Dr. Chiraz Guessaier spoke to Dr. David Kennedy, Clinical Professor and Co-clinical Director of the graduate orthodontics program at the Faculty of Dentistry, UBC, about the pertinence of early orthodontic treatment to correct a non-skeletal anterior crossbite.
Correction of non-skeletal anterior crossbites are fairly easy to recognize and can be treated successfully. In order to determine if early orthodontic intervention is required, the clinician can ask him/herself 3 questions:
- If I treat this condition now, will I still have more to do at a later date?
- If I don’t treat this issue now, will it cause harm?
- If I don’t treat now, will it be more difficult to treat later?
Anterior crossbites can be either of skeletal or dental origin with the former being more challenging to treat. Cephalometric analyses are important to help evaluate the origin of the crossbites. Additionally, a thorough family history and enquiring whether any family members have had or have been recommended to have orthognathic surgery will give clinicians insights into the potential for the same treatment for their patient.
An anterior dental crossbite often involves only one tooth and can be treated with a removable retainer with clasps in the anterior and molar regions and a spring in the region where the tooth is in crossbite. One must also keep in mind that in the mixed dentition, teeth will be exfoliating so clasps which are required for retention should not be placed in areas where teeth will be lost.
Not every patient is a candidate for a removable appliance, and some may be better suited to have a fixed appliance but, in the mixed dentition, the fixed appliance will automatically create distal tip of the roots of the lateral incisor which will interfere with the root of the developing permanent canine. Relapse rates of anterior crossbite treatment are rare.
Skeletal anterior crossbites are more challenging to treat and referral to an orthodontist is recommended.