Deep bites and anterior crossbites present significant challenges in a standard orthodontic setup. Left unmanaged, patients will repeatedly bite down on their lower brackets, causing constant breakages, treatment delays, and immense frustration for both the clinician and the patient. To bypass this issue and unlock faster tooth movement, you must strategically use anterior bite turbos or posterior bite bumps to temporarily alter the patient’s vertical dimension.

For severe deep bites, placing an appliance like a fixed bite plate supported by the palate or adding anterior bite turbos to the lingual surfaces of the front teeth is highly effective. This mechanic immediately prevents full closure, allowing the posterior teeth to erupt freely and leveling the curve of Spee, which can be accelerated by box or triangle elastics once you transition into larger wires. However, because the force concentrates heavily on the anterior segment, you must exercise extreme caution. Avoid placing anterior turbos on patients with a history of dental trauma or short roots, as the intensive localized force can widen the periodontal ligament space and exacerbate structural root vulnerabilities.

When your primary clinical objective is to quickly jump an anterior or posterior crossbite, temporary posterior bite bumps are the superior tool. By stacking composite on the occlusal surfaces of the molars or premolars, you slightly lift the occlusion so tucked teeth can slide forward without getting locked behind the lower arch. The danger with posterior bumps lies in leaving them on too long, which causes the supporting teeth to intrude over several months, resulting in an iatrogenic posterior open bite. To prevent this, limit their use to a short window of one to two months and tint the composite a subtle blue using primer mixed with blue articulating paper. This simple visual cue ensures your team will never mistake a lumpy, worn-down temporary bump for a standard composite filling, reminding you to drill it away completely the moment the crossbite clears.