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The gag reflex is a complicated physiological issue that often tampers with the quality of dental care and acts as an impediment to the administration of the best patient care for the patients. Gagging has been defined as the contraction of the alimentary canal muscles of the pharyngeal system (Hosseini et al., 249). The reaction has been perceived as being an unexpected protective defense mechanism that works on ensuring that the people protect themselves from any perceived imminent danger (Ardelean et al., 312). Before looking at some of the ways that the gag reflex can be reduced it would be prudent to look at some of the categories that have been grouped on the gag reflex. Gag reflex comes in four main categories, the local and the systemic disorder, the physiological disorder, iatrogenic disorder and psychological disorder.
Gagging mostly occurs during the dental care and most of the cases that have resulted to gag reflex, include the maxillary impression which is often sparked by the dentist's fingers and or instruments that touch the oral parts (Makar, 03). It is essential for one to differentiate between gagging and retching as they are a different case although they are similar. Gagging is a defense mechanism that protects one against the entry of foreign bodies from accessing the windpipe, pharynx or larynx (Makar, 05). Some of the factors that contribute to this phenomenon include as earlier stated, the local factors, anatomic factors, psychological factors, and iatrogenic factors. The local factors include Nasal obstruction as a result of catarrh, sinusitis and other illnesses that might result in one having a nasal obstruction (Makar, 06). It is also essential that one notes that persistent illnesses of the stomach and those that will drive one to be exposed to the gagging reflex when they are undergoing dental; care. Conditions such as a hernia and diabetes might also make one to be exposed to the problems that can be avoided. Some examples of the psychological factors might drive one to gag during the dental care include the TMJ dysfunction syndrome, denture sensitivity and even a condition that is concerned with the facial pain (Makar, 08). Psychological conditions such as classical conditioning and operant conditioning are as an influencing factor for one to have a gag reflex as seen by the interview of some of the patients (Jain, 03). Consider, for instance, the case of a patient who has been noticed to have the reflex whenever they are exposed to some abstract objects such as an impression tray or even the sight of related dental instruments. These factors are often psychological and can be explained by the theory of classical conditioning. Another scenario that drives one to gag is the operant conditioning where one teaches them to gag as a reflex for the process to be halted. The fact that the gag reflex might drive the dentist to stop the procedure creates the response that is wanted and hence becomes a habit, albeit unconditionally (Shriprasad & Shilpashree, 12). Other factors that might drive one to have the gag reflex include conditions such as the inadequacy of the dentist and hence might make the patient to gag as a result of poor handling. Overextension of the time that is stipulated for the procedure might also result to gagging as the body feels violated and initiates the gag reflex as a defense mechanism. The absence of a posterior palatal seal might also drive one to react as it will influence the reaction that one has (Choudhary & Tawfiq, 02).
When one looks at the factors that will drive one to have the gag reflex, it becomes apparent that these are some of the processes that one can manage as a dentist. They can be controlled through the reduction of the incidences or even stopping the reflex completely. In order one to solve the problem; it is essential that one comes to a conclusion on the driving factors to the problem. One needs to get a detailed analysis of the patient's history and look at the developments that the patient has had about some of the procedures that have been undertaken. Also, it is vital that one looks at the fact that the willingness of the patient will play a critical role in solving the problem (Ahmed, 05). The desire of the patient will ensure that the problem is solved or even at least managed for the dentist to have the time to carry out the procedures effectively. The patient also needs to be advised on some of the measures that will reduce the chances of gagging occurring especially when it happens because of issues such as dentures intolerance (Ahmed, 05). Encouraging the patient to practice by inserting their toothbrushes as far as they can and then stopping just before they retch, helps in solving the problem as one continues to advance the treatment (Jain, 06). Unlearning the conditioned response through hypnosis will also help in reducing and the management of the reflex.
Meshni, Abdullah Ahmed. "Gag Reflex: A Comparative Study Among Different Prosthodontic Treatment Modalities."
Choudhary, S., and O. Tawfiq. "Gag Reflex in Prosthodontics: An Overview Yee." correction among local community in Sibu, Sarawak Kay TM, Nay L., Mohamad RBS, Margareth WAY, Neoh PS, Hasheem SBH, Randy OMH, Li Na. 2.2 (2017): 2.
Shriprasad, S., and H. S. Shilpashree. "Gag reflex: No more a gag to a dentist the behavioral techniques, pharmacological techniques, acupressure and acupuncture in controlling the gag reflex-a review." Bangladesh Journal of Medical Science11.1 (2012): 12-17.
Ardelean, Lavinia, Cristina Bortun, and Marilena Motoc. "Gag reflex in dental practice-etiological aspects." TMJ 53 (2003): 312-5.
Hosseini, S. Mehran, Mohsen Jamshir, and Alireza Maleki. "The effect of gag reflex on cardiac sympathovagal tone." Oman medical journal 27.3 (2012): 249.
Jain, Anoop. "Management Of Severe Gag Reflex By An Unique Approach: Palateless Dentures." JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH (2013): n. Pag. Web.
Makar, Pryinka. "The Etiology And Management Of Gagging." Slideshare.net. N.p., 2014. Web. 6 June 2018.
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