Systematic Desensitization Technique Using Ultrasound-Guided Selective Glossopharyngeal Nerve Block for Severe Gagging Reflex: A Report of Two Cases.

The gagging reflex during dental treatment is a common concern for dentists and patients. Herein, we describe a novel approach to managing severe gagging reflex, termed the "KOJIMA program," using a systematic desensitization technique combined with an ultrasound-guided selective glossopharyngeal nerve block (UGSGNB). After performing the UGSGNB, the participants were trained to touch the inside of their mouths with a cotton swab. Two patients participated in the KOJIMA program. In case 1, before starting the KOJIMA program, palpating the lips, maxillary buccal gingiva, mandibular buccal gingiva, buccal mucosa, and maxillary palatal gingiva was possible. By the fifth session, the patient was able to palpate the palate and tongue. In case 2, before starting the KOJIMA program, only the lips, maxillary buccal gingiva, mandibular buccal gingiva, and buccal mucosa could be palpated. By the third session of the program, the patient was able to palpate the palate and tongue. Both patients were able to wear partial dentures. Our findings suggest that the KOJIMA program might be easily accepted by patients and could be used for managing severe gagging reflexes.