Those with the LQT2 form of Romano–Ward syndrome should avoid sudden loud noises such as alarm clocks as these may trigger arrhythmias. Fevers should be treated promptly with paracetamol. Grapefruit juice should be avoided as it contains a chemical which decreases IKr and further prolongs the QT interval. Medications that further prolong the QT interval such as sotalol should be avoided, lists of which can be found in publicly accessible online databases.Beta blockers such as propranolol or nadolol blunt the effects of adrenaline on the heart and thereby reduce the risk of arrhythmias. Mexiletine, flecainide and ranolazine decrease the  late sodium current and are of particular use in the LQT3 form of Romano–Ward syndrome, and mexiletine may also be of benefit in other subtypes. Potassium supplements may be used at times when potassium is being lost such as when experiencing diarrhoea or vomiting, but medications that encourage the retention of potassium such as spironolactone or amiloride may also be required.An implantable defibrillator, a small device that monitors the heart rhythm and can automatically deliver an electric shock to restart the heart, may be recommended. These devices are recommended for those with Romano–Ward syndrome who have experienced a cardiac arrest or a blackout whilst taking beta blockers. In those who experience recurrent arrhythmias despite medical therapy, a surgical procedure called sympathetic denervation can be used to interrupt the nerves that stimulate the heart. Epidemiology
Romano–Ward syndrome is the most common form of inherited long QT syndrome, affecting an estimated 1 in 7,000 people worldwide.
Since teeth are vulnerable during these acidic periods, the development of dental caries relies heavily on the frequency of acid exposure. The carious process can begin within days of a tooths erupting into the mouth if the diet is sufficiently rich in suitable carbohydrates. Evidence suggests that the introduction of fluoride treatments has slowed the process. Proximal caries take an average of four years to pass through enamel in permanent teeth. Because the cementum enveloping the root surface is not nearly as durable as the enamel encasing the crown, root caries tend to progress much more rapidly than decay on other surfaces. The progression and loss of mineralization on the root surface is 2.5 times faster than caries in enamel. In very severe cases where oral hygiene is very poor and where the diet is very rich in fermentable carbohydrates, caries may cause cavities within months of tooth eruption. This can occur, for example, when children continuously drink sugary drinks from baby bottles (see later discussion). Teeth
There are certain diseases and disorders affecting teeth that may leave an individual at a greater risk for cavities. Molar incisor hypo-mineralization, which seems to be increasingly common. While the cause is unknown it is thought to be a combination of genetic and environmental factors.