Adult · Crossbite
The crossbite that was pulling her jaw to one side
She did not arrive talking about a crossbite — she arrived talking about headaches when she ate, and a feeling that her jaw sat off to one side. The two were connected. A crossbite on the right was forcing her lower jaw to shift sideways every time she closed, and her muscles had been compensating for it for years.
Before treatment — in their own words
In her words: her upper teeth on the right sat too far inside, she had started getting headaches while eating, and her jaw felt as though it lived more on the left. She also felt awkward smiling. What she described as a cosmetic concern was, underneath, a functional one.
The clinical picture
Examination showed a constricted upper arch with a crossbite on the upper right, a deep bite, and a lower jaw that deflected to the right on closing to find a comfortable fit — a functional shift. The lower front teeth showed wear along their edges from grinding into that compromised position, and an upper wisdom tooth had been removed previously. The headaches were consistent with muscles working overtime to manage the shift.
The plan
A non-extraction Invisalign plan to widen the upper arch and lift the crossbite, so the lower jaw could close straight instead of sliding sideways. Correcting the deep bite and the arch width together was expected to remove the functional shift and take the load off the muscles — addressing the headaches and the smile at the same time.
The outcome
After sixteen months the crossbite was corrected and the upper arch was the right width to meet the lower cleanly. With the interference gone, the jaw closed straight, the off-centre feeling resolved, and the mealtime headaches eased. The worn lower edges were stable in their new, protected position, and she was smiling without the self-consciousness she had walked in with.
Clinical notes (for dental professionals)
- Diagnosis: Constricted maxillary arch; right unilateral crossbite; deep bite; functional mandibular shift to the right on closure; incisal wear lower anteriors
- Treatment: Invisalign Comprehensive, non-extraction; maxillary arch expansion; crossbite correction; deep-bite correction to eliminate functional shift
- Auxiliaries: As indicated for expansion and bite opening (e.g. attachments / elastics)
- Extractions: None during treatment (upper right third molar previously removed)
- Duration: 16 months
- Retention: Vivera upper and lower; monitor occlusal stability