Braces fix a crossbite by applying steady pressure that gradually shifts misaligned teeth and, in some cases, reshapes the jawbone itself. The specific approach depends on whether the crossbite is in the front teeth, the back teeth, or rooted in a skeletal mismatch between the upper and lower jaws. Most crossbite corrections with braces take 12 to 24 months, though simpler cases can resolve faster.
What a Crossbite Actually Is
In a normal bite, your upper teeth sit slightly outside your lower teeth, like a lid on a box. A crossbite reverses that relationship: one or more upper teeth close behind or inside the corresponding lower teeth. This can happen in two places. An anterior crossbite affects the front teeth, where upper incisors sit behind the lower ones. A posterior crossbite affects the back teeth, where the lower molars or premolars jut outward past the uppers during biting.
The cause matters for treatment. A dental crossbite means the teeth themselves are tilted the wrong way, but the jawbones are properly sized and positioned. A skeletal crossbite means the upper jaw is too narrow or the lower jaw is too wide, forcing the teeth into a misaligned relationship no matter their angle. Many crossbites involve some combination of both. Your orthodontist distinguishes between these by examining your facial profile and taking X-rays that measure jaw angles and dimensions.
How Braces Generate Tooth Movement
Braces work by converting a simple physical force into a biological remodeling process inside your jawbone. Brackets bonded to each tooth are connected by an archwire, which is bent or shaped to represent where your teeth should be. Because your teeth aren’t there yet, the wire pulls or pushes them toward the correct position. For a crossbite, this means applying lateral force to move upper teeth outward or lower teeth inward, depending on the situation.
What happens inside the bone is where the real correction takes place. When a tooth is pushed in one direction, the bone on the pressure side gets broken down by specialized cells called osteoclasts. This bone removal is actually the slowest part of the process and determines how fast your teeth can move. On the opposite side, where the ligament connecting tooth to bone gets stretched, different cells called osteoblasts lay down new bone to fill the gap. Over weeks and months, the tooth essentially migrates through the jawbone as old bone dissolves in front of it and new bone forms behind it. This is why braces work gradually: the biology can only remodel bone so fast.
Elastic Bands for Cross-Arch Correction
For many crossbites, archwire pressure alone isn’t enough to pull teeth across the bite. Orthodontists add small rubber bands (intermaxillary elastics) that stretch between the upper and lower arches to create a diagonal or horizontal pulling force. These elastics hook onto brackets, small bonded buttons on the tongue side of teeth, or tiny bends in the wire.
The typical elastic used for crossbite correction is a 1/8-inch medium-force band. If that doesn’t produce enough movement, a heavier-force elastic replaces it. You’ll remove these bands to eat and brush, then replace them. Consistent wear is critical because the force needs to be nearly constant to keep the biological remodeling process going. Skipping hours means the bone remodeling slows and treatment stretches longer.
When a Palatal Expander Comes First
If a posterior crossbite stems from an upper jaw that’s too narrow, braces alone can’t solve it. Moving teeth outward on a jaw that’s too small just tips them at unstable angles. Instead, orthodontists use a palatal expander before or alongside braces to physically widen the upper jaw.
A rapid palatal expander is a small device cemented to the upper back teeth with a screw mechanism running along the roof of your mouth. You turn that screw a tiny amount each day with a special key. Each turn widens the jaw by about 0.5 millimeters. The device works by pushing apart the two halves of the palate, which are joined by a seam of softer tissue called a suture. In children and adolescents, this suture hasn’t fully hardened, so it separates under steady pressure. New bone gradually fills in the gap, making the expansion permanent.
Once the jaw reaches the right width, braces take over to fine-tune individual tooth positions and lock in a stable bite. The expander typically stays in place for several months after reaching the target width, giving the new bone time to solidify.
Why Age Changes the Treatment Plan
Children and teenagers respond to crossbite correction more easily because their bones are still growing. The palatal suture is flexible, jaw growth can be guided, and bone remodels faster. This is why many orthodontists recommend treating crossbites in the mixed dentition stage, when a child still has both baby and permanent teeth.
Adults face a different situation. The palatal suture fuses during the late teens, so a standard expander can’t separate it. For adults with a mild skeletal crossbite, orthodontists may use braces to compensate by tipping teeth into better positions, accepting a compromise rather than true skeletal correction. For moderate cases, a surgically assisted expander can work: a surgeon loosens the suture, and then the expander widens it. For severe skeletal crossbites where the jaw discrepancy is too large for braces to mask, upper jaw surgery is the primary correction. Braces are then used before and after surgery to align the teeth within the newly positioned jaw. Jaw surgery is generally not performed until bone growth is complete, which happens around ages 14 to 16 in girls and 17 to 21 in boys.
What Treatment Feels Like
The first few days after braces are placed or adjusted are the most uncomfortable. You’ll feel a deep, aching pressure as the force begins compressing the ligament around each tooth. This pressure peaks around 24 to 72 hours after an adjustment and then gradually fades. Over-the-counter pain relievers and soft foods help during this window.
Palatal expanders create a different sensation. Each time you turn the screw, you may feel pressure across the roof of your mouth, the bridge of your nose, or even behind your eyes. This is normal and reflects the force traveling through the midface bones. Some patients notice a temporary gap opening between their two front teeth as the palate widens. That gap closes naturally as braces bring the teeth together later.
Cross-bite elastics add a pulling sensation that takes a day or two to get used to. Talking and opening your mouth wide feel awkward at first, but most people adapt within a week.
How Long Crossbite Correction Takes
Crossbites generally fall on the more complex end of orthodontic treatment. Simple dental crossbites involving one or two teeth can sometimes resolve in 6 to 12 months. Moderate cases with multiple teeth or mild skeletal involvement typically require 12 to 18 months. More severe crossbites, particularly those needing palatal expansion or surgical intervention, often take 18 to 24 months or longer. Bite correction adds time because the orthodontist isn’t just straightening teeth, they’re repositioning how the upper and lower jaws meet.
After active treatment ends, retention is essential. You’ll wear a retainer to hold the correction in place while bone fully hardens in its new configuration. This matters more for crossbite than for simple crowding corrections, because roughly 1 in 5 patients who had a posterior crossbite corrected during childhood experience some degree of relapse at long-term follow-up. About 19% of the expansion achieved tends to narrow back over time. Orthodontists account for this by intentionally over-expanding slightly, building in a buffer so that even with some relapse, the bite stays corrected.
What Happens if a Crossbite Goes Untreated
A crossbite doesn’t stay the same over time. Because the teeth meet in the wrong relationship, the biting forces hit at abnormal angles. This accelerates enamel wear on the affected teeth and can cause gum recession where the force concentrates. Over years, the uneven loading contributes to jaw pain and can aggravate or trigger problems with the jaw joint. Chewing efficiency drops, and some people unconsciously shift their jaw to one side to compensate, which can worsen facial asymmetry. In children, an uncorrected crossbite can redirect jaw growth, turning a dental problem into a skeletal one that becomes harder to fix with age.