scholarly journals Management of gag reflex for patients undergoing dental treatment

2019 ◽  
Author(s):  
Prashanti Eachempati ◽  
Sumanth Kumbargere Nagraj ◽  
Salian Kiran Kumar Krishanappa ◽  
Renjith P George ◽  
Htoo Htoo Kyaw Soe ◽  
...  
Keyword(s):  
Dental Treatment ◽  
Gag Reflex

scholarly journals Anesthetic Management of a Patient With Citrullinemia Type I During Dental Treatment

2021 ◽  
Vol 68 (3) ◽  
pp. 158-162
Author(s):  
Makiko Shibuya ◽  
Rie Iwamoto ◽  
Yukifumi Kimura ◽  
Nobuhito Kamekura DDS ◽  
Toshiaki Fujisawa
Keyword(s):  
Dental Treatment ◽  
Genetic Disorder ◽  
Anesthetic Management ◽  
Third Molar ◽  
Intravenous Sedation ◽  
Type I ◽  
Oral Medications ◽  
Gag Reflex ◽  
Serum Ammonia ◽  
Citrullinemia Type I

We report a case involving intravenous sedation for third molar extractions in a 32-year-old man with citrullinemia type I (CTLN1), a genetic disorder that affects the urea cycle. The patient was diagnosed with CTLN1 after he exhibited seizures soon after birth and was intellectually disabled because of persistent hyperammonemia, although his recent serum ammonia levels were fairly well controlled. We planned to minimize his preoperative fasting, continue his routine oral medications, and monitor his serum ammonia levels at least twice. Sedation with midazolam and a propofol infusion was planned to suppress his gag reflex and reduce protein hypercatabolism due to stress. Epinephrine-containing local anesthetics, which enhance protein catabolism, were avoided, replaced by plain lidocaine for blocks and prilocaine with felypressin for infiltration anesthesia. No significant elevation in ammonia levels was observed. In patients with CTLN1, sedation can be useful for preventing hyperammonemia. Patients who develop symptomatic hyperammonemia may require urgent/emergent treatment involving other medical specialists. Therefore, preoperative endocrinology consultation, perioperative monitoring of serum ammonia levels, and preemptively coordinating for appropriate care in the event hyperammonemia occurs should all be considered.

scholarly journals Delaying Intraoral Radiographs during the COVID-19 Pandemic: A Conundrum

2022 ◽  
Vol 2022 ◽  
pp. 1-5
Author(s):  
Harneet Kaur ◽  
Harshita Gupta ◽  
Himanshu Dadlani ◽  
Gulsheen Kaur Kochhar ◽  
Gurkeerat Singh ◽  
...  
Keyword(s):  
Dental Treatment ◽  
Imaging Techniques ◽  
Cross Contamination ◽  
Diagnostic Efficacy ◽  
Saliva Secretion ◽  
Planning Methods ◽  
Regulatory Bodies ◽  
Gag Reflex ◽  
Dental Radiographs ◽  
Dental Emergency

Background. The COVID-19 pandemic has made dentists very assiduous about cross-infection during dental treatment, thereby delaying dental radiographs for treatment. However, patients needing dental emergency treatment in the ongoing pandemic require relevant intra/extraoral dental radiography for adequate diagnosis and treatment planning. Methods. This article is aimed at adding to the hot debate: Is delay for intraoral radiographs justified or a possible proxy? As a narrative review, it provides an insight into the reasons for delaying intra-oral dental radiographs during in the pandemic and options of the nontraditional radiographic techniques available until the pandemic subsides. Discussion and Conclusion. Cross-contamination concerns through respiratory droplets grow while using intraoral film holders that stimulate gag reflex, coughing, saliva secretion, and if proper disinfection protocols are not applied. Since the patients’ acquiring emergency dental treatment cannot be neglected, the return-to-work guidelines by the health regulatory bodies urge to prioritize extraoral radiographic imaging techniques to curb the infection, offering the best diagnostic efficacy. The dental professionals can consider cone-beam computed tomography (CBCT) scans and sectional dental panoramic radiographs (SDPRs), followed by a risk assessment for COVID-19, a safer modality in reducing cross-contamination and assuring an innocuous environment for both patient and coworkers.

scholarly journals Gag Reflex: No More A Gag To A Dentist The Behavioral Techniques, Pharmacological Techniques, Acupressure and Acupuncture in Controlling the Gag Reflex - A Review

1970 ◽  
Vol 11 (1) ◽  
pp. 12-17 ◽  
Author(s):  
S Shriprasad ◽  
HS Shilpashree
Keyword(s):  
Patient Care ◽  
Dental Treatment ◽  
Management Strategies ◽  
Dental Patients ◽  
Behavioral Techniques ◽  
Gag Reflex ◽  
Management Techniques ◽  
And Control

Gagging in dental patients can be disruptive to dental treatment and may be a barrier to a patient care, preventing the provision of treatment and the wearing of prostheses. Many management techniques have been described to control the gagging. This article reviews the literature on various management strategies described to prevent and control the gagging. DOI: http://dx.doi.org/10.3329/bjms.v11i1.9816 BJMS 2012; 11(1): 12-17

Severe gag reflex during dental treatment associated with hiatus hernia: A case report

2021 ◽  
Author(s):  
Yuto Tanaka ◽  
Naohiro Ohshita ◽  
Tomohiko Okamura ◽  
Yoshihiro Momota ◽  
Yoshiaki Ono
Keyword(s):  
Case Report ◽  
Hiatus Hernia ◽  
Dental Treatment ◽  
Gag Reflex

scholarly journals The Gag Reflex: A Hurdle in Dentistry– Literature Review

2021 ◽  
pp. 224-237
Author(s):  
S. Meenakshi ◽  
Shyla Dureja ◽  
G. C. Kavita ◽  
M. Pallavi ◽  
K. N. Raghavendra Swamy ◽  
...  
Keyword(s):  
Dental Treatment ◽  
Alternative Methods ◽  
Treatment Techniques ◽  
Dental Procedures ◽  
Wide Range ◽  
Extreme Response ◽  
Therapeutic Procedures ◽  
Gag Reflex ◽  
Management Approaches ◽  
Treatment Procedures

Gagging reflex poses a hurdle in numerous dental procedures. It causes discomfort for the patient, extended procedure time for the clinician, compromised quality of treatment and along with a lot of physiological discomfort for both. The normal gag reflex is protective in nature, but few individuals elicit extreme response, leading to problems during the treatment procedures. It is extremely important for the clinician to identify the cause and severity of the condition so that it can be decided whether the patient can handle standard treatment techniques or whether alternative methods must be considered. There is no universal solution for successfully managing the gagging patient. Various modalities can be used according to the doctor’s assessment and patient’s conditions in order to control the gag reflex so that the patient can be comfortable and cope with the dental treatment. A wide range of management solutions are available, and many cases need a combination of therapeutic procedures. The main aim of the present article is to comprehensively report the clinical significance, etiology, symptoms and various management approaches used during prosthodontic treatments.

Propofol Target Controlled Infusion (TCI) Sedation for Dental Treatment in the Exaggerated Gag Reflex Patient

2012 ◽  
Vol 12 (2) ◽  
pp. 105
Author(s):  
Soonyoung Shin ◽  
Min-Joo Cha ◽  
Kwang-Suk Seo ◽  
Hyun-Jeong Kim ◽  
Jung-Man Lee ◽  
...  
Keyword(s):  
Dental Treatment ◽  
Target Controlled Infusion ◽  
Gag Reflex

scholarly journals Combating the Hypersensitive Gag Reflex in Patients Undergoing Dental Treatment – A Review

2020 ◽  
Vol 7 (6) ◽  
Author(s):  
Neha Hajira ◽  
Pulkit Khandelwal ◽  
Harleen Sachdeva ◽  
Sumit Khare
Keyword(s):  
Dental Treatment ◽  
Gag Reflex

scholarly journals The Effect of Adding Midazolam to Propofol Intravenous Sedation to Suppress Gag Reflex During Dental Treatment

2018 ◽  
Vol 65 (2) ◽  
pp. 76-81
Author(s):  
Toru Yamamoto ◽  
Keiko Fujii-Abe ◽  
Haruhisa Fukayama ◽  
Hiroshi Kawahara
Keyword(s):  
Dental Treatment ◽  
Cardiovascular Effects ◽  
Intravenous Sedation ◽  
Respiratory Compromise ◽  
Cardiovascular Adverse Event ◽  
Event Frequency ◽  
Treatment Interruptions ◽  
Respiratory Event ◽  
Gag Reflex ◽  
Dental Mirror

We retrospectively investigated the efficacy and safety of propofol administration alone and in combination with midazolam for gag reflex suppression during dental treatment under intravenous sedation. We included 56 patients with an overactive gag reflex who were to undergo dental treatment under intravenous sedation. They were divided into propofol (P group, n = 22) and midazolam with propofol (MP group, n = 34) groups. The P group received propofol alone, while the MP group received midazolam (0.04 mg/kg) prior to target-controlled infusion (TCI) of propofol (titrated for adequate sedation). The patients' anesthetic records were evaluated for vital sign changes, adverse cardiovascular or respiratory event frequency, the number of forced treatment interruptions, and the TCI-predicted cerebral propofol concentration at gag reflex suppression (posterior tongue stimulation with a dental mirror). No significant differences were observed between the 2 groups preoperatively. There were no cases of forced interruptions or significant respiratory compromise in either group. Cardiovascular adverse event frequency was lower in the MP group than in the P group (all p < .05). Our results suggest that propofol, when combined with midazolam, minimized cardiovascular effects compared with propofol alone when used to suppress the gag reflex in patients during dental treatment under intravenous sedation.

scholarly journals GAGGING A REVIEW

2014 ◽  
Vol 04 (01) ◽  
pp. 149-155
Author(s):  
Laxman Singh Kaira ◽  
Esha Dabral ◽  
Harpreet Singh Kukreja
Keyword(s):  
Patient Care ◽  
Dental Treatment ◽  
Behavioral Management ◽  
Strong Potential ◽  
Dental Procedures ◽  
Optimal Patient Care ◽  
Gag Reflex

Abstract:The gag reflex is a complex physiologic phenomenon. The problem compromises the quality of dental treatment and is a barrier to optimal patient care. The function of the reflex is protective in nature. When the reflex is abnormally active, the dentist may be presented with a bewildering and frustrating problem in various dental procedures, resulting in a strong potential for compromised treatment. The technique or techniques used should be dictated by the cause or causes involved. If organic disturbances, anatomic anomalies, or bio mechanical inadequacies of the existing prosthesis are not key causes the services of trained specialists are needed to help with behavioral management of the problem. A review of management of patients follows and includes strategies to assist clinicians.

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