Gagging: Not a Problem!

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MANY PATIENTS have stated to me that they dread dental procedures because they make them “gag.” A patient’s fear of gagging during a procedure increases anxiety throughout the entire visit. Therefore, I have found, it is important to allay the patient’s fear and assure the patient that steps will be taken to control gagging. A patient’s trepidations are alleviated as the treatment visit finishes without an undesired episode of gagging. This successful experience strengthens the bond between the doctor and the patient. Thus, the potential “gagger,” who may have been a challenge to treat at first, is a problem no more.

There are many views of the causes of a patient’s gagging and how those causes should be handled. However, I have found that even if all of the varied opinions are true, the method that consistently works for me is to anesthetize an area.

The gag reflex is also called the pharyngeal reflex. It is an involuntary reflex triggered by touching the soft palate. The reflex is an immediate response that occurs in order to prevent foreign objects from entering the airway. The degree of sensitivity of the soft palate is different with each patient. Thus, the tactile stimulation that is needed to trigger the gag reflex in each patient varies. Therefore, I have found that an easy method to overcome the patient’s gag response is to anesthetize the soft palate, thus preventing the triggering of the gag response. Some patients may find success with an over-the-counter throat spray that seems to superficially numb the throat.

There are other explanations for an individual’s gagging, and there are other suggestions for handling the gagger. One explanation is that patients gag due to anxiety and panic. There is a belief that patients are worried that they will not be able to breathe or swallow during the procedure. If that is the case, the practitioner should remind the patient to breathe through the nose, not through the mouth. In addition, the practitioner may suggest a nasal decongestant. Other patients may have success with ear acupuncture. Most importantly, being able to relax the patient in order to control the gag response is vital no matter which method the practitioner uses.

Making the gagger feel comfortable in the office and throughout the procedure is critical. Not only does establishing that comfortable feeling build a trusting doctor-patient relationship, but it also allays the practitioner’s fear of an unexpected movement that would interrupt treatment. Decreasing the gagger’s fears and anxieties creates a positive dental visit for the patient, and having a successful treatment visit for the patient is equally important in order for the practitioner to be productive.

April - June 2012