Cross Bite
Are you aesthetically bothered by the crowding of your upper teeth? Do you sleep with your mouth open at night and wake up in the morning tired and groggy, despite having spent up to 8 hours "sleeping"?
About crossbite in general
Lateral crossbite is becoming increasingly common in both my pediatric and adult patients. After deep bite, it is the most common dental anomaly. It is usually associated with a high degree of tooth distortion and is often associated with chronic mouth breathing.
The solution to crossbite specifically requires early treatment, as it is easier to shape the growth of facial bones at a young age. There is no point in delaying treatment, as crossbite may require surgery in adulthood.
If you are interested in the possibilities of mouth expansion, read on.
What is a cross-bite?
Under ideal biting conditions, the teeth of the lower dental arch are outlined by the teeth of the upper dental arch. In the case of closed dentitions, the upper teeth should always be on the outside and the wide upper arch fits "under" the lower.
Any case where this relationship changes, i.e. the teeth of the lower arch are "outside" the upper teeth, is called crossbite or cross-contact, depending on whether a group of teeth or just one or two teeth are affected.
Forms of crossbite and causes of its development
Crossbite has two characteristic forms.
1.
From lateral cross-bite is the most common problem. In this case, the upper dental arch is narrow and narrow compared to the lower arch. The teeth do not fit neatly in a neat row. Congestion appears and on the sides we see the lower teeth biting outside the upper teeth. This phenomenon can appear on one or both sides depending on the degree of upper arch crowding.
2.
From anterior crossbite, also known as bulldog bite. A less common form. In this case, the front teeth are involved, with the lower front teeth biting in front of the upper teeth.
The development of lateral crossbite is caused by inadequate tongue function as the face grows, or by all kinds of childhood bad habits: prolonged sucking, finger sucking, lip sucking, etc.
During harmonious facial development, the infant swallowing reflex is transformed into the adult swallowing reflex (when the tip of the tongue rests on the palate behind the teeth during the swallowing cycle), in parallel with the consumption of solid foods.
At the same time, the resting position of the tongue changes and it rises from the floor of the mouth to the roof of the mouth. This active internal muscle force will ensure the proper development of the midface and upper dental arch. I used to say that ideally the upper arch should grow practically around the tongue. This gives the upper arch a nice wide parabolic shape, so that the teeth fit neatly side by side.
If this natural process does not take place and the tongue remains on the floor of the mouth, the growth of the maxilla and the upper dental arch is slowed down and the development of the dental arch is also impeded by the action of the external mimic muscles.
If the abnormality is only due to the position of the teeth, treatment requires simple orthodontic treatment.
In the genetically determined form of bulldog bite, however, there is a discrepancy in the size and position of the jaw bones. This pattern of facial growth is passed down from generation to generation, and the most famous and well-known family in history is the Habsburg dynasty.
Symptoms and consequences
Aesthetic consequences
From lateral cross-bite the first symptoms are crowding of the teeth and changes in the shape of the dental arch.
However, a shift of the lower dental midline is often observed, which in most cases indicates a forced bite.
In this case, the lower dental arch cannot close in the middle, so the whole mandible slides sideways with the jaw tip. If this is not corrected in early childhood, the "misalignment" will stabilize, causing the bone and dental arch to deform.
In such cases, asymmetry of the chin and face can be observed.
From anterior crossbite - i.e. bulldog bite a high percentage of cases also show dental crowding and reverse contact of the front teeth. The lower front teeth bite in front of the upper teeth.
In terms of facial aesthetics, a well developed jaw with a prominent chin.
Health consequences
- In the oral aspect, congested teeth are more difficult to keep clean. This causes plaque to adhere, making it easier for tartar to form, which later leads to more serious gingivitis.
- Uncleaned tooth surfaces also harbour caries-causing bacteria, increasing the chances of tooth decay.
- In terms of general health, the first thing I have to mention is halitosis, with all its consequences.
- One long-term effect of breathing through your mouth abnormal development of the skull and facial bones, which affects us for the rest of our lives.
- Over time, people with untreated halitosis can face more serious problems, such as abnormal facial muscles and tooth growth, and an elongated mouth, gingivitis and tooth decay.
- Shallow sleep is also a common feature of mouth breathing, which can impair daytime performance and, in children, can damage the body's growth processes.
- Children with mouth breathing tend not to sleep well, which can lead to poor concentration and behavioural problems, including ADHD.
- Mouth breathing also reduces the oxygen content of the blood, leading to high blood pressure and heart problems, sleep apnoea and other health problems.
Treatment of crossbite
Nowadays, almost all malocclusions can be treated in adulthood, which is why I like to say that orthodontic treatment is not an SOS procedure.
There is one exception to this. This is the so-called ASAP task of solving the crosscutting. The earlier you recognise it, the easier it is to solve.
From lateral cross-bite is treated by dilating the upper dental arch. We choose the device depending on the degree of upper arch narrowing.
If 4 mm or less of arch expansion is required, the braces themselves are sufficient, either fixed or invisible Invisalign.
In cases where more than 4 mm of arch expansion is needed, we choose the methods of mouth expansion. There are different designs of appliances, collectively known as Hyrax mouth expander. A hyrax Device, in English palate expander, as the name implies, is a device for expanding the palate.
Treatment of anterior crossbite
Front crossbite, also known as bulldog bite treatment, is possible with both fixed and Invisalign appliances.
We use a supplementary rubber band in most cases.
When the cause of a bulldog bite is a genetically determined "overgrowth" of the lower jaw, maxillofacial surgery is considered.
The following results can be achieved by treating crossbite
- We adjust the smile aesthetics, setting the front teeth in the ideal position.
- The relationship between the arches is settled.
- We create a beautiful, harmonious smile.
- We eliminate overloading of the chewing teeth.
- We adjust the bite, making chewing more comfortable and efficient.
- We improve the support of the upper lip, so it can be more fully exposed.
- We improve the appearance of the face by harmonising the functioning of the mimic muscles.
- By regulating the functions of the tongue, breathing and sleep quality are also improved.
Treating bite deviations is not just about creating a beautiful smile! In all our treatments, the goal is to improve the overall quality of life.
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