The Use of an Alternative Extraoral Periapical Technique for Patients with Severe Gag Reflex

Abstract

Gag reflex is a physiologic mechanism that promotes contraction of the muscles of the tongue and pharyngeal walls. Different factors, including intraoral radiographic films and sensors, may trigger this reflex. Patients with severe gag reflex may not be able to tolerate the presence of intraoral radiographic films or sensors during root canal therapy (RCT). This factor may prevent an appropriate intraoral radiograph, which is important in RCT. Different approaches have been used to facilitate dental procedures in patients suffering from severe gag reflex. The use of an extraoral radiographic technique is an alternative method to obtain working length confirmation in patients with severe gag reflex. In this report of 2 cases, the use of an extraoral radiographic technique as an alternative approach during RCT in patients with severe gag reflex associated with phobic behavior and trismus was successfully demonstrated.

Covid-19

“…Extraoral imaging such as panoramic radiograph or cone-beam computed tomography should be used to avoid the gag reflex or cough that may ensue with intraoral imaging. [ 31 ] When intraoral imaging is mandated, sensors should be double barrier to prevent perforation and cross-contamination. Dentists should use a rubber dam to reduce splatter generation.…”

Prevention of Hyperactive Gag Reflex during Dental Procedures in COVID-19 Pandemic

“…A panoramic radiograph or cone-beam computed tomography (CBCT) can also be used as an alternative examination. 8 In another recent review study, Nasiri and Wrbas stated that electronic apex locators, regardless of their generation, prove to be beneficial for patients suffering from gag reflex or those who cannot endure X-ray film or sensor. 9 Another challenge for clinicians in this pandemic is the cyclic vomiting syndrome (CVS); it was first recognized in pediatrics; however, it is now confirmed that adults can also suffer from CVS.…”