HOW TO REDUCE EMBARRASING GAGGING AT THE DENTIST
Do you avoid your dentist because you suffer from gagging? Dentists, have you experienced patients that gag the moment they see you walk in the room which ultimately delays or prevents examination and treatment? I created a Tiktok to offer a simple remedy. https://www.tiktok.com/@the_girldoc/video/6882495967996742918https://www.tiktok.com/@the_girldoc/video/6882495967996742918
 |
| Compliments of Pixabay artist guzzy70080 |
WHAT WE KNOW
In my years of experience in the dental profession as an oral and maxillofacial surgeon and dental hygienist, I’ve seen many patients that avoid the dentist due to an overly sensitive gag response. Many of these people are embarrassed by their inability to control this response and need an empathetic Doctor to support them. I’ve had patients present for full mouth extraction due to a non-restorable dentition, all because the patient has an active gag reflex and they have given up on treatment or their dentist has told them they can’t be helped and refer them to me. Patients unable to tolerate an intraoral radiograph and we perform an extraoral image to avoid placing dental instrumentation intraorally, triggering the reflex. Patients have been referred specifically for sedation and in this anesthetized state causes them to be unaware of touching and manipulation of the oral tissues and obtunds the gag reflex and allows the oral surgeon to perform the necessary work.
 |
Avoid contact with shaded areas as they are the most sensitive. Courtesy of Thefreedictionary.com https://medical-dictionary.thefreedictionary.com/reflex |
GAIN PATIENTS TRUST
Remember as their dentist you must be compassionate with these individuals and show them that you have patience with their problem and are willing to give them time. Communicate to them that it’s ok if It may take a few appointments for them to feel comfortable with you to be able to sit in your chair and to know that you are not upset with them because nothing was accomplished. In some cases, the only thing that is accomplished is an introduction to each other which ultimately prevents a full examination, and the taking of intraoral radiographs etc. However, it is not wasting time and it is another step that helps to build confidence in their trust in you and that is one step closer to our goal, to help them.
PURPOSE OF THE GAG(PHARYNGEAL) REFLEX
Without going into great detail, this reflex is an important bodily function like many other physiologic processes. It is mediated by two pathways, the afferent limb of the reflex is supplied by the glossopharyngeal nerve (cranial nerve IX), to the brain. The efferent limb is supplied by the vagus nerve (cranial nerve X) from the nucleus ambiguous to the musculature of the oral cavity producing the response. It is there to protect our airways. Anxiety can heighten this reflex and response. The posterior oral cavity which connects to the upper airway are more sensitive to touch and can elicit an exaggerated gag response.
 |
| The anatomical pathways of the Gag Reflex. Compliments of Quora. https://www.quora.com/What-is-the-biology-behind-the-gag-reflex |
HOW ORAL SURGEONS/DENTIST CAN WORK AROUND A GAG REFLEX:
• Utilizing extraoral imaging, a Panoramic radiograph avoids the oral cavity
• Breath-rite strips properly placed on the nostrils (nares) reduces airflow resistance through the nose and into the upper airway and into the lungs. We place these on all patients receiving sedation to maximize oxygen intake and ultimately blood oxygenation.
• Nitrous Oxide (N2O2) relaxes the upper airway musculature and obtunds the reflex
• Sedation obtunds the reflex and relaxes the upper airway musculature to a much greater extent than the other options.
The Girldoc😉
Comments