The Gag Reflex – Is Dental Cleaning Difficult For You?

Do you have a sensitive throat?

“I need to warn you that my throat is very sensitive during cleaning.” said the new patient sheepishly. “Let’s try to keep you comfortable!” I said optimistically.

What is a gag reflex?

The gag reflex is also called the pharyngeal reflex or laryngeal spasm.  

It is an involuntary movement response to the stimulation of the back of the tongue, throat and tonsil area by contact with a foreign object.

This means that it is not something you can normally control.

Why Do We have a Gag Reflex?

The gag reflex is wired into our brain from birth. It serves a protective function by causing us to expel foods that may be too chunky for us to digest. This protects us from potential choking. The gag reflex tends to decrease for most infants at the 6th to 7th month mark as they transition to solid foods.

Did You Know?

In infants, the area stimulating the gag reflex starts off in the mid-tongue and then moves back as they age!

Why are some People More Prone to Gagging?

It is said that 10 – 15% of people have a hypersensitive gag reflex. This is said to be linked to delayed introduction of solid foods to the infant (after 7 months of age). Some recommend starting solid foods earlier between five to seven months of age.

How is Gagging a Serious Problem for Dental Treatment?

The constant sensation of gagging during dental cleaning for people with a hypersensitive gag reflex can be very unpleasant for them.

They may dread the appointment and feel embarrassed about the problem, or be self-conscious about potentially making the dentist and staff impatient or fed-up with them.

In some cases, people who have had unpleasant dental visits may delay or avoid dental treatment altogether.

What Can The Dentist Do For Hypersensitive Gag Reflex Patients?

I have had the opportunity to treat a number of patients who are hypersensitive to contact to their throat and tongue or choke / gag easily with the water pooling in their mouth.

Some tips that I have found very useful in keeping such patients comfortable are:

1. Both the patient and the dentist should be extremely patient, cautious and not get complacent even when things are going well! The moment that the first gag reflex is triggered, the subsequent gag reflexes all trigger very easily.

2. Strategic positioning – I usually request the hypersensitive patient to angle the head in a way as to minimize the sensation of gagging.

3. Distraction techniques – I usually employ some or even all of a number of distraction techniques – from using acupuncture techniques, sea-sickness bands, teaching the patient to do certain repetitive movements to distract their mind and using taste distraction.

4. Being very wary to avoid the gagging trigger zones during treatment.

5. Nerve Block Anaesthesia – it is safe and possible to numb the tongue and jaw so as to reduce the gag reflex sensation greatly.

Conclusion

1. A strong gag reflex is an issue that is very serious for a small proportion of people.
2. It is important to recognize and manage serious gagging problems correctly.
3. Hypersensitive gag reflex patients do need to experience a more pleasant and comfortable dental treatment session and not delay important treatment.

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Dr. Hong Qixian

Dr. Hong Qixian