Ridhi Garg, BDS, MDS Ankit Singhal, BDS, MDS Kavita Agrawal, BDS, MDS Neeraj Agrawal, BDS, MDS.The gag reflex is an involuntary defence mechanism to protect the pharynx and throat from foreign objects. Managing Endodontic Patients with Severe Gag Reflex by Glossopharyngeal Nerve Block Technique. Jeff Lineberry, D.D.S., F.A.G.D., FICOI, Accredited Member-AACD, Spear Visiting Faculty, practice owner and contributing author for Spear Digest. The next time you have a patient who has a hyperactive gag reflex, try some of these tips and hopefully you and your patient will have a better visit.Ĭlick here to read more articles by Dr. For example, allowing the patient to listen to music as distraction throughout the procedure can help them forget about gagging at all.
Diaphragmatic breathing has long been a proven method to help the body relax and reduce stimulation of the sympathetic nervous system (the flight-or-fight part of the nervous system). Have the patient practice focusing on taking nice, even breaths in and out through their nose. A third method puts the impetus on the patient.I have personally used this method several times for patients for some, it works wonders. Salt? Yes, simple table salt rubbed or placed on the sides of the tongue helps diminish the gag reflex. There is another method that is difficult to understand, but seems to work: using salt.This is, of course, something that can be obtrusive to one's ability to swallow. The technique was recently published 1 for helping the severe gagging patient who has endodontic treatment needs, thus requiring the use of rubber dams. Outside of dentistry, the Glossopharyngeal Nerve Block Technique has been used by anesthesiologists and otolaryngologists. This can be achieved using topical gels and sprays or doing nerve blocks to numb the tongue. One of the most common ways to manage the gagging patient is with the use of topical or local anesthetics to numb either the tongue, roof of the mouth/soft palate area, or all of the above.
Using my own personal experiences as well as anecdotes from fellow clinicians, I created a list of methods to help manage that gagging patient the next time they walk in your door. Therefore, the more tricks you have in your bag to manage these patients, the better off you and your patient will be. Until we know otherwise or have a “cure” for hypersensitive gag reflexes, we can only manage the issue using a variety of methods that may or may not work. Why do some people have worse gag reflexes than others? There is no clear evidence of what exactly causes the gag reflex to be worse on some patients than others, but it can be a mix of anatomical and/or constricted airways, hypersensitive gag reflexes, and directly or indirectly related anxiety/psychological issues. So, what is the gag reflex and why do some people have it worse than others? The gag reflex, also known as the pharyngeal reflex, is a protective mechanism to help prevent something from occluding the throat/pharynx/larynx/trachea area and expelling it out of the way to help protect the airway. And, since almost everything we do is related to invading this area that sets off the gag reflex, you have to figure out ways to manage those patients and help them maintain their oral health in a way that works for everyone involved. They are the patient whose gag reflex goes crazy if you simply place a mirror in their mouth or if they lay back too far in the chair. If you have been in dentistry for any time at all, you know that one of the challenges we deal with when it comes to patient management is the gagging patient.
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