The adolescent after cancer treatment: when the thorough plan is the wrong plan

A young patient finishes chemotherapy and radiation and arrives a few years later with widespread decay. The first plan on the table is complete coverage: crown everything, in porcelain. It looks thorough. It is expensive. And on this dentition it can do harm that shows up years later, when nobody connects it to the plan. This is how I read the radiographs before I read the plan.

In short

On a dentition treated with childhood chemotherapy and jaw radiation, the thorough plan is often the harmful one. Roots may be short or arrested, pulps are large, saliva is reduced, and the bone heals poorly for life. Full-coverage porcelain crowns remove structure the pulp needs, invite an unnecessary change in vertical dimension, and put a tall crown on a short root, which loosens teeth years later. Direct composite at the existing crown form and vertical dimension restores function, preserves options, and changes nothing that does not need changing.

Full piece · registered dentists

The scenario, the mechanism, the precautions and the sources are available to registered dentists. Registration is free and takes a moment: your name, your email, and your NPI, which is checked against the public NPPES registry. Nothing is sold and no list is shared.