<p><strong>SOLUTION:&nbsp;</strong>Most doctors frequently indicate that crossbites should be corrected as soon as they are observed. A single anterior crossbite can, if left untreated, affect not only loss of space in the arch for this tooth, but also the growth pattern of the entire arch. Simple interceptive procedures at an early age can have a dramatic effect on the long-term dental health of the patient.</p>

<p><img alt="Anterior Crossbite Case 2 Solution - Click for Larger Image" src="https://www.ordont.com/images/problem-solution/Anti-Crossbite-with-Gear---.jpg" style="float:right; height:204px; width:220px" />One of the most frequently prescribed appliances for anterior crossbite is a Hawley Removable Appliance with Mini-Gear. The mini-gear mechanism has the advantage that the patient or parents can be instructed to activate the appliance at home, thus providing continuous pressure between visits. A key is provided with the appliance to activate the gear once approximately each three to seven days. The acrylic is moved labially against the lingual surface of the tooth with each adjustment. One turn of the gear provides approximately one-quarter millimeter of activation. A posterior bite block provides clearance for the lingually locked tooth. Where space has already been lost, appliance modifications can be included to assist in regaining the space needed.</p>

<p>At the outset, most doctors will schedule their patients once a month to check the progress of the case. An appliance that does not seat fully usually indicates the need for more continuous wear. The gear is reversed until the appliance seats once again and the patient is instructed that the appliance should be worn at all times.</p>

<p>The labial bow serves as a guide for final labial positioning as the case progresses. Once the anterior is out of crossbite, the appliance can be used as a retainer. The occlusal bite block can be removed and the gear stabilized with ligatures.</p>
