Crossbite Treatment in Shelby Township
A crossbite is when one or more upper teeth bite inside the lower teeth, not outside them. At Fredal Orthodontics, Dr. Thomas Fredal Jr. treats crossbites in children, teens and adults.
*For new patients only. Patients transferring from another orthodontist: $250 consultation fee, credited toward treatment if they start here.
What Is a Crossbite?
In a typical bite, the upper teeth close slightly outside the lower teeth, like a lid over a box. A crossbite reverses this for one or more teeth.
Crossbites are named by which teeth are involved and by whether one side of the mouth or both are affected.
Fredal Orthodontics serves families across Shelby Township, MI and the surrounding communities.
The Four Crossbite Patterns
Posterior Crossbite (Back Teeth)
One or more upper back teeth bite inside the lower back teeth.
Anterior Crossbite (Front Teeth)
One or more upper front teeth bite behind the lower front teeth. It can involve a single tooth or several front teeth.
Unilateral Crossbite (One Side)
The crossbite is on only the right side or only the left side of the mouth.
Bilateral Crossbite (Both Sides)
The back teeth are in crossbite on both sides of the mouth.
Skeletal vs Dental Crossbite
A crossbite can come from where the teeth sit, from the size or position of the jaws, or from both.
Dental Crossbite
The teeth cause the crossbite. One or more teeth are tipped the wrong way, while the size and position of the jaws are not the problem.
Skeletal Crossbite
The jaws are the cause. The upper jaw may be too narrow, or the upper and lower jaws may differ in size or position.
Combined Crossbite
Both the teeth and the jaws play a part.
The Functional Shift
Sometimes the lower jaw slides to one side as the teeth close. This lets the upper and lower teeth fit together.
This is called a functional mandibular shift (a shift of the lower jaw). It is the single most important feature to identify at the first crossbite evaluation.
How Dr. Fredal Diagnoses a Crossbite
Every case at Fredal Orthodontics is diagnosed in 3D with an i-CAT CBCT scan (a 3D X-ray) and an iTero digital scan. Dr. Fredal uses them to check the roots, the bone around them, how the jaws relate and the airway. He looks beyond the crowns (the visible parts) of the teeth.
What he finds can change his decisions, such as whether to expand, guide growth, use braces or Invisalign, or recommend surgery.
When Fredal Orthodontics Treats Crossbite Early
For a true posterior crossbite or narrow upper jaw, timing matters. When palatal expansion is indicated, Dr. Fredal ideally treats between approximately ages 7 and 9½, during the early mixed-dentition years when the maxillary sutures are more responsive to orthopedic expansion.
This is especially important when a crossbite causes a functional shift of the lower jaw. If left uncorrected during growth, that shift may contribute to developing facial and jaw asymmetry. Early expansion can improve the transverse relationship of the jaws while growth is still favorable.
Research supports expansion before the pubertal growth peak, when an RPE can produce greater skeletal widening of the upper jaw and less dental tipping than treatment later in development.
Dr. Fredal does not routinely recommend expansion simply because a child is young. Treatment before age 7 is generally reserved for specific growth concerns, such as Class III cases requiring early facemask therapy. The goal is to treat the right problem at the stage of growth when orthopedic correction can be most effective.
How to Fix a Crossbite at Fredal Orthodontics
Posterior Crossbite in Children: Rapid Palatal Expander
When early treatment is indicated, Dr. Fredal uses palatal expansion while a child is still developing. Fredal Orthodontics offers the rapid palatal expander (RPE). Most Phase 1 (early) treatments at the practice combine a palatal expander with limited braces, and in some cases the expander alone is the most appropriate treatment.
Expansion takes place over 4-6 weeks of daily at-home turns, with a parent turning the screw once per day. The expander then stays in place unturned for at least six months as a retainer. For discomfort, Dr. Fredal advises Tylenol as needed, following the recommended dosing instructions.
Fredal Orthodontics also offers the Invisalign Palatal Expander, a removable, 3D-printed expander. It was the first practice in Michigan to offer it.
Anterior Crossbite: Depends on the Cause
For a skeletal anterior crossbite, Dr. Fredal treats growing children with a reverse-pull facemask, a type of headgear worn on the face. He asks for 8 to 10 hours of wear a day, at night. A typical facemask phase runs 3 to 6 months before he re-evaluates.
Older Teens and Adults: MARPE and SARPE
For older teens and adults, Fredal Orthodontics offers MARPE (miniscrew-assisted rapid palatal expansion), an expander held in place with mini-screws in the palate. Dr. Fredal routinely treats adult skeletal cases with MARPE expansion.
Dr. Fredal plans the treatment, but he does not place the mini-screws himself. A trusted oral surgeon outside the practice places them and may bill separately.
When surgery is part of the plan, Dr. Fredal coordinates SARPE (surgically assisted rapid palatal expansion, where surgery helps widen the upper jaw) with an oral and maxillofacial surgeon. The surgeon does the surgery, and Fredal Orthodontics manages the orthodontic treatment before and after it.
Braces and Invisalign
Fredal Orthodontics offers comprehensive (full) treatment with Damon Ultima braces or Invisalign. Many comprehensive cases are completed in about 12 to 18 months. Dr. Fredal gives you an estimate for your own case after your diagnostic evaluation.
Crossbite Treatment Options at Fredal Orthodontics
| Treatment | Who It Is For | Duration | Starting Price |
|---|---|---|---|
| Palatal Expander (RPE) | Children in Phase 1 (early) treatment | Active: 4-6 weeks; retention at least 6 months | $2,980 for the expander alone |
| MARPE + Braces | Older teens and adults | Dr. Fredal estimates it for your case | From $10,080 as one package, with $2,000 down |
| SARPE | Dr. Fredal advises you at your first visit | Dr. Fredal estimates it for your case | Orthodontic fee in writing at your first visit. The surgeon bills for the surgery. |
| Reverse-Pull Facemask | Skeletal anterior crossbite, children 7-10 | 3-6 months (up to 10 for some) | $4,180 Phase 1 total |
| Damon Ultima Braces | Children, teens and adults | Many comprehensive cases: about 12-18 months | From $5,280 (comprehensive) |
| Invisalign | Children (Invisalign First), teens and adults | Many comprehensive cases: about 12-18 months | Invisalign First from $3,480; comprehensive from $5,280 |
Typical Palatal Expansion Timeline
| Stage | Duration | What Happens |
|---|---|---|
| Consultation and records | 50 minutes | CBCT scan, iTero digital scan and clinical photographs |
| Active expansion | 4-6 weeks | A parent turns the expander’s screw at home once per day |
| Retention with expander in place | At least 6 months | No more turns; the expander stays in place as a retainer |
| Phase 2 comprehensive (if needed) | Many comprehensive cases: about 12-18 months | Braces or Invisalign |
What to Expect at Your Consultation
-
Time.
The visit takes 50 minutes, including 20 minutes with Dr. Fredal. He personally conducts every consultation. -
Records.
A free CBCT scan on the i-CAT FLX V17, an iTero Lumina digital scan of the teeth and clinical photos. -
Airway screening.
Airway screening is part of every comprehensive orthodontic consultation. He asks about habitual mouth breathing, snoring and restless or disrupted sleep. The screening does not diagnose sleep apnea. For concerning findings, he refers patients to an ENT (an ear, nose and throat doctor), typically Dr. Thottam. -
Your review with Dr. Fredal.
He reviews the complete records with you and gives his treatment recommendation. You can also talk about treatment options, timelines and payment options. -
The exact cost in writing.
You get the exact treatment cost in writing.
Before & After
How Much Does Crossbite Treatment Cost in Shelby Township?
Palatal expander, Phase 1 (early) treatment: $2,980 for the expander alone
Phase 1 (early) treatment with braces: from $2,980
Phase 1 with a reverse-pull facemask: $4,180 total
Damon Ultima braces or Invisalign, comprehensive (full) treatment: from $5,280
Comprehensive fees have three levels, by case complexity: $5,280, $6,880 and $7,175. Your fee does not change with how long treatment takes, and it includes every appliance your case needs. Phase 1 and Phase 2 (comprehensive) treatment are not sold together. If your child goes on to Phase 2, $500 comes off the Phase 2 fee.
Insurance & Financing
Fredal Orthodontics is in network with Delta Dental PPO, a preferred provider (PPO) dental plan. For its other accepted PPO plans, the team files your claims on your behalf as a courtesy. The team takes your insurance card when you book, and you get your benefits verification in writing. You can also use HSA or FSA funds (money in a health savings or flexible spending account).
In-house financing has 0% interest and no credit check. The down payment is $500 for Phase 1, $750 for comprehensive braces or Invisalign, or $2,000 for braces with MARPE. Cherry and CareCredit financing are also offered.
The lowest monthly payment the practice advertises is $179. Payment amounts vary based on treatment costs, down payment and financing terms, and plans run up to 30 months.
Paying in full takes 5% off by cash, check or ACH (a bank transfer), or 3% by credit card, on your out-of-pocket portion. Phase 1 qualifies too, and paying in full can be combined with one eligible community discount. Insurance details Current discounts
Frequently Asked Questions About Crossbite
What is a crossbite?
A crossbite is a bite in which one or more upper teeth close inside the lower teeth instead of outside them. It can affect the front teeth, the back teeth, one side of the mouth, or both sides. Those four patterns are called anterior, posterior, unilateral and bilateral.
What is the best age to treat a crossbite?
It depends on your child. Dr. Fredal decides not only how to treat but when treatment should begin. He weighs growth, dental development, skeletal relationships (how the jaws relate) and the goals of treatment.
When palatal expansion is indicated, he ideally treats between approximately ages 7 and 9½. Treatment before age 7 is generally reserved for specific growth concerns. Dr. Fredal recommends that every child have an orthodontic evaluation by age 7.
How is a crossbite treated at Fredal Orthodontics?
It depends on the type of crossbite and the patient’s age. Most Phase 1 (early) treatments at Fredal Orthodontics combine a palatal expander with limited braces. With a rapid palatal expander, a typical case takes roughly 4-6 weeks of active expansion followed by at least six months of retention.
Dr. Fredal uses a reverse-pull facemask for a skeletal anterior crossbite in children 7 to 10. For older teens and adults, the practice offers MARPE.
Who turns the rapid palatal expander, and how often?
On a rapid palatal expander (RPE), a parent turns the screw once a day at home. Those daily turns run for 4-6 weeks. After that there are no more turns: the expander stays in place, unturned, for at least six months as a retainer. If your child is sore, Dr. Fredal advises Tylenol as needed, following the recommended dosing instructions.
Does Fredal Orthodontics treat crossbites in adults?
Yes. Fredal Orthodontics treats children, teens and adults, and Dr. Fredal routinely treats adult skeletal cases with MARPE expansion. MARPE uses an expander held in place with mini-screws in the palate. A trusted oral surgeon outside the practice places the mini-screws and may bill separately.
Braces with MARPE are priced as one package from $10,080. When surgery is part of the plan, Dr. Fredal coordinates SARPE with an oral and maxillofacial surgeon.
Is the consultation for a crossbite free?
Yes, for new patients, and every new-patient consultation includes a free CBCT scan. A second opinion on treatment you are having elsewhere is free too, and so is a consultation about MARPE or other skeletal expansion.
Patients transferring from another orthodontist pay a $250 consultation fee, credited toward treatment if they start here. A return consultation before treatment starts is free, unless a consultation was missed as a no-show; then it costs $100.
Related Conditions
Concerned About a Crossbite?
Book a free new-patient visit at Fredal Orthodontics in Shelby Township. Community discounts take $250 off the part you pay after insurance. One applies per patient. Military, teachers and first responders qualify. So do healthcare workers, students and additional family members in treatment. You need ID proof to claim one.
*For new patients only. Patients transferring from another orthodontist: $250 consultation fee, credited toward treatment if they start here.