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Gagging in dental patients can be disruptive to dental treatment and may be a barrier to patient care, preventing the provision of treatment and the wearing of prostheses. This article reviews the literature on the gagging problem from English-language peer-reviewed articles from the years 1940 to 2002 found by conducting an electronic search of PubMed, coupled with additional references from citations within the articles. Dentally relevant articles have been cited wherever evidence exists, and a balanced view given in situations where there is controversy. The first section considers the normal gag reflex and factors that may be associated with the etiology of gagging, including anatomical and iatrogenic factors, systemic disorders, and psychological conditions. A review of the management of patients with an exaggerated gag reflex follows and includes strategies to assist clinicians.


Some people have a pronounced gag reflex that can be a severe limitation to their ability to accept dental care and the clinician's ability to provide it. It can compromise all aspects of dentistry, from diagnostic procedures to active treatment and can be distressing for all concerned. Many techniques have been described that attempt to overcome the problem. Dentists will undoubtedly see patients with gagging problems and knowledge of a variety of management strategies is necessary to aid the delivery of dental care. This first paper looks at the background to gagging problems and their classification and categorization prior to clinical treatment. The second article will look at the clinical assessment of the patient presenting for dental treatment with a history of gagging problems. It will also review methods used to manage patients with gagging reflexes during dental treatment.

Nearly 74% of people possess a gag reflex, and it ranges in intensity from minor to strong enough to interfere with daily activities of life [4]. Major factors contributing to intense gag reflexes can be divided into two categories: somatogenic and psychogenic [3,5]. Somatogenic events leading to gagging include sensory stimuli of any kind while psychogenic influences only require a psychological event [6].

Our study is limited for two principle reasons. First, we have a limited sample of patients who took our survey and then received a dental implant and had the intensity of their gag reflex assessed. In our sample, there were no patients whose gag intensity was very severe and one patient who was rated as severe. These ratings corresponded to grades V and IV on the Dickinson and Fiske GSI respectively. Despite this, there were 14 patients in our sample who had a very mild or moderate gag reflex (grades I through III). Second, we did not separately measure the gag responses of men and women. This could have been an interesting addition to see if there was as sex difference among the 59 undergraduate participants who took our survey, or if there was a sex difference in the gag response among the dental patients. However, one study found no sex difference in gagging severity [16].

Our survey may allow professionals to identify gagging patients a priori, and then administer treatments preemptively before dental treatment. Using the linear regression equation from the best-fit line through the data, a score of 2 on the GSI (a mild gag reflex that requires reassurance from the dental team) corresponds with a score of 6.58 on the Predictive Gagging Survey. Thus, we recommend that anyone who scores a 7 or greater on the Predictive Gagging Survey may benefit from treatment methods to control the gag reflex. This score corresponds to the upper 25% of respondents.

There's a difference between choking and gagging. Gagging is a normal reflex as your baby learns to chew and swallow solid foods. Gagging is loud. Your child's skin may also look red when they're gagging, but redness can be harder to see on brown and black skin. Choking is quiet. If your child has white skin, it may begin to look blue (cyanosis) when they're choking. If they have brown or black skin, their gums, inside their lips, or their fingernails may begin to look blue.

Most cat parents have had the experience of seeing their fur baby gag. It can be scary to watch them, as it looks very serious as it is happening. It is normal for cats to gag now and then. However, if the gagging persists, it could signify a serious issue.

Your cat gagging can often be attributed to having hairballs, especially if your cat is an avid groomer. Gagging could also signify a situation requiring a trip to the emergency vet. Your cat may be gagging because they have a blockage in their throat or rear.

A cat gagging now and then is not a serious issue, but if it is consistent and other symptoms are present, you may need to take your cat to the vet. If you want to know more about why your cat is gagging, take a look at this article.

The most common reason a cat may gag is that they have a hairball. If a cat is gagging on a hairball, they will cough it up most of the time. However, it may take several tries before that occurs. Hairballs tend to accumulate in the stomach. Sometimes if one hairball comes up, there is more to follow. If your cat has frequent hairballs, it could be due to:

Sometimes cats get anxious when it comes to food, and it causes them to eat too quickly. When cats consume their food too fast, their bodies cannot tolerate it. It can make the cat gag until the food goes down and settles in the stomach. Your cat may also overeat, which is a bad combination. Either or, both can trigger gagging issues.

Cats will sometimes swallow objects they should not, leading to gagging. When they break down something through the chewing action, pieces of the thing can trigger the gag reflex. There are many items that cats can inadvertently swallow:

Cats may gag due to an upset stomach. If your cat is gagging and vomiting, it is a sign that they are nauseated. Nausea may be a sign of an illness or disease. It could also mean that your cat is nauseous from their food. Some cats cannot tolerate certain foods, and sometimes even the smell of certain foods can make them gag. If your cat experiences nausea, it will likely cause them to gag.

If your cat eats something toxic to them, it can trigger gagging. For example, they may have eaten a specific toxic plant, like the asparagus fern. When a cat consumes a poisonous plant, it will trigger a bad reaction. If your cat has ingested a toxic ingredient, get them to the emergency vet right away.

Sometimes cats who suffer from heart disease will gag. Cardiomyopathy is the most common type of acquired heart disease in cats. Gagging is one of the most common indicators of heart disease in cats. Other symptoms will often accompany the gagging:

It is essential to note that just because a cat is gagging does not mean that they have a disease. If they are gagging and these symptoms accompany the gagging, they may be ill and require immediate veterinary attention.

Allergies can trigger gagging in cats because allergies create inflammation in the throat area. It may cause them to retch, even when nothing comes up. If the problem is serious, it can cause the respiratory tract to close and give them breathing difficulties. An allergen can be almost anything that causes a bad reaction in your cat. Even dust can make them gag.

Coughing and gagging may seem very similar, although they are two different actions. Coughing is a strong and abrupt ejection of air from the lungs, but gagging presents as a choking sound. When a cat coughs, it is a symptom of a disease or medical issue.

Most babies gag frequently for 1-2 weeks when starting BLW. Fortunately, as they get more proficient at lateralizing the food to the side of their mouths to chew it before swallowing, gagging greatly reduces. Essentially, as your baby practices and learns that they cannot just swallow whole food, they will gag less as and lateralize/chew more. The more gagging and practicing they do, the less they will gag in the long run.

Instead of fearing the gag reflex, we want to teach you more about what it is, how it protects your child, and how to help your baby learn to chew safely. Our online course Infant Feeding: the Baby-led Way goes into even more detail about gagging and shows you multiple videos of what it looks like!

Choking, on the other hand, means a piece of food has partially or completely blocked the windpipe. Whereas gagging involves a lot of coughing and gurgling, choking can cause high pitched sounds while breathing or may even be silent. If this occurs, you need to intervene immediately.

Gagging and choking are not the same thing. Gagging is an involuntary movement meant to prevent choking. The person gagging can still breathe. Choking is when the airway is blocked or partially blocked. If a person is unable to breath, call 911 immediately.

The aim of this study was to investigate two different acupuncture approaches in the treatment of orthodontic patients with a gagging reflex (GR). Forty-five patients (mean age 10.1 2.6 years) had an upper dental alginate impression taken prior to receiving laser stimulation. GR assessment was evaluated by using the Gagging Severity Index (GSI). Fifteen patients in Group A underwent a red-light soft magnetic field laser stimulation of conception vessel 24 (CV 24) for 1 min. Fifteen other patients in Group B undertook a combination of laser stimulation of CV 24 and acupressure pericardium 6 (PC 6). Group C, which consisted of the remaining 15 patients, formed the placebo group. After the laser stimulation and acupressure, a second impression was taken. The Gagging Prevention Index (GPI) was used to evaluate gagging reflex after the laser stimulation and acupressure. Both GSI and GPI were recorded at three stages of the dental impression taking procedure, ie with an empty impression tray, with a loaded tray and the ability to keep the impression in the mouth until set. A significant decrease in GPI values compared to GSI values, was observed at the three stages of the impression taking process and after the laser stimulation in Group A and B (p 041b061a72


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