Article Data

  • Views 1163
  • Dowloads 187

Case Reports

Open Access

Multiple dental caries management of a 5-year-old child with MIS-C: a case report

  • Praparat Tungjitphianpong1,*,
  • Kongkarn Pornsoongsong1
  • Jarintorn Kotheeranurak1
  • Krisadi Phannarus1

1Dental Department, Queen Sirikit National Institute of Child Health, 10400 Bangkok, Thailand

DOI: 10.22514/jocpd.2023.093 Vol.47,Issue 6,November 2023 pp.185-190

Submitted: 10 March 2023 Accepted: 06 May 2023

Published: 03 November 2023

*Corresponding Author(s): Praparat Tungjitphianpong E-mail:


The rare hyper-inflammatory condition known as “multisystem inflammatory syndrome in children (MIS-C)” develops after a COVID-19 infection. Providing dental treatment for patients with MIS-C can be very challenging due to the immunocompromised condition found in these patients leading to rapid progression of other infections, including dental caries. Currently, there is a lack of information regarding the dental management of patients with MIS-C. This case report presents the multiple dental caries management in a 5-year-old Cambodian boy with MIS-C in a dental chair unit, without general anesthesia. Despite the challenges this case presented, i.e., the patient’s age, hyper-inflammatory condition due to MIS-C, taking several medications, multiple caries lesions, and the language barrier for behavior management, we were able to meet this patient’s needs. The patient’s dental and physical health were found to be satisfactorily stable with no complications. At the 6-month recall, his overall oral health had dramatically improved. Careful treatment planning along with a multidisciplinary approach is highly recommended in such cases. The important roles of dentists are not only to treat oral infection, but also to approach patients holistically because the body systems are all connected.


Case report; Dental management; MIS-C; Oral manifestations

Cite and Share

Praparat Tungjitphianpong,Kongkarn Pornsoongsong,Jarintorn Kotheeranurak,Krisadi Phannarus. Multiple dental caries management of a 5-year-old child with MIS-C: a case report. Journal of Clinical Pediatric Dentistry. 2023. 47(6);185-190.


[1] Panaro S, Cattalini M. The spectrum of manifestations of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2) infection in children: what we can learn from multisystem inflammatory syndrome in children (MIS-C). Frontiers in Medicine. 2021; 8: 747190.

[2] Centers for Disease Control and Prevention. Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19). 2020. Available at: (Accessed: 25 January 2023).

[3] Levy N, Koppel JH, Kaplan O, Yechiam H, Shahar-Nissan K, Cohen NK, et al. Severity and incidence of multisystem inflammatory syndrome in children during 3 SARS-CoV-2 pandemic waves in Israel. JAMA. 2022; 327: 2452–2454.

[4] Sharma C, Ganigara M, Galeotti C, Burns J, Berganza FM, Hayes DA, et al. Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison. Nature Reviews Rheumatology. 2021; 17: 731–748.

[5] Rafferty MS, Burrows H, Joseph JP, Leveille J, Nihtianova S, Amirian ES. Multisystem inflammatory syndrome in children (MIS-C) and the coronavirus pandemic: current knowledge and implications for public health. Journal of Infection and Public Health. 2021; 14: 484–494.

[6] Dufort EM, Koumans EH, Chow EJ, Rosenthal EM, Muse A, Rowlands J, et al. Multisystem inflammatory syndrome in children in New York state. New England Journal of Medicine. 2020; 383: 347–358.

[7] McArdle AJ, Vito O, Patel H, Seaby EG, Shah P, Wilson C, et al. Treatment of multisystem inflammatory syndrome in children. New England Journal of Medicine. 2021; 385: 11–22.

[8] Gupta K, Kumar S, Anand Kukkamalla M, Taneja V, Syed GA, Pullishery F, et al. Dental management considerations for patients with cardiovascular disease—a narrative review. Reviews in Cardiovascular Medicine. 2022; 23: 261.

[9] Rehman R, Hai O. Digitalis toxicity. 2023. Available at: (Accessed: 25 January 2023).

[10] Marte F, Francheska P, Manouchkathe C. Captopril. 2023. Available at: (Accessed: 25 January 2023).

[11] Yifan Z, Benxiang N, Zheng X, Luwei X, Liuhua Z, Yuzheng G, et al. Ceftriaxone calcium crystals induce acute kidney injury by NLRP3-mediated inflammation and oxidative stress injury. Oxidative Medicine and Cellular Longevity. 2020; 2020: 6428498.

[12] Guleng SR, Wu RH, Guo XB. Vancomycin-induced thrombocytopenia in endocarditis: a case report and review of literature. World Journal of Clinical Cases. 2021; 9: 1696–1704.

[13] Römer P, Heimes D, Pabst A, Becker P, Thiem DGE, Kämmerer PW. Bleeding disorders in implant dentistry: a narrative review and a treatment guide. International Journal of Implant Dentistry. 2022; 8: 20.

[14] Seo KH. Perioperative glucocorticoid management based on current evidence. Anesthesia and Pain Medicine. 2021; 16: 8–15.

[15] Nascimento RB, Araujo NS, Silva JC, Xavier FCA. Oral manifestations of multisystemic inflammatory syndrome in children (MIS-C) and Kawasaki disease associated to COVID‐19: a systematic review. Special Care in Dentistry. 2022; 42: 266–280.

[16] Halepas S, Lee KC, Myers A, Yoon RK, Chung W, Peters SM. Oral manifestations of COVID-2019-related multisystem inflammatory syndrome in children: a review of 47 pediatric patients. The Journal of the American Dental Association. 2021; 152: 202–208.

[17] Adar A, Onalan O, Aktas H, Ertuğrul S, Çakan F. A very rare complication of sublingual captopril. Journal of Experimental and Clinical Medicine. 2019; 36: 91–93.

[18] Rooijers W, Rademacher WHM, Raber-Durlacher JE, Aziz Y, Hielema AP, Rozema FR. Medicaments and oral healthcare. Adverse effects of medications on the oral mucosa. Nederlands tijdschrift voor tandheelkunde. 2020; 127: 434–440. (In Dutch)

[19] Zaheer K, Sanikop R, Cant A, Bhujel N, Singh RP. Oral lesions in paediatric patients with COVID-19 and paediatric inflammatory multisystem syndrome: a review. Advances in Oral and Maxillofacial Surgery. 2022; 5: 100213.

[20] Fitzpatrick SG, Cohen DM, Clark AN. Ulcerated lesions of the oral mucosa: clinical and histologic review. Head and Neck Pathology. 2019; 13: 91–102.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

PubMed (MEDLINE) PubMed comprises more than 35 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full text content from PubMed Central and publisher web sites.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 2.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time