The Clinical Management of the Gagging Patient.

A pronounced gag reflex can be a burden for patients and dentists alike. It can limit the capability of a patient to undergo dental treatment and complicate the dentist’s ability to provide treatment. Understanding the somatic and psychological basis of an overactive gag reflex is key to providing treatment. The first techniques involved should be local measures to reduce anxiety. Further techniques can be used if this proves fruitless. Local anaesthetic, conscious sedation, acupuncture, hypnosis and TENS are techniques that have been suggested in the literature to overcome a pronounced gag reflex. This paper will explore the aetiology of the gag reflex and the many suggested approaches to the management of a patient with a pronounced gag reflex. Understanding the causes and having a working knowledge of the management approaches will help dentists overcome gag reflexes in the treatment of these patients.