Orthodontic Care in Pediatric Cancer Survivors: A Review

Abstract

Around 50-200 million children in the age group of 0-19 years worldwide are diagnosed with cancer every year. The success rate of eradicating childhood cancer in developing countries is around 80% depending on the stage at which it is diagnosed. The current oncological therapies of radiotherapy, chemotherapy and bone transplant have helped increase the number of pediatric cancer survivors exponentially. However, these modalities have necessitated the long term medical and dental follow-up. The various anomalies that occur in patients after the treatment affect general health like auditory defects, weight gain, precocious puberty and dental development like stunted root development, trismus, which deter the patient from leading a normal life. Since the growth of the dentition continues up to 14-18 years of age, the paediatric cancer survivors present with a spectrum of ailments from simple xerostomia to osteoradionecrosis and agenesis of teeth. The patients have the manifestations of the previous dental ailments and the deleterious effects of oncological therapy. Hence, orthodontic evaluation and therapy for these pediatric cancer survivors become essential to correct the dental deformities. The different features like mucositis, xerostomia, gingivitis that are typically seen in cancer survivors, can affect not only the length of the orthodontic treatment but also the oral hygiene of the patient in general. Hence, this review article aims to highlight the anomalies seen due to the onco-therapy, a few preventive measures that can be exercised to maintain the patient’s dental hygiene, the factors that are to be assessed prior to the commencement of the therapy and the effects of orthodontic therapy on the oral cavity.