The occurrence of multiple supernumerary teeth in individuals without any associated syndrome is rare. In this report, a rare case of a 48-year-old woman who had an impacted supernumerary fourth molar in the bilateral mandibular ramus is described. She presented with a swelling in the left cheek region. Radiographic examination revealed an impacted supernumerary tooth in the left mandibular ramus with pericoronal resorption of the bone, suggesting peripheral inflammation. She also had an impacted supernumerary tooth on the right side. After administering an antibiotic and antiinflammatory drug, tooth extraction was performed under general anesthesia.

Introduction: Carotid sinus syndrome is rarely associated with head and neck malignant cancer. We usually have no effective treatment for carotid sinus syndrome in terminal stage of cancer. We experienced a case in which continuous explanation of his condition and lifestyle guidance resulted in alleviation of syncope attacks. Case: A 73-year-old male who was diagnosed with oropharyngeal cancer and with multiple lymph node metastases in the neck. Dizziness and syncope attacks occurred to him due to carotid sinus syndrome. He was referred to the outpatient department of palliative medicine, then he and his wife received explanation of his condition and lifestyle guidance of avoiding triggers and of how to avoid syncope attacks at the onset of prodomal symptoms. The frequency of attacks decreased and he resumed his daily walk. However, attacks without triggers began to occur to him seven months after the intervention started. Although he continued to stay at home, he was hospitalized due to difficulty in body movement and died the next day. Discussion: Explanation of his condition and lifestyle guidance were useful for management of syncope attacks because the syncope attacks had triggers and prodomal symptoms. The interventions including lifestyle guidance improved his quality of life and let him stay at home.