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Nasser Antonious, DDS, MAGD, FICOI
Master of the Academy of General Dentistry
Fellow of the International Congress of Oral Implantologists

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Gag Reflex-Sunnyvale Dental Care
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Gag Reflex

1. Why You Can Have Problems With Your Gag Reflex
2. Getting Rid of Gag Reflex Through Desensitization
3. Tips to Prevent Gagging While Brushing Your Teeth
4. Tips to Prevent Gagging During Dental Treatment
5. Tips to Get Rid of Your Persistent Gag Reflex (professional help)
6. Gag Reflex Management In The Dental Office

 

Why You Can Have Problems With Your Gag Reflex

Your gag reflex is a perfectly natural part of your body's self defense mechanism.

The back of your throat naturally contracts when an object touches your soft palate. This natural contraction is called the gag reflex or pharyngeal reflex, and it prevents you from choking.
Which is good to know until you're lying back in the dentist's chair, waiting for some routine work to be done and then suddenly you feel the irresistible urge to vomit.
Then the panic starts to kick in and as well as gagging, you maybe break out in a cold sweat.

What can you do to reduce your gag reflex at times when it's being a hindrance rather than being helpful?

Some patients cannot even brush their back teeth without starting to gag. This is a very real problem at the dentist office since many patients may not be able to withstand having their tongue touched with a dental mirror or other instruments (even fingers). This gag reflex is instantaneous and makes it impossible for many patients to complete even basic dental care.

Resultantly, such patients may avoid going to the dentist for cleanings and dental care for many years. It can become an embarrassing and frustrating problem for patients.

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Getting Rid of Gag Reflex Through Desensitization

It is possible to get rid of your gag reflex through desensitization, which means training your soft palate to receive objects without gagging. The best time to train your soft palate is when you're brushing your teeth. Do the following steps while you're brushing, and get rid of your gag reflex as soon as possible.

  • Find out where the gag reflex starts. Use the toothbrush to brush your tongue. Start from the farthest tip of your tongue, and then work your way in deeper.
  • Once you begin to gag, try to brush that area for about 10 seconds even while you're gagging. This process is quite unpleasant, but training yourself not to gag naturally involves some gagging. Stop brushing when you feel like you can't continue any longer; training yourself can't be done in a day.
  • Repeat the process over the next few days, concentrating on the exact same spot. You'll notice that you gag less each time you repeat it. Stay on the same spot until you can handle most of the gagging or gagging completely stops. That part of your mouth is now desensitized.
  • Reach deeper into your mouth using the toothbrush. Try brushing half an inch behind the desensitized spot. Keep moving further back until you’ve reached the farthest area that the brush can reach

The whole desensitization process should take about a month to complete, so don't lose hope if nothing improves in the first couple of days. Remember to repeat the process from time to time because your gag reflex may return if you don't.

Some tips to make desensitization work:

    • Don't start too far back because you'll only gag pointlessly. This process only works if you do it one tiny step at a time.
    • It's not advisable to do this twice a day because if you vomit your food, then your body won't be able to digest the nutrients it needs. Do it once either in the morning or before you go to sleep in the evening.
    • Don't breathe through your mouth while you're brushing; instead, breathe through your nose to avoid triggering the gag reflex.
    • You should talk to your doctor first before desensitizing your soft palate. This training is also not recommended for children, as they might choke on the toothbrush.

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Tips to Prevent Gagging While Brushing Your Teeth

Common problem among people with overactive gag reflex is brushing their teeth. Some experience the condition from childhood, while others develop it through time, sometimes as a symptom of a more serious condition, like an eating disorder. The following tips can help prevent you from gagging while brushing your teeth:

  • Use an electric toothbrush: Your gag reflex may be a response to the jerky motions while you're brushing your teeth. In this case, use an electric toothbrush with a very small brush head to make brushing easier and a lot more comfortable. Select the slower speed setting of the toothbrush to minimize the jerky movement.
  • Slowly increase the brushing area: Start brushing the area you find easiest to brush, and then move slowly to other areas until you can cover your whole mouth. Some people with overactive gag reflex find it easier to brush with their lips closed. Starting with the outer surfaces of the lower teeth then increasing the brushing area also works well for other people.
  • Choose a time that works best for you: Many people say that gag reflex is worse in the morning for reasons unknown. You can use a mouthwash in the morning, and then just brush your teeth later to reduce the risk of gagging. Keep in mind that it is recommended to brush your teeth at least twice a day.

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Tips to Prevent Gagging During Dental Treatment

Even if your gag reflex is not overactive, you may still find yourself gagging when the dentist starts working in your mouth. There are many ways to control or completely stop your gag reflex during dental treatment. Some of them are the following:

  • Concentrate on breathing through your nose: You gag because you're trying to breathe in air through your mouth while the dentist's tools are also in there. Breathe through your nose instead of your mouth to keep the right amount of oxygen in your body.
  • Lift both of your legs up: For some people, lifting both of their legs up when they feel the gag sensation coming helps to prevent or reduce it.
  • Use a nasal decongestant before your appointment: Nasal decongestant keeps your nasal passageways open, promoting easier breathing through the nose.
  • Use table salt: Putting a pinch of table salt on the tip of the tongue during dental examination to prevent gagging works for many people. This method probably works because your mind concentrates on the taste of the salt rather than on the tools in your mouth.
  • Talk to the dentist: Gagging can be caused by psychological factors as much as it is caused by physical factors. Some people gag when they go to the dentist because of fears that the dentist will do something wrong, and they'll be in pain. They fear that they are not in control of the situation, and so their mind overreacts and encourages the gag reflex to go off. Talking to the dentist about your concerns makes you feel more relaxed during the whole procedure and could alert your dentist to take certain precautions to minimize your gag reflex.  
  • Desensitize yourself: Gagging is so unpleasant that you may soon start to fear going to the dentist irrationally. Remind yourself of the purpose of dental treatment by reading about the effects of poor dental care. Desensitize yourself by asking your doctor if you can take some of his tools at home, so you can practice putting them in your mouth. Find ways to have positive feelings about your dental visit to reduce your risk of gagging during a dental procedure.
  • Take a sip of very cold water: Some dentists say that taking a sip of very cold water before a dental procedure helps prevent gagging. There's no harm done in it, so try this for your next dental visit.
  • Listen to music: If it's OK with your dentist, bring your headphones, and simply listen to music while having a dental procedure. Listening to your favorite music shifts your attention from the tools in your mouth to the music in your ears.
  • Sit up rather than lie down: Gagging also sometimes has to do with your position during a dental procedure. Ask your dentist if it's possible to sit up rather than to lie down during the particular dental procedure being performed.

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Tips to Get Rid of Your Persistent Gag Reflex (professional help)

  • Consult your doctor or a visit a psychologist: Gagging can be caused by a different medical problem; for instance, an eating disorder. Consult your doctor if you suspect that your oversensitive gag reflex is just a symptom of another illness. Gagging may also be caused by past psychological trauma or repressed fears. In this case, it's a good idea to visit a psychologist to determine the deeper issues that fuel your gag reflex.
  • Consider hypnosis and acupuncture: Quite often, your gag reflex is something that you learned to do. At some stage, your body may have got into an "over protective" mode. The trouble is, once you've learned how to do something, including gagging in certain circumstances, it's not always easy to "unlearn" how to do it. But it is possible. Using methods such as hypnosis, you can re-train your mind to deal with the situation differently next time it occurs.

Many people suffering from overactive gag reflex find relief in hypnotherapy. A hypnotherapist puts you in a trance-like condition to implant ideas, concepts, and lifestyle adaptations in your subconscious mind. This method may work if your overactive gag reflex is caused by past psychological trauma. Another alternative treatment to overactive gag reflex is acupuncture. One study found out that ear acupuncture helps prevent gagging, although it's controversial whether this is a placebo effect or not.

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Gag Reflex Management In The Dental Office

Some of the popular sedation methods used by dentists with patients who have severe gag reflex responses are:

1. Nitrous Oxide (Laughing Gas) Sedation

2. Benzocaine spray can be used to briefly numb the gag reflex areas for simple things like taking x-rays or taking an impression. The back of the throat stays numb long enough for most patients to get through these procedures. For severe cases it may not work.

3. Oral sedation with the Benzodiazepine medications like Valium or Halcion can greatly reduce the gag reflex response. Conscious Sedation can control and eliminate the gag reflex response to almost any number of stimuli or conditions that elicits this involuntary behavior. Although patients will have unique responses to the different types of sedation methods used, the gag reflex can be effectively controlled. The sedation medications help the patient achieve a state of total relaxation. This type of medication not only eliminates the response but allows the pleasant perception of time passing quickly with little or no memory of treatments performed.



4. In severe gag reflex patients, I.V. sedation medications such as Versed or Fentanyl are also popularly effective for eliminating the gag reflex.

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Nasser Antonious DDS is licensed as a general dentist in California. Sunnyvale Dental Care established since 1995
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