Abstract
Brugada syndrome shows a right bundle branch block-like waveform and a coved-type or saddle-back-type increase in ST on an electrocardiogram, leading to sudden death due to ventricular fibrillation. We conducted dental treatment for a patient with this syndrome, odontophobia, and an abnormal pharyngeal reflex.
The patient was a 52-year-old female. Concerning her medical history, she had Brugada syndrome, dental phobia, and an abnormal pharyngeal reflex. She consulted our hospital with left upper and lower molar pain. Concerning her family history, her father had died suddenly, and her younger brother had a history of syncope, for which he had undergone ICD implantation. Furthermore, her son also had this syndrome.
At the initial consultation, radiography showed caries reaching the dental pulp in the left upper second molar, caries on the mesial proximal surface of the left lower second molar, and bone resorption at the root apex of the right lower second premolar. Initially, to resolve caries-related pain and reduce stress, which may induce an abnormal pharyngeal reflex and ventricular fibrillation, pulp extirpation and caries treatment were performed under intravenous sedation. In addition, systematic desensitization was applied, and dental treatment was conducted while preparing an external defibrillator for the prompt management of ventricular fibrillation. During treatment, there were no systemic abnormalities such as ventricular fibrillation.
In this patient with dental phobia and Brugada syndrome, dental treatment could be performed through behavioral adjustment using intravenous sedation/systematic desensitization and the preparation of an external defibrillator for the prompt management of ventricular fibrillation. There were no abnormalities, such as ventricular fibrillation, or the appearance of abnormal pharyngeal reflex.
