Your Child Has a Crossbite: What Can Phase 1 Treatment Do?
Your 8-year-old still has plenty of baby teeth, but you've noticed something off. When they bite down, some of their top teeth sit behind the bottom ones. Maybe their jaw seems to slide to one side when they close their mouth. Is it too early to see an orthodontist? Or is this something that should be checked now?
Baby teeth don't rule out an orthodontic evaluation. In fact, some bite problems are easier to correct while a child is still growing. The real question is whether your child has a specific concern worth treating now, or whether watching and waiting is the better choice.
This guide explains what a crossbite is, the signs to watch for at home, how early (Phase 1) treatment works, and what to ask at your child's first visit.
The American Association of Orthodontists (AAO) recommends a first orthodontic checkup by age 7. By then, a child usually has a mix of baby and permanent teeth, which lets an orthodontist spot developing problems early.
That's a recommendation to check, not to start treatment. Most children seen at age 7 don't need braces right away. At Textbook Orthodontics, we see an early visit as a chance to understand what's happening now and explain what, if anything, needs to happen next.
What is a crossbite?
A crossbite means some upper teeth close inside the lower teeth instead of outside them. There are two main types:
- Posterior (back teeth) crossbite: upper back teeth sit inside the lower back teeth, on one side or both. This often happens when the upper jaw is narrow compared to the lower jaw.
- Anterior (front teeth) crossbite: one or more upper front teeth sit behind the lower front teeth when your child bites down.
Crossbites can also be caused by the position of a single tooth, or by the size and shape of the jaws. That difference matters, because it affects whether and when treatment makes sense.
Signs to watch for at home
You can't diagnose a crossbite at home, but you can notice clues worth mentioning at an evaluation:
- Upper teeth sit behind or inside lower teeth when your child bites down
- The lower jaw slides to one side as your child closes their mouth
- Your child's chin or smile looks off-center
- Uneven wear or chipping on certain teeth
- Your child says biting or chewing feels uncomfortable
- Your child often breathes through their mouth or has trouble chewing certain foods
A jaw that shifts to one side when closing is especially worth having checked. When a crossbite forces the jaw into an off-center position, it may affect how the jaw grows over time.
Why timing matters
Children's jaws are still growing. In younger children, the two halves of the upper jaw haven't fully fused yet, which is why a device called a palatal expander can gently widen a narrow upper jaw. As children get older and that growth slows, widening the upper jaw becomes harder.
That's why some crossbites are worth treating during the mixed-teeth years, when both baby and permanent teeth are present. But not every crossbite needs early treatment. As Dr. Nathan Nourian discusses in his book Breathe. Bite. Smile., growth and development are part of the timing decision. Waiting for every baby tooth to fall out isn't automatically the best plan, but neither is starting treatment automatically.
Other reasons a child might need early treatment
Crossbites are one of several issues an early evaluation can catch. Others include:
- Severe crowding, where there isn't enough room for permanent teeth
- Upper front teeth that stick out and are more likely to be injured
- An underbite, where the lower teeth sit in front of the upper teeth
- An open bite, where front teeth don't meet, sometimes linked to thumb sucking
- Baby teeth lost very early or very late
What happens at the first evaluation
At a complimentary evaluation with Dr. Nourian, here's what to expect:
- Bite check: Dr. Nourian watches how your child's teeth meet and whether the jaw shifts as they close.
- X-rays and photos: these show the position of the jaws and teeth, available space, and which permanent teeth are still developing.
- A plain-language explanation: what's happening now, what problem treatment would solve, and what might happen if you wait.
- A recommendation: either a targeted first phase of treatment, or monitoring with check-ups as more permanent teeth come in.
No responsible recommendation can be made for any child without an exam. Two 8-year-olds with crossbites can need very different plans.
Phase 1 and Phase 2 at a glance
If treatment is recommended, it's often split into two phases with very different jobs:
| Phase 1 (early) | Phase 2 (comprehensive) | |
|---|---|---|
| When | Mixed teeth, while baby and permanent teeth are both present | After most permanent teeth have come in |
| Goal | Fix a specific problem now, like a crossbite or narrow upper jaw | Full alignment and final bite correction |
| Common tools | Palatal expander or limited braces | Full braces or clear aligners |
| Typical length | About 9 to 12 months, though it varies | Depends on the teeth and bite at that time |
| Needed for everyone? | No, only when a specific concern benefits from early care | No, some children who complete Phase 1 won't need it |
A successful Phase 1 means meeting its specific goal. It doesn't mean every future crowding or bite issue is solved, and we won't promise that it is.
What life with an expander is like
If Dr. Nourian recommends a palatal expander, here's what families can generally expect:
- Adjustments at home: many expanders are widened gradually with a small key, following a schedule we'll show you.
- A short adjustment period: speech and eating may feel different for the first several days.
- A gap between the front teeth: this is a normal sign the expander is working, and it usually closes on its own or with later treatment.
- Extra cleaning: food can get trapped around the appliance, so brushing and rinsing after meals helps.
The break between phases is still part of the plan
After Phase 1, your child may go a while without any appliance as baby teeth continue to fall out. It can feel like treatment is over, but this resting period still matters. Follow-up visits let us watch how permanent teeth come in, how the jaws grow, and whether the crossbite correction is holding.
Because you see Dr. Nourian throughout care, the orthodontist who set the original goal is the one checking your child's progress against it.
Frequently asked questions
Will my child's crossbite fix itself?
Some minor tooth-position issues improve as permanent teeth come in, but crossbites caused by a narrow jaw or a jaw shift usually don't. An evaluation can tell you which type your child has.
Is 7 or 8 too young for braces?
Not for an evaluation. Most children don't need treatment at that age, but some benefit from a short, targeted Phase 1 while they're still growing.
Does the resting period mean treatment is over?
Active Phase 1 treatment may be over, but monitoring isn't. We'll keep checking growth and new teeth before deciding whether Phase 2 is needed.
Does early treatment mean paying for braces twice?
Not necessarily. Some children won't need Phase 2. Others will need braces or aligners for goals Phase 1 was never meant to cover. We'll explain the purpose and cost of each recommended phase before you decide. Early treatment shouldn't be sold as a guaranteed way to save money later.
Is the first evaluation really free?
Yes. Our early consultation is complimentary and includes x-rays and photos.
Three questions to bring to the evaluation
- What is my child's crossbite affecting right now?
- If you recommend Phase 1, what will count as success?
- What would we need to see at follow-up visits to consider Phase 2?
For families in the San Fernando Valley, Whittier, and nearby Los Angeles communities, Textbook Orthodontics offers a complimentary early consultation, including x-rays and photos. You'll meet Dr. Nourian, talk through whether treatment or monitoring makes sense, and can ask about Medi-Cal, PPO insurance, monthly payments, and 0% interest financing. Coverage, financing eligibility, and costs are confirmed for each family. Schedule a visit at textbookorthodontics.com.