E-mail address: h-karibe tky. Use the link below to share a full-text version of this article with your friends and colleagues. A reliable assessment method is required to manage the gag reflex. This study included 21 healthy adults 10 women, 11 men; mean age, An examiner inserted a standard saliva ejector slowly down the participant's throat to determine the maximum tolerance of the gag reflex; the insertion depth was used as an index of gag reflex.
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Special Offers. Getting a dental impression is never a pleasant or comfortable procedure, but for those individuals who have an active gag reflex, the thought of suffering through the process is enough to cause nightmares. Allowing your gag reflex to keep you from regular dental visits, however, is not the solution. There are ways to reduce the severity of your gag reflex during procedures like dental impressions if you let your dentist know of the issues beforehand.
Your gag reflex is your body's natural defense mechanism that is intended to keep foreign objects out of your upper respiratory tract. When your body senses something other than air headed toward your larynx, pharynx or trachea, your muscles spasm and contract uncontrollably as your body tries to force the foreign objects away from your airway.
When your dentist puts the dental impression tray in your mouth, the tray and the viscous impression material oozing in your mouth can cause your gag reflex to engage. What You Can Do. There are a few things you can do to reduce the chance of gagging when the tray is in your mouth:.
A dental impression is an important part of the treatment you need to keep your teeth healthy and looking great. Don't let your fear of gagging keep you from a great smile. This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.
The first step in this process is to find a dentist with whom you feel comfortable, and then schedule an appointment. On your first visit, your dentist will take a full health history.
On follow-up visits, if your health status has changed, make sure to tell your dentist. Then he or she will polish and floss your teeth. All Rights Reserved. You are viewing the US English site.
Search Search. Oral Care Center. Oral Care Products. Bright Smiles, Bright Futures. Buy Now. Back Oral Care Center. Back Oral Care Products. Ingredient Information. What Causes The Gag Reflex? What You Can Do There are a few things you can do to reduce the chance of gagging when the tray is in your mouth: Breathe through your nose.
It's not easy remembering to breathe through your nose when your mouth is propped open, but focusing on breathing deeply through your nose can help you get through the minutes required to get a good impression. If you're congested, take a decongestant before your dental appointment, or perhaps try nasal strips designed for snoring cessation to help open your airways.
Don't be afraid to drool. Drooling isn't elegant, but having your saliva drool out of your mouth is less likely to make you gag than trying to swallow when your mouth is filled with the impression material. Distract yourself. Bring a stress ball to squeeze, recite your multiplication tables, conjugate verbs in a foreign language, or anything else that will focus your mind away from what's going on in your mouth. Not all dentists are great conversationalists, but if yours is, ask him to talk to you while you have the tray in your mouth.
As long as you aren't asked questions you can't answer, the distraction of a good story can help reduce the chance of gagging. Sit you up. If you are seated in an upright position, and tilt your head forward, the impression material will ooze forward, rather than toward your throat.
This should reduce the chance of triggering your gag reflex while the impression is being made. Administer nitrous oxide. For severe gaggers, nitrous oxide commonly known as laughing gas has a significant effect on stopping or reducing the gag reflex, according to the US National Library of Medicine.
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E-mail address: h-karibe tky. Use the link below to share a full-text version of this article with your friends and colleagues. A reliable assessment method is required to manage the gag reflex. This study included 21 healthy adults 10 women, 11 men; mean age, An examiner inserted a standard saliva ejector slowly down the participant's throat to determine the maximum tolerance of the gag reflex; the insertion depth was used as an index of gag reflex. The reflex was measured by one examiner during two sessions S1 and S3 and by a second examiner during one session S2 under the same conditions.
The galvanic skin response GSR and heart rate HR were recorded during each session to test the method validity. The ICC of the gag reflex measurements was 0.
Differences in the measurements according to sex and session were not significant. Measurement revealed significant autonomic reactivity, which is common for this reflex. The gag reflex is a normal, protective, physiological mechanism that occurs to prevent foreign objects and noxious material from entering the pharynx, larynx, and trachea.
There are two different factors in the gag reflex. Although trigger areas are specific to individuals, sites such as the lateral border of the tongue and certain parts of the palate commonly elicit the reflex. A previous study also reported that gagging was associated with female patients, increased dental anxiety, anxious depression, and neuroticism.
A number of strategies have been used to control the profound gag reflex and allow dental care. They include relaxation, distraction, and desensitization techniques; psychological and behavioural therapies; local anaesthesia, conscious sedation, and general anaesthesia techniques; and complementary medicine therapies such as hypnosis, acupressure, and acupuncture. All participants were healthy Japanese who had no psychiatric disorders, somatic illnesses, or oral diseases.
None wore partial or full dentures of the maxilla or mandible. None used medication that could influence autonomic nervous activity.
The participants provided informed consent prior to participation. The participants informed the examiner when their maximum tolerance had been reached by pushing a button that beeped Wireless Chime X; Revex Co. The examiner then removed the saliva ejector. The duration of the insertion from the commencement of the insertion to the maximum tolerance was also measured. We performed a pilot study to test the effect of visual stimuli and habituation of the gag reflex measurement method described above.
Six healthy volunteers two women, four men; mean age, The participants were then instructed to close their eyes, and the same measurements were performed. Measurements of each participant were performed randomly with the eyes open and closed. Gag reflex measurements were obtained by one examiner YK during two different sessions S1 and S3 and by a second examiner AO in a single session S2 under the same conditions.
Subjective ratings were obtained immediately after each measurement session. The participants rated their own unpleasant feelings unpleasantness when their maximum tolerance had been reached. The galvanic skin response GSR and heart rate HR were recorded during each measurement session as a physiological index of autonomic reactivity.
The sensors were attached to the medial phalanges of the index and middle fingers of the nondominant hand. The same devices were used to record each participant's electrocardiogram activity. The HR was obtained using a pulse transducer attached to the medial phalanges of the thumb of the nondominant hand. LabChart software was used to identify the peak slope, and the pulse identification was examined.
The Japanese versions of the psychometric tests were used in this study; the validity and reliability of these tests have been previously verified. Paired t tests were used to compare the GSR and HR values before and after the maximum tolerance of the gag reflex to assess autonomic reactivity. A Student's t test and a Fisher's exact test were used to assess the differences in the sample characteristics between the sexes. The ICC of the gag reflex measurement was 0. The correlation coefficient of the gag reflex measurements was 0.
The correlation coefficients of the duration of the insertion and the VAS rating were 0. Significant internal physiological changes during measurement were also observed, reflecting the validity. A number of questionnaires to assess the gag reflex have been presented and revised. A recent study stated that despite promising developments, a reliable, valid instrument to quantitatively measure gagging sensitivity is still not available.
There is wide variation in the sensitivity of the oral cavity and the ability of patients to withstand intraoral stimuli. However, they did not show the reliability or validity of their method, and it is generally not used in daily practice. In the present study, we used a standard saliva ejector as a trigger stimulus for certain parts of the palate and measured the distance of the saliva ejector from the maxillary central incisor and the duration of the insertion.
We also used a VAS to confirm whether the participants had similar unpleasant experiences when their maximum tolerance had been reached during different measurement sessions. However, there was no significant correlation between the gag reflex measurement and the VAS rating in each session data not shown.
These findings may indicate that the objective measurement value is not consistent with the subjective rating. To assess the validity of our method, we recorded the GSR and HR as a physiological index of autonomic reactivity. Although the baseline of the HR in each session did not change throughout the time course of the experiment, the baseline of the GSR gradually increased. Gagging may be accompanied by excessive salivation, lacrimation, sweating, and fainting.
In our study, sample characteristics age, levels of state anxiety and trait anxiety, level of dental fear, and frequency of gagging during dental treatment were not significantly different between male and female participants.
However, there is some controversy regarding differences in gag reflex between the sexes. They reported that the gagging severity score of male patients was significantly higher than that of females, but there was no significant difference in the STAI or dental anxiety scale scores among the grades. The mean level of DFS among the Japanese population is estimated to be These factors may have contributed to the lack of an observed difference in the measured gag reflex and dental anxiety between sexes.
Our study included limitations. Our study evaluated the individual maximum tolerance of the gag reflex during the tactical stimulation of the anterior and posterior faucial pillar and soft palate. However, we could not attempt to determine the measurement to distinguish among patients with different levels of gag reflex; further research is necessary.
The measurement method in our study can be used to measure the effect of an intervention on an individual. This study may help quantify further studies and develop additional treatments for gagging problems. This study was conducted in accordance with the Declaration of Helsinki, and each participant received oral and written information about the study before providing informed consent.
Karibe reports grants from Japan Society for the Promotion of Science, during the conduct of the study. Okamoto reports grants from Japan Society for the Promotion of Science, during the conduct of the study. The other authors have stated explicitly that there are no conflicts of interest in connection with this article. Volume 45 , Issue The full text of this article hosted at iucr. If you do not receive an email within 10 minutes, your email address may not be registered, and you may need to create a new Wiley Online Library account.
If the address matches an existing account you will receive an email with instructions to retrieve your username. Journal of Oral Rehabilitation. Hiroyuki Karibe Corresponding Author E-mail address: h-karibe tky. Tools Request permission Export citation Add to favorites Track citation. Share Give access Share full text access. Share full text access. Please review our Terms and Conditions of Use and check box below to share full-text version of article. Summary A reliable assessment method is required to manage the gag reflex.
Figure 1 Open in figure viewer PowerPoint. Gag reflex measurement process. A, Standard saliva ejector with a stopper made of heavy body addition silicone impression putty. B, The insertion distance of the saliva ejector from the maxillary central incisor at the maximum tolerance was determined as an index of the gag reflex. Figure 2 Open in figure viewer PowerPoint.
HR bpm HR bpm Rest 1 Management of gag reflex for patients undergoing dental treatment. Cochrane Database Syst Rev. Google Scholar. Crossref PubMed Google Scholar. Volume 45 , Issue 10 October Pages Figures References Related Information. Close Figure Viewer. Browse All Figures Return to Figure. Previous Figure Next Figure. Email or Customer ID. Forgot password? Old Password. New Password. Password Changed Successfully Your password has been changed. Returning user.