Management of Dental Demineralization in a Patient with Complex Medical Conditions: A Case Report and Clinical Outcomes

<b>Background and Clinical Significance</b>: Dental demineralization is a multifactorial process influenced by biofilm activity, diet, and systemic conditions. While gastroesophageal reflux disease (GERD) is known for its role in enamel erosion, its contribution to cariogenic processes r...

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Main Authors: Luigi Sardellitti, Enrica Filigheddu, Egle Milia
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Reports
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Online Access:https://www.mdpi.com/2571-841X/8/2/39
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author Luigi Sardellitti
Enrica Filigheddu
Egle Milia
author_facet Luigi Sardellitti
Enrica Filigheddu
Egle Milia
author_sort Luigi Sardellitti
collection DOAJ
description <b>Background and Clinical Significance</b>: Dental demineralization is a multifactorial process influenced by biofilm activity, diet, and systemic conditions. While gastroesophageal reflux disease (GERD) is known for its role in enamel erosion, its contribution to cariogenic processes remains underexplored. Additionally, Brugada syndrome, a genetic arrhythmia disorder, may indirectly affect oral health due to medical complexities and reduced motivation for dental care. This case highlights the management of extensive mineral loss in a patient with GERD and Brugada syndrome, emphasizing the importance of personalized remineralization strategies and interdisciplinary collaboration. <b>Case Presentation</b>: A 27-year-old male with Brugada syndrome, treated with a subcutaneous implantable cardioverter defibrillator (S-ICD), presented with widespread enamel demineralization, multiple active carious lesions, and gingival inflammation. Clinical evaluation revealed a high DMFT index (15), significant plaque accumulation, and an oral pH of 5.8, indicating an elevated risk of mineral loss. Poor hygiene habits, frequent sugar intake, and GERD-related acid exposure contributed to his condition. The therapeutic approach included patient education, fluoride-functionalized hydroxyapatite toothpaste and mousse, dietary modifications, and restorative procedures. After 120 days, improvements included enhanced enamel integrity, a reduction in plaque index (from 50% to 25%), and the resolution of gingival inflammation (BOP: 38% to 12%). <b>Conclusions</b>: This case underscores the importance of an integrated approach to managing dental demineralization in patients with systemic conditions. The combination of remineralization therapy, behavioral modifications, and structured follow-up yielded significant clinical benefits. Further research is needed to develop standardized protocols for individuals at high risk due to systemic factors affecting oral health.
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spelling doaj-art-e2cce8b08978453fa859e95868a7386a2025-08-20T03:16:39ZengMDPI AGReports2571-841X2025-03-01823910.3390/reports8020039Management of Dental Demineralization in a Patient with Complex Medical Conditions: A Case Report and Clinical OutcomesLuigi Sardellitti0Enrica Filigheddu1Egle Milia2Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, ItalyDepartment of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, ItalyDepartment of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy<b>Background and Clinical Significance</b>: Dental demineralization is a multifactorial process influenced by biofilm activity, diet, and systemic conditions. While gastroesophageal reflux disease (GERD) is known for its role in enamel erosion, its contribution to cariogenic processes remains underexplored. Additionally, Brugada syndrome, a genetic arrhythmia disorder, may indirectly affect oral health due to medical complexities and reduced motivation for dental care. This case highlights the management of extensive mineral loss in a patient with GERD and Brugada syndrome, emphasizing the importance of personalized remineralization strategies and interdisciplinary collaboration. <b>Case Presentation</b>: A 27-year-old male with Brugada syndrome, treated with a subcutaneous implantable cardioverter defibrillator (S-ICD), presented with widespread enamel demineralization, multiple active carious lesions, and gingival inflammation. Clinical evaluation revealed a high DMFT index (15), significant plaque accumulation, and an oral pH of 5.8, indicating an elevated risk of mineral loss. Poor hygiene habits, frequent sugar intake, and GERD-related acid exposure contributed to his condition. The therapeutic approach included patient education, fluoride-functionalized hydroxyapatite toothpaste and mousse, dietary modifications, and restorative procedures. After 120 days, improvements included enhanced enamel integrity, a reduction in plaque index (from 50% to 25%), and the resolution of gingival inflammation (BOP: 38% to 12%). <b>Conclusions</b>: This case underscores the importance of an integrated approach to managing dental demineralization in patients with systemic conditions. The combination of remineralization therapy, behavioral modifications, and structured follow-up yielded significant clinical benefits. Further research is needed to develop standardized protocols for individuals at high risk due to systemic factors affecting oral health.https://www.mdpi.com/2571-841X/8/2/39tooth demineralizationtooth remineralizationoral hygienedentin hypersensitivitypreventive dentistry
spellingShingle Luigi Sardellitti
Enrica Filigheddu
Egle Milia
Management of Dental Demineralization in a Patient with Complex Medical Conditions: A Case Report and Clinical Outcomes
Reports
tooth demineralization
tooth remineralization
oral hygiene
dentin hypersensitivity
preventive dentistry
title Management of Dental Demineralization in a Patient with Complex Medical Conditions: A Case Report and Clinical Outcomes
title_full Management of Dental Demineralization in a Patient with Complex Medical Conditions: A Case Report and Clinical Outcomes
title_fullStr Management of Dental Demineralization in a Patient with Complex Medical Conditions: A Case Report and Clinical Outcomes
title_full_unstemmed Management of Dental Demineralization in a Patient with Complex Medical Conditions: A Case Report and Clinical Outcomes
title_short Management of Dental Demineralization in a Patient with Complex Medical Conditions: A Case Report and Clinical Outcomes
title_sort management of dental demineralization in a patient with complex medical conditions a case report and clinical outcomes
topic tooth demineralization
tooth remineralization
oral hygiene
dentin hypersensitivity
preventive dentistry
url https://www.mdpi.com/2571-841X/8/2/39
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