Crossbite: Symptoms, Diagnosis and Treatment

what is crossbite

What is an Crossbite? How To Diagnose, Treatment Methods, and More

Are your teeth misaligned? You may have a crossbite. Crossbite – sometimes called an underbite – is a form of malocclusion, or bad bite, that results in rows of teeth that overlap improperly.

Rather than a proper bite, where the top teeth fit snugly over the bottom teeth with a very slight overbite, a crossbite or underbite occurs when the bottom teeth stick out past the top teeth, either in the front teeth or the back teeth.

There are a variety of different kinds of crossbites and underbites. This guide will help you understand what a crossbite is, the signs to look for in diagnosing a crossbite, and how to treat it. Quality orthodontic care from a licensed, experienced orthodontist can help you achieve a great smile and a proper bite.

Read on to get answers to all your crossbite questions.

What is a Crossbite?

A crossbite occurs when one or more of the bottom teeth sticks out past the top teeth.

There are two types of crossbites: anterior and posterior.

Anterior Crossbites

Anterior crossbites occur when the front bottom teeth stick out further than the front top teeth. The front teeth are the four incisors and the canines on each row of teeth. Anterior crossbites affect about 4-5% of the population. They can be treated with orthodontic care, but for severe cases in adults, some crossbites require a combination of orthodontic care and surgery to set back the lower jaw and achieve optimal results.

Posterior Crossbites

Posterior crossbites are an improper bite in the back of the teeth: the back bottom teeth (the premolars and molars) jut out further than the top bottom teeth. The crossbite may occur on only one side of the mouth, or both sides. Posterior crossbites are more common, affecting roughly 16% of the population, and can also be corrected with a common orthodontic appliance called an expander.

Underbite vs. Crossbite

An underbite is another way to describe a crossbite – the bottom front teeth protrude past the top teeth, creating an improper bite, or underbite. In a healthy smile with a correct bite, there is a very small overbite: the top teeth slightly overlap the bottom teeth, and all the teeth connect when the bite is closed. With an underbite, the reverse is true, leading to malocclusion, or a bad bite. The underbite may occur in the front teeth (anterior crossbite), back teeth (posterior crossbite), or both.

Overbite vs. Crossbite/Underbite

In a healthy bite and a well-aligned smile, there will be a small overbite: the top teeth will overlap the bottom teeth, and the rows of teeth will fit together comfortably when the bite is closed.

With a crossbite, the opposite is true: the bottom teeth stick out past the top teeth. This may be true of just a single tooth or a whole section of teeth.

Overbites may be too deep and require correction; crossbites must also be corrected.

overbite vs crossbite

What Causes a Crossbite?

There are two main causes of crossbites or underbites, genetic causes, and developmental causes.

Like other physical features, teeth alignment and jaw structure are inherited traits. Crossbites are hereditary, so if a parent, grandparent, or other relative has a crossbite, there is a good chance a child will inherit a similar condition.

There is no way to prevent children from inheriting crossbites, but they can be effectively treated with orthodontic care from an experienced, licensed orthodontist.

Various factors during dental development can cause a crossbite, including:

  • Thumb-sucking
  • Mouth breathing
  • Tongue-thrusting
  • Prolonged use of a pacifier or bottle
  • Losing the baby teeth too early
  • Growing the adult teeth

All of the above can contribute to the development of a crossbite. For that reason, dental experts recommend children see an orthodontist beginning at age 7, so the orthodontist can monitor the growth of their adult teeth and determine any potential issues that may arise with their teeth and bite.

Is a Crossbite Bad for Your Teeth?

Yes. If left untreated, crossbites can cause significant damage to your health over time:

  • Headaches, toothaches, or jaw aches
  • Pain when chewing or biting
  • Trouble closing your mouth properly
  • Speech impediments such as lisp or slurs
  • Poor sleep quality
  • Temporomandibular disorder (TMD)
  • Pain in jaw joints or muscles
  • Difficulty maintaining proper oral hygiene
  • Bacterial growth
  • Plaque build-up
  • Cavities
  • Gum or periodontal disease
  • Tooth loss

Crossbites or underbites are treatable with careful intervention from an experienced orthodontic doctor. Children should see an orthodontist as early as age 7, to determine future growth patterns and make any necessary interventions for the development of healthy smiles.

A proper bite and a healthy smile are key to overall health: get expert orthodontic care from licensed, experienced orthodontists to achieve the healthiest teeth possible for a lifetime of good outcomes for your whole body, your confidence, and your life!

How to Treat Crossbites

Crossbites can be treated with orthodontic intervention. If you are concerned about your crossbite or underbite, schedule a consultation with a licensed orthodontist. They will do thorough examinations, including x-rays, to determine your specific condition, and help you choose a treatment plan that works for your preferences, lifestyle, and budget.

There are a variety of treatment options for correcting a crossbite.

adult braces colors


Metal and ceramic braces are both effective for treating crossbites or underbites. Using brackets on each individual tooth, connected by a wire, your orthodontist will carefully and skillfully move each tooth into its correct alignment, moving the misaligned teeth until the bite is proper.

Braces are easy, effective, and comfortable, and a great treatment option for kids, teens, and adults of all ages. They offer quick treatment times with excellent, predictable results, and their widespread use has made them one of the most affordable orthodontic treatment options.

invisalign aligner with case

Invisalign Clear Aligners

Invisalign treatment is an extremely reliable, effective method for correcting crossbites when used by an experienced orthodontist. (Remember, Invisalign is a tool and only works in hands of an experienced professional doctor).

Since they first started creating healthy smiles over 20 years ago, Invisalign clear aligners have gained in popularity for their ease of use and discreet, subtle appearance. Invisalign treatment has helped many people correct their crossbites, and can certainly help you!

Invisalign aligners are custom-created by your orthodontist for each patient’s unique case,  so when you choose Invisalign to correct your crossbite or underbite, your orthodontist will use 3D modeling to create a custom set of aligners designed to safely and effectively align your teeth into the proper position.

The clear aligners are removable, allowing you to eat or drink whatever you want during treatment, and are nearly invisible when worn, so you can achieve a beautiful, healthy smile without disrupting your appearance.

Elizabeth, 18 years old, Crossbite (upper left lateral incisor) correction in 9 months with Invisalign Treatment
elizabeth  yo with crossbite before and after Invisalign treatment


Expanders are an orthodontic tool used in children to expand the upper arch. The expander appliance is used to correct a developing posterior crossbite and facilitate healthy, proper growth of the teeth. Since children’s teeth, bones, and palate are all still developing, this is the best time to intervene and redirect growth in a healthy direction. If the child’s upper arch is constricted, this will likely lead to malocclusion, particularly a posterior crossbite.

The expander helps open the upper arch and make room for all the growing teeth. Expanders are very safe, comfortable, and effective when used as a tool in the hands of an experienced orthodontist. It is not visible when your child smiles, and they will likely not notice it at all once it is fitted on the roof of their mouth

dental surgery

Oral Surgery

For very rare cases, the crossbite may be so severe that oral surgery will be required to help re-align the teeth. Your orthodontist may refer you for oral surgery.  You may be referred for oral surgery prior to beginning orthodontic treatment, or during treatment. Orthodontic treatment will then continue after surgery, and the orthodontist will complete the case and provide a retainer to protect the results of the full treatment.

Jay, 23 Years Old, Surgical Case

Initial Smile and Profile
jay  years old crossbite surgical case initial
Before Surgery
jay  years old crossbite surgical case before surgery
Final Smile and Profile After Surgery
jay  years old crossbite surgical case after surgery final


Retainers are used post-treatment to protect the results of your orthodontic care. After your orthodontist has moved your teeth into their proper positions, you will be given a set of retainers to wear at night and keep your teeth in their new, correct places.

Make sure to wear your retainers as instructed – you want your healthy bite and beautiful smile to last, to keep you healthy and your confidence high for a lifetime.

Crossbites: Before & After Orthodontic Treatment

Manuel, 18 Years Old,  Crossbite Surgical Correction, 24 Months Treatment

Before Treatment
manuel  years old crossbite sugicalcorrection before treatment
In Progress
manuel  years old crossbite sugical correction in progress treatment
After Treatment
manuel  years old crossbite sugical correction after treatment

Tingting, 35 Years Old,  Crossbite, 20 Months Invisalign Treatment

Before Treatment
tingting  years old crossbite before invisalign treatment
After Treatment
tingting  years old crossbite after invisalign treatment

Carlos, 18 Years Old, Front and Back Crossbite, Before and After Treatment with Braces

Frequently Asked Questions About Crossbites

  • 1Why is a Crossbite Bad?

    Crossbites are not only embarrassing and make people want to hide their smiles, they can also cause toothaches, headaches, earaches, jaw pain or tension in the jaw, and lead to temporomandibular disorder (TMD) as well as severe pain in the jaw joints (TMJ). A crossbite can create problems with biting and chewing, making eating painful.

    Misaligned teeth are harder to keep clean, leading to plaque build-up, which can cause cavities, dental caries, abscesses, and decay of the teeth, gums, and bones. This can cause periodontal disease and bone and tooth loss.

    It is very important to treat a crossbite or underbite. For optimal results, it’s recommended that treatment begin when patients are young, and the teeth and bones are still growing. However, a crossbite can be corrected by a skilled professional, with excellent results at any age. Licensed orthodontists are very skilled in correcting crossbites and underbites.

  • 2What Does a Crossbite Look Like?

    A crossbite occurs when the teeth are not properly aligned with the top teeth fitting past the bottom teeth. Instead, one or more of the bottom teeth stick out past the top teeth. This can happen in the front teeth or in the back molar teeth.

    When you bite down, smile to show your teeth and see if any of your bottom teeth stick out past the top teeth, either in the front or back. If they do, this is a crossbite, and you should consult an orthodontist for treatment.

    You may also experience frequent headaches, jaw pain, or discomfort when eating or chewing. These are signs of a potential crossbite.

  • 3What is an Anterior Crossbite?

    An anterior crossbite or underbite is a “bad bite” where the bottom teeth stick out past the top teeth in the front area of the teeth. Anterior crossbites occur in the front four incisor teeth and the canine teeth.

    Anterior Crossbite
  • 4What is a Posterior Crossbite?

    A posterior crossbite or underbite is a bad bite in which the bottom teeth protrude past the top teeth in the back or side areas of the teeth. Posterior crossbites affect the molars and premolars and can occur on only one side or both sides simultaneously.

    Posterior Crossbite
  • 5Can Braces Correct Crossbite?

    Yes, braces are an excellent treatment method to correct a crossbite or an underbite. Metal or ceramic braces can both be used to safely and effectively move teeth into their correctly aligned positions.

    Orthodontists are very experienced with treating all kinds of crossbites and use specialized technology to carefully correct this issue, with lasting results.

  • 6Can Invisalign Correct a Crossbite?

    Yes, Invisalign is an excellent form of orthodontic treatment for correcting a crossbite when used as a tool in the hands of a skilled orthodontic professional. (Remember, any treatment is only as good as the provider who is treating you). Invisalign clear aligners are custom-designed for your specific condition.

    Your orthodontist will use 3D predictive modeling to design an Invisalign regimen that will safely and precisely move your teeth into the correct positions. People love Invisalign for the discreet appearance of the clear aligners, which are nearly invisible when worn, and the effectiveness of the treatment. If you have a crossbite, Invisalign can be an excellent choice to correct it.

    Seek an orthodontic provider with the highest Invisalign experience credentials, such as a Diamond Plus or Diamond Invisalign Provider. These providers are in the top percentage of orthodontists for Invisalign experience and can provide you with the most effective results.

  • 7At What Age Should You Correct a Crossbite?

    The American Association of Orthodontists recommends children see an orthodontist beginning at age 7. Even though treatment may not begin at this stage, a professional orthodontist will take x-rays and be able to predict future development, and make adjustments if necessary, to create the best outcomes for your child’s smile.

    If the child is developing a crossbite, the orthodontist can use early interventions, such as spacers or a palate expander, to encourage proper growth and correct the crossbite as early as possible.

    However, you can expect great results from crossbite orthodontic treatment at any age! Kids, teens, and adults of all ages can get orthodontic treatment for a proper bite and a healthy, beautiful smile!

  • 8How Long Does It Take to Correct a Crossbite with Braces?

    Treatment times depend on the severity of your crossbite, the level of experience of your orthodontic provider, and which treatment you use. Metal and ceramic braces can correct a crossbite in between 6 months and 2+ years. Very mild cases can be completed in 6-8 months.

    Seeking an experienced orthodontist is the most important factor: your provider will use the braces to straighten your teeth, and the most experienced licensed professionals are the most equipped to do this efficiently and effectively.

  • 9How Long Does It Take to Correct a Crossbite with Invisalign?

    Each treatment is different, depending on your unique treatment needs, which treatment you select, and the level of experience of your Invisalign provider. A mild case crossbite can be corrected in 6-8 months; a more severe crossbite will take between 12 and 24 months.

  • 10How Much do Braces Cost for Crossbites?

    Costs vary depending on your specific treatment needs for your diagnosis and where you seek treatment. Braces can cost anywhere between $1,700 and $7,000. Insurance can help you cover the costs of braces treatment, and most orthodontic offices offer payment plans to break up costs into manageable monthly installments.

  • 11How Much Does Invisalign Cost for Crossbites?

    There is a range of Invisalign costs, depending on the severity of your crossbite and the provider you choose. Invisalign costs range from $2,650 to $9,000.

    Insurance can help lower the costs you pay, as well as promotional discounts and monthly payment plans. Your orthodontic provider will work out the financials with you so you can correct your crossbite and achieve a healthy smile.

  • 12How Can Adults Correct a Crossbite?

    Crossbites can be corrected at any age. Beginning treatment in childhood when the teeth and bones are still developing is ideal since this can achieve the longest-lasting results, but crossbites can be corrected in adults of all ages, by an experienced, licensed orthodontist using braces or Invisalign.

    Orthodontists are very experienced with safely and effectively aligning teeth in patients of all ages. Crossbites can have serious consequences for the health of your teeth and your overall health, so it’s important to get them corrected by a skilled orthodontist, no matter your age – for a lifetime of confidence and healthy smiles.

  • 13Can I Correct a Crossbite With Braces for Free?

    Programs like Medicaid and CHIP can help qualifying families cover the costs of children’s braces. In some cases, they may cover the costs in full. Coverage and eligibility vary by state. If your child has a crossbite that needs to be corrected, look into your state’s guidelines for using Medicaid or CHIP to pay for braces, and seek an orthodontist that takes your insurance coverage.

  • 1Sources

    American Association of Orthodontists (AAO) - What is a Crossbite?

    Columbia University in the City of New York - Principles of Cross-bite Treatment (PDF)

    National Center for Biotechnology Information - Orthodontics, Posterior Crossbite

    Crossbite - What you need to know about transforming your smile with Invisalign® treatment

    Doctor Locator - Find the right Invisalign® provider for you

    American Association of Orthodontists (AAO) - Your's First Visit | Parents Guide to Orthodontics