The Importance of Treating Functional Cross Bite: A Clinical Viewpoint

Functional cross bites can bring about structural changes on account of asymmetric condylar positioning and neuromuscular patterns. In the long term uneven bite forces and asymmetric EMG loading patterns can lead to mandibular asymmetry, periodontal damage and poor esthetics. Moving the involved teeth into optimal functional positions can normalize the path of mandibular closure and eliminate asymmetric neuromuscular function. It is important that these changes are done early, during the mixed dentition stage, to minimize factors that are detrimental to harmonious occlusion and jaw growth. However, sometimes due to insufficient awareness, the visit to the dental office for regular checkups does not take place until signs of facial asymmetry or gross irregularity in the alignment of anterior teeth are evident. The adolescent is well into the permanent dentition by then and has a firmly established forward path of closure of the mandible which is not easy to alter. Eliminating the forward slide of mandible even at this stage can position the condyles symmetrically within the glenoid fossae. Establishing a positive overjet can help to limit the unrestricted mandibular growth that might have occurred, had the reverse incisor relationship persisted.