Crossbite is one of those problems that looks different depending on when it gets treated. In a child, the treatment options are broader, often faster, and generally less invasive. In an adult, the same underlying issue typically requires more planning and sometimes more complex intervention to achieve the same result.
Understanding why comes down to one thing: whether the jaw has finished growing.
What a Crossbite Actually Is
A crossbite is present when one or more upper teeth sit inside the lower teeth when the mouth is closed. Normally, the upper teeth sit slightly outside the lower teeth. When that relationship is reversed, the affected teeth are in a crossbite.
It can affect the front teeth (anterior crossbite), the back teeth (posterior crossbite), or both. And it can be a tooth-level problem, a jaw-level problem, or a combination of both, which is one reason crossbites vary so much in how they’re treated from one patient to the next.
Why Children Respond Differently to Crossbite Treatment
Before puberty, the bones of the face and jaw are still growing, and the midpalatal suture, the joint running down the center of the upper palate, hasn’t fully fused. This creates a window of opportunity that orthodontists are specifically trained to use.
Palatal expansion in children
For children with a narrow upper jaw causing a posterior crossbite, a palatal expander is often the first-line treatment. The expander applies gentle, consistent pressure that gradually widens the upper arch by stimulating new bone formation at the midpalatal suture. Because the suture is still pliable, it responds to this pressure without surgery.
Dr. Anisa Omar at Omar Orthodontics uses palatal expanders as part of children’s treatment plans where expansion is clinically indicated. The device sits on the upper teeth and is adjusted incrementally, typically over several weeks to months.
Timing here matters. The window for expansion without surgery closes as the suture fuses, which happens progressively through puberty and is generally complete by the mid-to-late teens. Treating a posterior crossbite at age 8 is meaningfully different from treating the same problem at age 25.
Phase 1 treatment for crossbites in younger children
Beyond expansion, Dr. Omar also offers early interceptive treatment for crossbites caught in younger children, particularly anterior crossbites where an upper front tooth is sitting behind a lower tooth. Even minor anterior crossbites can cause abnormal wear on the teeth in contact and, over time, may affect jaw development if the lower jaw repeatedly shifts to accommodate the bite.
A short course of braces, an expander, or a simple removable appliance can address many of these situations in children before they compound into larger problems during adolescent growth.
How Adult Crossbite Treatment Differs
In adults, the jaw is no longer growing, and the midpalatal suture has fused. This changes what’s possible and what’s required.
Dental crossbites in adults
Not all adult crossbites involve bone structure. Some are purely at the tooth level, where individual teeth are angled incorrectly rather than the underlying arch being too narrow. These respond well to orthodontic treatment alone, whether with traditional braces or Invisalign, and don’t require surgical or expansion approaches.
Dr. Omar is a Platinum+ Invisalign Provider with specific expertise in using clear aligners to correct bite issues in adults. For tooth-level crossbites, aligner therapy can be highly effective and has the advantage of being discreet during treatment.
Skeletal crossbites in adults
When the crossbite involves the width of the jaw itself rather than just tooth position, adult treatment becomes more complex. The fused suture can’t be widened through a standard expander the way it can in a child.
Options at this stage include:
- Surgically assisted rapid palatal expansion (SARPE), where a surgical procedure separates the fused suture, allowing an expander to then work similarly to how it does in children
- Orthognathic surgery combined with orthodontics, for cases where the jaw discrepancy is significant, and tooth movement alone isn’t sufficient to correct the underlying skeletal problem
- Dental compensation, where the teeth are moved to mask the crossbite as much as possible without addressing the skeletal cause, which works for milder cases but has limits
The right approach depends on the severity of the skeletal component, the patient’s age, bone density, and whether they’re willing to consider surgery as part of the plan. Not all adults with crossbites need surgery. But it’s important to have an honest conversation about what orthodontics alone can and can’t achieve in a jaw that’s finished growing.
The Practical Takeaway
If your child’s dentist has mentioned a crossbite, getting an orthodontic evaluation sooner rather than later genuinely changes the treatment picture. Problems that require surgery or complex combined treatment in adulthood are sometimes addressed with simpler, less invasive interventions in childhood, simply because the jaw is still accessible.
For adults, crossbite treatment is still very much possible. It just requires a thorough assessment of whether the issue is at the tooth level, the bone level, or both before the right approach can be determined.
Book a Free Consultation at Omar Orthodontics
Dr. Anisa Omar offers free consultations for both children and adults at Omar Orthodontics in South Riding and Chantilly, VA. She holds expertise in crossbite correction, palatal expansion, Invisalign, and dentofacial orthopedics for all ages.
Learn more about children’s orthodontics, palatal expanders, adult orthodontics, and common treatments on the Omar Orthodontics website.
Call (703) 542-6336 or book your free consultation online. The clinic is at 25401 Eastern Market Place Plaza, Suite 100, Chantilly, VA 20152. Flexible financial options and no money down braces are available.