There is little doubt that the prevalence of patients with underlying medical condition seeking orthodontic care has increased over the past two decades. A pilot study performed in 2002 of several orthodontic practices revealed that more than 25% of patients seeking orthodontic therapy had some medical diagnosis that potentially impacted their care. While the general dentistry literature addresses many of these diagnosis and their medical and dental management, there is a paucity of information in the orthodontic literature as to the impact of these conditions on orthodontic care.