Orthodontic considerations in the pediatric cancer patient: A review

Abstract

It is now estimated that 1 in every 900 young adults between the ages of 16 and 44 is a survivor of childhood cancer. The overall survival rate for all types of childhood cancer is now approaching 80%. Approximately 50% of all survivors will experience delayed sequelae of therapy. This review focuses on the special considerations to be taken into account when planning orthodontic treatment of long-term survivors of childhood cancer. Both chemotherapy and radiation therapy given to the growing individual will have consequences for growth, dental development, and craniofacial growth. The caries risk may also be increased due to salivary dysfunction. It has been shown that although ideal treatment results are not always achieved, orthodontic treatment does not produce any harmful side effects. Strategies used by orthodontists in treating this patient group may include using appliances that minimize the risk of root resorption, low force application, accepting a compromised treatment result by simplistic mechanics and terminating the treatment earlier than normal, and not treating the lower jaw. It is advised to postpone the start of orthodontic treatment at least 2 years after completion of cancer therapy.