Fixing a crossbite depends on the type of crossbite, your age, and how severe the misalignment is. Treatment ranges from palatal expanders in children to braces, clear aligners, or surgery in adults. The best outcomes happen with early intervention, ideally around age 7 or 8, but adults have effective options too.
What a Crossbite Actually Looks Like
In a normal bite, your upper teeth sit slightly outside your lower teeth when you close your mouth. A crossbite reverses that relationship, either in the front or back of your mouth, so that one or more upper teeth end up tucked behind or inside the lower ones.
There are three main types. A posterior crossbite affects the back teeth, where the upper molars or premolars sit inside the lower ones instead of outside. An anterior crossbite involves one or more front upper teeth sitting behind the lower front teeth. A less common type called a buccal crossbite (or Brodie bite) is the opposite problem in the back of the mouth: the upper teeth bite completely outside the lower teeth with no contact between them.
The type matters because it determines which treatment works best. Posterior crossbites often involve a narrow upper jaw and may need expansion, while anterior crossbites can sometimes be corrected by repositioning individual teeth.
Why Early Treatment Gets Better Results
The American Association of Orthodontists recommends children have their first orthodontic screening no later than age 7. That timing isn’t arbitrary. In children, the two halves of the upper jaw haven’t fully fused yet. A seam of cartilage runs down the center of the palate, and while it’s still flexible, the jaw can be widened without surgery.
Orthodontists typically recommend starting a palatal expander around age 7 or 8 for this reason. Once the palatal suture fully fuses, usually in the mid-to-late teens, non-surgical expansion becomes much harder or impossible. Catching a crossbite early can mean the difference between a simple appliance worn for a few months and a surgical procedure years later.
Palatal Expanders for Children
A palatal expander is the most common fix for posterior crossbites in kids. It fits against the roof of the mouth and gradually pushes the two halves of the upper jaw apart, making it wider so the upper teeth can sit properly outside the lower teeth.
There are a few types your orthodontist might recommend:
- Rapid palatal expander: The most common type. It attaches to the upper back teeth and has a small screw in the center. You (or your child) turn the screw a tiny amount each day with a special key. It widens the jaw at a rate of about 0.5 millimeters per day. Active expansion usually takes a few weeks, followed by several months of wearing the device so the bone can stabilize.
- Removable expander: Made from chrome and similar in appearance to a retainer. This option works when the jaw only needs minor widening.
- Surgically assisted expander: Placed into the palatal suture by an oral surgeon. This is reserved for older teens or adults whose suture has partially or fully fused.
After the expander has done its job, most kids still need braces or another appliance to fine-tune tooth alignment. The expander fixes the jaw width; the braces fix the individual tooth positions.
Braces and Clear Aligners
Traditional braces remain a reliable option for crossbite correction at any age. They work well for both anterior and posterior crossbites, especially when teeth need to be moved individually rather than expanding the whole jaw. Braces can apply precise force to specific teeth, tipping them into the correct position over months of treatment.
Clear aligners are an increasingly popular alternative, particularly for mild to moderate crossbites. Clinical evidence shows they perform well for anterior crossbite correction and can achieve meaningful arch expansion of roughly 3.0 to 3.5 millimeters. For children in mixed dentition (a mix of baby and adult teeth), clear aligner systems designed for younger patients can address both posterior and anterior crossbites effectively.
That said, clear aligners have limits. When significant palatal expansion is needed, rapid maxillary expanders consistently outperform aligners. Research comparing the two approaches found that traditional expanders produce greater increases in palatal width and volume. If your crossbite stems from a narrow jaw rather than a few mispositioned teeth, an expander followed by braces or aligners will likely give you a better result than aligners alone.
Fixing a Crossbite as an Adult
Adults can absolutely correct a crossbite, but the path is different because the palatal suture has fused. The jaw bones are no longer flexible enough to be pushed apart with a standard expander, so treatment often involves one of two routes.
For mild crossbites where the jaw width is adequate but individual teeth are out of position, braces or clear aligners can shift teeth into proper alignment. This is the simpler scenario and works much the same as it does for teens.
For crossbites caused by a genuinely narrow upper jaw, adults may need surgically assisted rapid palatal expansion (SARPE). In this procedure, an oral surgeon makes small cuts in the palatal bone to reopen the fused suture, then an expander is placed to gradually widen the jaw over the following weeks. The decision between a non-surgical approach using mini-screws and a surgical approach depends on how completely the palatal suture has fused. Imaging can reveal the maturation stage of your suture, and patients with fully fused sutures are generally advised to go the surgical route.
Recovery from SARPE involves swelling and discomfort for the first week or two, followed by a daily expansion phase similar to what children experience. The total process from surgery through stabilization typically takes several months before any additional orthodontic work begins.
What Happens if You Leave It Untreated
A crossbite doesn’t correct itself. In children, an untreated crossbite can cause the jaw to grow asymmetrically as the lower jaw shifts to compensate for the misalignment. Over time, this can become a skeletal problem rather than just a dental one, making treatment more complex later.
In adults, the main concerns are uneven tooth wear and jaw discomfort. When teeth don’t meet properly, certain surfaces grind against each other in ways they weren’t designed to, wearing down enamel unevenly over years. There’s also some association with jaw pain: research has found that people with crossbites affecting both the front and back teeth simultaneously have a higher prevalence of painful jaw disorders compared to people with normal bites, though the relationship is modest and varies between individuals.
Crossbites can also cause gum recession on the affected teeth, since the abnormal bite forces push teeth in directions that stress the surrounding gum tissue.
Cost and What Affects It
The cost of crossbite correction varies widely depending on the treatment approach, the number of appointments, and where you live. The main cost drivers are the type of appliance used, staff and facility time, lab fees for custom devices, and the length of treatment.
Simpler appliances cost far less in materials than complex ones. A European study comparing two approaches for anterior crossbite correction found that material costs for the simpler method averaged around €32 per patient, while the more involved approach averaged €227. When factoring in all costs including appointments, staff time, and parents’ time off work, total costs ranged from roughly €630 to €945 per patient for successful treatment. U.S. prices tend to be higher, and full orthodontic treatment involving braces after expansion can add significantly to the total.
Many dental insurance plans cover orthodontic treatment for children, though coverage for adults is less common and more limited. If your plan includes orthodontic benefits, crossbite correction generally qualifies since it’s considered a functional issue, not purely cosmetic. Payment plans through orthodontic offices are widely available and can spread costs over the length of treatment.