patient's age, the treatment method, and the overall complexity of the case.
Phase 1 palatal expansion for children often falls on the lower end of this range, while comprehensive adult crossbite treatment requiring braces or aligners may approach the upper end. Most dental insurance plans with orthodontic benefits cover $1,000 to $2,500 of the total cost — and because crossbite can be classified as a functional problem, some plans may offer enhanced coverage. We verify your benefits before treatment begins and offer flexible monthly payment plans and interest-free financing. Your exact cost is determined at your free consultation.
A crossbite is typically caused by genetics — a mismatch between the width of the upper and lower jaws. If the upper jaw is too narrow, the upper teeth collapse inward and sit inside the lower teeth. Other contributing factors include prolonged thumb-sucking or pacifier use, chronic mouth breathing, delayed loss of baby teeth, and abnormal eruption patterns. Dr. Zipper identifies the specific cause during a free consultation to recommend the most effective treatment.
No. A crossbite will not correct itself and typically worsens over time. In children, an untreated crossbite causes the lower jaw to shift to one side, and this functional shift can become a permanent skeletal change as the jaw grows asymmetrically. In adults, untreated crossbites lead to accelerated tooth wear, gum recession, and TMJ discomfort. The earlier a crossbite is treated, the simpler and more predictable the correction.
The ideal window for crossbite treatment is between ages 7 and 10, when the palatal suture has not yet fused. At this stage, a palatal expander can widen the upper jaw without surgery in just a few weeks. This is why the American Association of Orthodontists recommends a first orthodontic evaluation by age 7. Teens and adults can still be treated effectively with braces, aligners, or advanced expansion techniques, though treatment may be more involved.
A palatal expander is a custom appliance cemented to the upper back teeth. A small key is turned once daily (by a parent or the patient), gradually widening the upper jaw by separating the palatal suture. Active expansion takes about 2 to 4 weeks, followed by 4 to 6 months of stabilization while new bone fills in the expanded area. The process is painless for most patients — mild pressure is normal. Dr. Zipper monitors progress at regular check-ups.
Absolutely. While the palatal suture fuses in adulthood, making traditional expanders less effective, several treatment options remain highly successful. Mild to moderate dental crossbites respond well to braces or clear aligners. For skeletal crossbites, Dr. Zipper may recommend micro-implant assisted rapid palatal expansion (MARPE) or, in severe cases, surgically assisted expansion in coordination with an oral surgeon. A free consultation determines the best path.
Yes. Most dental insurance plans with orthodontic benefits cover a portion of crossbite treatment — typically $1,000 to $2,500 toward the total cost. Because crossbite causes functional issues like jaw shifting and uneven wear, some plans may classify it as medically necessary, potentially increasing coverage. Zipper Orthodontics accepts most major providers and verifies your benefits upfront. We also offer flexible monthly payment plans and interest-free financing.
Dr. Brandon Zipper, DMD, MS — board-certified orthodontist and AAO member — treats crossbites for patients of all ages in Boca Raton, Boynton Beach, and throughout South Florida.
