Gagging is the body's way of protecting us from choking. It's that feeling we get when something's "going down the wrong way" and we cough and splutter to get it back out of our mouth. If we didn't have a gag reflex some of our food would go into our airway and down into our lungs, causing blockages and infections. If we didn't have a gag reflex, we wouldn't last long. We have this reflex from when we are babies. But some babies are "fussy feeders", and some adults are too sensitive, too.
When is gagging a problem?
It is normal to gag when too much is in your mouth, and it can also be triggered by foreign objects in your mouth, bad odours (that stinky nappy), bad tastes (Brussels sprouts? durian?), anxiety (that medicine is going to make me feel sick), swallowing tablets, and very importantly, dental treatment and hygiene.
Some people cannot brush their teeth without gagging. So, coming to the dentist for cleaning, fillings, impressions, etc is a nightmare for them. Lots of these people avoid coming to the dentist, and only show up when they absolutely have to. The result is that a hypersensitive gag reflex affects their quality of life and everyday activities.
What can be done to manage gagging?
There are a few strategies to help but not eliminate gagging when you come to the dentist.
Here are a few of our favourites:
1. Distract your thoughts: Try to think about something else. Maybe listening to music, concentrating on knitting, listen to what your dentist/hygienist is saying to you and the dental assistant. Perhaps a psychologist can assist in this and with helpful relaxation techniques.
2. Distract your nerve endings: Put a different flavour in your mouth (e.g. a pinch of salt, or a sprinkle of chilli)
3. Suppress your nerve endings: Try using numbing cream or a numbing mouth wash at the beginning of your appointment. The dentist may find that giving anaesthetic needles to numb much of the mouth works well.
4. Sitting up more: For some people laying all the way back makes them more sensitive, so we may try having you a little more upright.
5. Relax you with pre-medication: A number of people benefit from taking a relaxant tablet before the appointment. Natural remedies include Valerian and lavender oil as an aromatherapy. Prescription medicines include Valium and similar. Your dentist or your doctor will need to prescribe these for you.
6. Desensitization: This is quite a good idea when people need to wear a denture, retainer, mouth guard, etc. When something new is put in the mouth it feels uncomfortable for all of us, but even more so for those with a hypersensitive gag reflex. After trying a number of the options above, we sometimes suggest leaving the appliance in your mouth for an extended time (e.g. leave a denture in overnight for a few days just to get used to it).
7. Sedation/ "Sleep Dentistry": For those who just cannot tolerate treatment even with all the ideas above, we can have an anaesthetist/sedationist come in and sedate you for your dental treatment. This medication is given in the arm into the bloodstream, and is the same as when other small procedures are carried out, e.g. Gastroscopy, colonoscopy, biopsies and cataract surgery. We routinely use this when taking out wisdom teeth, but also find it great for gaggers. Almost everyone has complete amnesia (they don't remember anything) and the gag reflex is suppressed, so the dentist/hygienist can do their job well and you can be comfortable.
Any more questions?
Why not ask your dental professional at Power Dental Practice at your next appointment!