Case Study: An Early Referral Corrects A Posterior Crossbite Avoiding Problems Later

Madeline came to Baltimore Orthodontic Group as a referral from her pediatric dentist. At the time, Madeline was 8 years old.

Patient. Madeline’s dentist had noticed the development of a posterior crossbite forming on her right-side. A crossbite occurs when the upper dental arch is too small to fit properly on the lower dental arch. Additionally, Madeline had limited space in the anterior to allow for the eruption of her front teeth. Both her pediatric dentist and mom were concerned about how that crowding would potentially restrict the proper development of her permanent dentition.

Problem. Posterior crossbites do not self-correct with time. In actuality, posterior crossbites become harder to treat as children grow older and their bones begin to "solidify" and become more resistant to changes. Because of this, early intervention is recommended to address posterior crossbites at a young age. It is also important to ensure that adequate space exists for the eruption of all permanent teeth. When there is no space, teeth can often become ectopic (or out of position), and in severe cases, the teeth can even get stuck.

Solution. The decision was made to begin Madeline's case with a palatal expander, which would create additional room to either side of her mouth in order to address the fact that her upper and lower teeth didn’t align properly. Several months later, upper and lower braces were added to help align the front teeth and create more space for the eruption of all adult teeth.

Process. Phase 1. Madeline began her first phase of treatment with Baltimore Orthodontic Group in 2018 and was finished by 2020. In order to stabilize the work that had been done, Madeline was then prescribed retainers to wear at night.

Madeline continued to see us at 4-6 month intervals during this stabilization period. During this time, we kept track as she lost her baby teeth and observed the eruption of her adult teeth. Upon the eruption of her 12-year molars, Madeline was ready for a short course of treatment to finalize her bite and make her smile absolutely perfect.

Phase 2. Her second phase of treatment spanned less than 24 months with full upper and lower braces.

Result.  The results for Madeline were absolutely stunning – as you can see by the photos above. Madeline was a great patient and committed to a positive result throughout the whole process. A lower permanent retainer was placed at the end of Phase II in order to help the lower front teeth stay in their most ideal position.