Did you have orthodontia when you were a kid? I did, and it mostly worked, but later on, when I started to have spontaneous abscesses, my endodontist, who was competent at root canals but clueless about listening to patients, insisted that the abscesses were due to the orthodontia. I kept telling him that the abscesses were a typical symptom of XLH, but he wouldn’t listen.
At the time (this was thirty years ago!), I didn’t have access to medical journals, and there weren’t any articles on the topic. Now there is one! It’s small, and covered a short period of time, so further study is needed, but it’s better than nothing, and the findings are encouraging.
In “Orthodontic treatment in children and adolescent patients with X-linked hypophosphatemia,” they found that XLH kids’ orthodontic treatment had similar success to non-XLH patients, and no more relapse than the non-XLH patients.
It was a small study, with only 15 XLH patients (and 15 non-XLHers for comparison), and a short period of monitoring to check for relapse, so it would be good to see further research, looking at more patients over a longer period of time. Even so, this study is an encouraging bit of data for anyone considering the pros and cons of pediatric orthodontic work today.
One interesting tidbit (which the authors indicated needs further study for confirmation) was that the course of orthodontia was slightly shorter for XLHers, possibly because our softer bones allowed the teeth to move faster. It would be interesting to look deeper at a) whether that’s true, and b) whether burosumab treatment causes the patients’ teeth move at the same (slower) rate as non-XLHers’ teeth.
So if you ever wondered if your abscesses were caused by long-ago (or not-so-long-ago for those of you who aren’t ancient like me) orthodontia, you can rest assured that they (probably) weren’t. And if you need a resource to share with your child’s orthodontist, especially if they’re reluctant to get involved with an XLH patient, you finally have one!
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Please note that the author is a well-read patient, not a doctor, and is not offering medical or legal advice.
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