I have a very strong gag reflex and it’s gotten worse as I got older. I haven’t been to the dentist in years because the last time I went I nearly threw up while getting my teeth cleaned. The hygienist kept rushing along trying to finish quickly, but her impatience made it worse. I couldn’t bring myself to go back again after that. I know I have a problem with a tooth, but if I can’t manage to control my gag reflex, there’s no way the dentist will be able to fix it. What should I do?
-Claire
Dear Claire,
Most people enjoy a good gag, like when Taco Bell announced they were purchasing the Liberty Bell and renaming it the “Taco Liberty Bell” or perhaps when Burger King unveiled their left-handed Whopper, but there’s nothing funny at all about gagging while you’re in the dental chair. For some people, it’s a minor annoyance. Maybe they get a slight twinge while they’re having x-rays or only when certain areas of their mouth are being touched. For others like you, it can be completely debilitating, triggered by almost anything and it keeps them out of the dental office.
Not every hygienist or dentist knows how to help a patient overcome their gag reflex. It’s possible your hygienist was trying to be helpful and get your cleaning done quickly, but I can see how that would add to your anxiety. There are many techniques that can aid in reducing or eliminating your gag reflex, but the first thing you should do is let the staff know about your history so that they can schedule you with a hygienist who has more experience in helping patients with a strong gag reflex. You should also speak with the dentist and let him know your concerns so he can help find which method(s) work best for you.
The most important thing to remember when you’re receiving dental treatment is to keep breathing through your nose. Focusing on or counting the breaths can also help relieve anxiety. You can work at home by slowly desensitizing your reflex, perhaps by edging closer to trigger areas while you brush until you can eventually touch them without an issue. There’s a number of topical sprays that can numb the area or you can start out by rinsing your mouth out with Listerine first or putting salt on your tongue. Changing position can help as well. While sitting in the chair, elevate your feet and legs, making an “L” shape with your body and point your toes away from you. Hold that position as long as possible and resume it again once the muscle fatigue fades. Whenever the procedure allows, request to be seated upright- this tends to lessen the gag reflex too. In cases where none of these techniques work, your dentist may be able to numb you with an injection or use a dental dam to keep instruments and water away from the back of your mouth. Some dentists also practice sedation or sleep dentistry, which can be an option for someone who is anxious or has a severe gag reflex.
Your dental team may have more suggestions and options available for you, but wherever the solution lies, it begins with a discussion between you and your partners in treatment.
This blog is sponsored by Port St. Lucie sedation dentist, Dr. Schamback