Stopping Gagging at the Dentist

Stopping Gagging at the Dentist

Jul 01, 2020

Q: I finally saved up for a new smile with porcelain veneers, implants and crowns, but I have a terrible gag reflex and can’t open wide enough. My doctor won’t do any more dental work on me! What can be done with patients like me?

A: I had to rewrite the question for this reader. She originally wrote: “I keep gagging at my dentist.” I believe she meant: “I keep gagging at the dental office.” I can’t imagine just the sight of the dentist would make one blow a donut. (Although, I did have a dental school professor that had fingers like sausages and no neck; a real bruiser. One look at his hands could make one hurl, I suppose.)

Many of our patients who have tons of veneers, implants and crown and bridge work have hyperactive gag reflexes and limited opening. (Defined as not being able to stack your pointer finger vertically over your middle finger insert between your upper and lower front teeth.)

I was shocked to read a recent article on line by a clinical assistant professor at NYU College of Dentistry which made no mention of any of the methods we use every day in our practice. Matter of fact, some of his recommendations, I totally disagree with as they can make things worse:

This is what should NOT be done for gaggers:

  1. liquid lidocaine to numb up the palate. Forget it! Patients hate the feeling of a numb throat, plus they can accidentally swallow small dental tools.
  2. Injecting Novocain into the tongue and palate: Painful and can cause more side effects than the actual dental work.
  3. Taking panoramic and CT Scans vs. regular dental X-rays which do not place any sensors or film in the mouth. : Not smart; these give more radiation and will not pick up cavities, most abscesses and other small but significant pathologies in the mouth.
  4. Nitrous Oxide: Laughing gas can interfere with patient’s meds and cause vomiting.
  5. Valium before your appointment: Same issues as number 4.

What we do to stop gagging:

  1. use of digital impressions called iTero: no-gagging, goopy molds of yore.
  2. Acupressure: squeeze the groove between your pinky and ring finger knuckle with the thumb and index finger of the opposite hand during the dental procedure.
  3. Bring your ear buds and listen to music on your phone.
  4. Eat a light meal before the treatment; don’t come in on an empty stomach, but don’t eat a Big Mac either.
  5. If the dental operatory has windows with a nice outside view, focus on one object such as a swaying palm tree during the treatment, or your favorite TV show on a screen in the room.
  6. Comfort resting block to keep open and allow you to relax.
  7. Halcion meds one hour before visit. (Short acting, no rebound sedation.)
  8. Reduce chair time with Hi Tech equipment, procedures and materials that can make a crown visit less than 30min. in the chair. (Electric drills, diamond drills, superfast setting temporary materials, and more.)

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