{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T19:14:26Z","timestamp":1770232466947,"version":"3.49.0"},"reference-count":94,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Orofacial pain, diagnosed and treated in a subfield of dentistry, highly relies on long-term psychotropic, neuromodulating, and analgesic regimens that have the potential to alter cardiac ion channels and autonomic tone. In patients with inherited arrhythmia syndromes such as Brugada syndrome (BrS), these drugs may unmask a type 1 Brugada electrocardiographic pattern or trigger malignant ventricular arrhythmias and sudden cardiac death, yet most dental guidance addresses only short-term use of local anesthetics. In this narrative review, we synthesize evidence on the arrhythmogenic potential of medications used for orofacial pain\u2014non-steroidal anti-inflammatory drugs, tricyclic antidepressants, anticonvulsants, and primary headache therapies. Finally, we propose a pragmatic risk-stratified approach for orofacial pain specialists. Incorporating channelopathy-specific precautions into orofacial pain pharmacotherapy may reduce drug-induced ventricular arrhythmias and sudden cardiac death while preserving effective long-term pain control.<\/jats:p>","DOI":"10.3389\/fcvm.2026.1754683","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T06:48:51Z","timestamp":1770187731000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dental drugs with proarrhythmic risk in patients with Brugada syndrome: precaution instructions for practices in the field of orofacial pain"],"prefix":"10.3389","volume":"13","author":[{"given":"Dawool","family":"Han","sequence":"first","affiliation":[{"name":"Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na Yeong","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry","place":["Seoul, Republic of Korea"]},{"name":"BK21 FOUR Project, Yonsei University College of Dentistry","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunae Sandra","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry","place":["Seoul, Republic of Korea"]},{"name":"BK21 FOUR Project, Yonsei University College of Dentistry","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung-Young","family":"Roh","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"B1","volume-title":"M.R.R., Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management (AAOP the American Academy of Orofacial Pain)","author":"Klasser","year":"2023"},{"key":"B2","doi-asserted-by":"publisher","first-page":"103","DOI":"10.11607\/ofph.3010","article-title":"Psychologic impact of chronic orofacial pain: a critical review","volume":"36","author":"Karamat","year":"2022","journal-title":"J Oral Facial Pain Headache"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.oooo.2025.02.005","article-title":"Chronic orofacial pain and pharmacological management: a clinical guide","volume":"140","author":"Guan","year":"2025","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1111\/ors.12542","article-title":"Pharmacological management of orofacial pain\u2014a clinician\u2019s guide","volume":"13","author":"Clark","year":"2020","journal-title":"Oral Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"785","DOI":"10.2147\/JPR.S435219","article-title":"The association between orofacial pain and depression: a systematic review","volume":"17","author":"Anita","year":"2024","journal-title":"J Pain Res"},{"key":"B6","doi-asserted-by":"publisher","first-page":"261","DOI":"10.31083\/j.rcm2308261","article-title":"Dental management considerations for patients with cardiovascular disease-A narrative review","volume":"23","author":"Gupta","year":"2022","journal-title":"Rev Cardiovasc Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/S1079-2104(96)80376-3","article-title":"Incidence and significance of cardiac arrhythmia in geriatric oral surgery patients","volume":"82","author":"Jacobson","year":"1996","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e012361","DOI":"10.1161\/JAHA.119.012361","article-title":"Is it safe for patients with cardiac channelopathies to undergo routine dental care? 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