Management of gag reflex for patients undergoing dental treatment

Eachempati, Prashanti; Nagraj, Sumanth Kumbargere; Krishanappa, Salian Kiran Kumar; George, Renjith; Soe, Htoo Htoo Kyaw; Karanth, Laxminarayan

doi:10.1002/14651858.cd011116.pub3

Cited by 16 publications

(10 citation statements)

References 57 publications

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“…According to the results of this study, we believe that the best alternative to avoid this problem when introducing the plate into the oral cavity would be to promote the marketing and use of a trimmed plate. We also agree with other authors [ 17 ] that behavioral management such as distraction is another way to control this reflex. We believe that the use of self-affirmation techniques [ 18 ], although they may favor the child’s collaboration, do not allow control of the gag reflex, unless it is caused by an emotional factor.…”

Section: Discussionsupporting

confidence: 93%

“…According to Katsouda et al [ 6 ], 20% of children between the ages of 4 and 12 years present this reflex, which is why it is considered a fairly common obstacle that pediatric dentists encounter, reducing the effectiveness of preventive, diagnostic, and therapeutic procedures and encouraging the child to reject the need for care. Its management is complex [ 17 ], and the scientific literature provides a wide range of possibilities: antiemetics, sedatives, local anesthetics, relaxation techniques, distraction, desensitization, acupuncture, acupressure, or the use of low-intensity laser alone or associated with specific acupuncture points [ 16 ]. The technique of inverse or extraoral radiography has even been developed [ 8 ], doubling the exposure time, but leaving aside the principle of the minimum possible ionizing radiation, since it is necessary to optimize its application to avoid unhealthy exposures [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

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Study Regarding the Optimal Dimension of Intraoral Bitewing Radiographs in Patients with Primary Dentition

Pérez

Cuerva

Costa-Ferrer

et al. 2022

IJERPH

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The aim of this study was to determine the optimum dimensions of a radiographic plate to allow correct visualization of dental tissues and correct fit in the oral cavity of children with deciduous dentition. A quasi-experimental clinical study was carried out in children of both sexes aged between 3 and 5 years. The study variables were the complete visualization of the dental structures, the surveillance of ischemia on soft tissues, stimulation of the gag reflex, and acceptance of the radiographic plate by the pediatric patient through a validated visual analogue scale that measures anxiety. The data obtained were subjected to a descriptive and comparative statistical analysis carried out for both study phases. A total of 80 children participated in the study. The optimal dimensions obtained for the radiographic plate were 19.5 mm in height and 27.3 mm in width. Visualization of the dental tissues during both phases was not statistically significant (p = 0.412). However, there were statistically significant differences regarding the presence of ischemia, gag reflex, and child rejection (p < 0.001). A smaller radiographic plate allows correct visualization of the coronal dental tissues without causing rejection, ischemia, or gag reflex in patients in the deciduous dentition.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Study Regarding the Optimal Dimension of Intraoral Bitewing Radiographs in Patients with Primary Dentition

Pérez

Cuerva

Costa-Ferrer

et al. 2022

IJERPH

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“…Use computed tomography and extraoral radiographs in preference to intraoral radiographs, and avoid the generation of lumps in the areas that trigger coughing and vomiting [ 194 , 195 ].…”

Section: Figurementioning

confidence: 99%

Oral Lesions Associated with COVID-19 and the Participation of the Buccal Cavity as a Key Player for Establishment of Immunity against SARS-CoV-2

Gutiérrez-Camacho

Ávila-Carrasco

Martinez-Vazquez

et al. 2022

IJERPH

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Background: Some oral lesions have been described in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); the possibility has been raised that the buccal lesions observed in patients with the coronavirus disease 2019 (COVID-19) are due to this virus and the patient’s systemic condition. The aim of this review was to integrate the knowledge related to the oral lesions associated with COVID-19 and the participation of the buccal cavity in the establishment of immunity against SARS-CoV-2. Methods: A literature search on the manifestations of buccal lesions from the beginning of the pandemic until October 2021 was carried out by using the PubMed database. A total of 157 scientific articles were selected from the library, which included case reports and reports of lesions appearing in patients with COVID-19. Results: Oral lesions included erosions, ulcers, vesicles, pustules, plaques, depapillated tongue, and pigmentations, among others. The oral cavity is a conducive environment for the interaction of SARS-CoV-2 with the mucosal immune system and target cells; direct effects of the virus in this cavity worsen the antiviral inflammatory response of underlying oral disorders, immunodeficiencies, and autoimmunity primarily. Conclusions: The oral cavity is an accessible and privileged environment for the interaction of SARS-CoV-2 with the mucosal immune system and target cells; the direct effects of the virus in this cavity worsen the antiviral inflammatory response of underlying oral disorders, in particular those related to immunodeficiencies and autoimmunity.

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“…The gag reflex is a normal, involuntary physiologic defense mechanism triggered in response to foreign objects in the upper airway. 1 Though well studied in the dental literature, 2 little is known about the experience of gag in patients undergoing flexible laryngoscopy with stroboscopy (FL-S). The gag reflex is activated through intraoral or intranasal stimulation via afferent fibers of the trigeminal, glossopharyngeal, and vagus nerves.…”

Section: Introductionmentioning

confidence: 99%

“…To our knowledge, gag has not been a focus of study in association with FL-S, though gag has received attention in relation to dental procedures. [2][3][4][5] Several studies have evaluated discomfort of FL without stroboscopy, and have found it to be better tolerated than rigid laryngoscopy. [6][7][8][9][10] One approach to reduce discomfort during FL has been to use topical anesthetics and vasoconstrictors.…”

Section: Introductionmentioning

confidence: 99%

Predicting Gag, Discomfort, and Laryngeal Visualization in Patients Undergoing Flexible Laryngoscopy with Stroboscopy

Kiessling

Bayan

Lohse

et al. 2021

Ann Otol Rhinol Laryngol

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Objective: To investigate potential associations between the Predictive Gagging Survey (PGS) with patient experience of gag and discomfort as well as provider perception of patient gag and level of laryngeal visualization during flexible laryngoscopy with stroboscopy (FL-S). Methods: A total of 53 adult patients undergoing FL-S were recruited for this prospective non-controlled study. PGS was completed before FL-S. Patients rated perceived level of gag and discomfort on a 10-point severity scale after FL-S. Additionally, providers completed a Gagging Severity Index (GSI) reflecting their impression of patient gag and level of laryngeal visualization following FL-S. Spearman rank correlation coefficients were used to assess associations. Results: There was a positive association with PGS score and patient perception of gagging (0.34; P = .013) and patient perception of discomfort (0.38; P = .005). No significant association was found between PGS score and provider GSI (−0.12; P = .39) or level of laryngeal visualization (0.15; P = .29). A negative association was found between level of laryngeal visualization and patient perception of gagging (−0.34; P = .012) and discomfort (−0.44; P = .001). No significant differences were found between current and former smokers compared to never smokers for GSI or patient-perceived gag or discomfort. Conclusions: While not predictive of GSI or level of laryngeal visualization, the PGS was found to be a useful tool in predicting patient experience of gagging and discomfort during FL-S, further reinforcing the subjective experience of this procedure. Use of the PGS may be helpful in identifying specific candidates who may struggle with subjective discomfort or gagging during FL-S for future studies considering interventions to manage and meaningfully decrease discomfort. Having such an instrument is important given the low number of individuals who struggle with discomfort during the exam.

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Management of gag reflex for patients undergoing dental treatment

Cited by 16 publications

References 57 publications

Study Regarding the Optimal Dimension of Intraoral Bitewing Radiographs in Patients with Primary Dentition

Study Regarding the Optimal Dimension of Intraoral Bitewing Radiographs in Patients with Primary Dentition

Oral Lesions Associated with COVID-19 and the Participation of the Buccal Cavity as a Key Player for Establishment of Immunity against SARS-CoV-2

Predicting Gag, Discomfort, and Laryngeal Visualization in Patients Undergoing Flexible Laryngoscopy with Stroboscopy

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