How to overcome an increased gag reflex in dental treatment

In some patients, when visiting the dentist, a persistent gag reflex may occur, which makes it difficult, if not completely nullified, to carry out dental procedures.

This can be a real problem for both the patient and the dentist.

What it is

Vomiting is the act of contraction of certain groups of the muscles of the gastrointestinal tract, as a result of which the food bolus moves from the distal sections to the oral cavity. The mechanism of formation of the urge to vomit has a complex reflex nature, the implementation of which provides the vomiting center in the medulla oblongata in the region of the reticular formation. The activation of the vomiting center can occur through impulses from the visual, olfactory, and taste receptors.

Due to the close localization to the vomiting center of the nerve centers of many reflexes - respiratory, vasomotor, center of salivation - the process of vomiting is accompanied by reactions caused by irritation these centers:

• change in breathing
• salivation,
• tachycardia,
• increased sweating
• pallor of the skin.

Degrees of manifestation

The gag reflex consists of several stages:

1. Desire phase.
2. Directly an attack of vomiting.
3. Recovery period.
4. Intermediate stage.

The first phase is characterized by the appearance of the following symptoms:

• stomach cramps
• feeling of nausea
• dizziness,
• increased sweating.

The urge phase can last from a few minutes to a couple of hours, and in some situations it can be absent. You can avoid the transition to the next stage by suppressing the attack of nausea, for example, with drugs.

The second stage consists directly in the emetic act. It proceeds very painfully. Taking fluids and medicines is difficult.

When the attack of vomiting passes, the pressure in the stomach decreases, and endorphins enter the bloodstream, contributing to the appearance of a feeling of relief. A healthy complexion returns to a person, an appetite appears.

In the interim between vomiting outbreaks, there are no signs of malaise.

Why we feel the urge to vomit

The reasons for the urge to vomit are highly variable. The gag reflex (hereinafter - PP) performs a protective function for the body, contributing to the extraction from the stomach toxic substances formed in it or preventing unwanted substances from entering the digestive system substances.

Vomiting is a response to irritation:

• receptors of the gastric mucosa as a result of intoxication,
• vestibuloreceptors when changing the speed and direction of body movement in space;
• mechanical irritation of the walls of the pharynx and the root of the tongue.

Attacks of nausea and vomiting can provoke strong emotional experiences, stress, serious illnesses affecting the central nervous and cardiovascular system of the body, diseases of the abdominal organs, toxicosis in early pregnancy, as well as taking certain medicinal drugs.

Symptoms of increased PP

The mouth reflex during dental treatment can occur due to excessive nervousness and patient fear before the procedure itself, as well as with increased sensitivity of the receptors of the tongue and the mucous membrane of the palate. The urge to vomit acts in this situation as an excessive defensive reaction of the body, aimed at preventing the ingress of a foreign body into the respiratory tract.

Some patients with elevated RR may experience discomfort even when brushing their teeth. They react with the urge to vomit even to touching not the back of the pharynx, but also at the very front teeth. If the touch of one's own fingers and food do not cause unpleasant symptoms, then foreign objects always provoke nausea - be it a toothbrush or a doctor's tools. This makes it difficult for an otolaryngologist to see the throat and perform most dental procedures.

It becomes problematic to treat posterior teeth, examine wisdom teeth, make impressions, install prostheses, since all these actions are accompanied by contact with the soft tissues of the oral cavity, provoking the emergence of RR.

How a doctor can help these patients

If a person suffers from an increased gag reflex, he should definitely inform his dentist about the problem. In the arsenal of doctors there are many techniques and medications that will help stop unpleasant symptoms.

First, they try to treat the patient in a sitting position, since when placed horizontally at the base of the tongue, saliva accumulates, causing PP.

In the course of treatment, the dentist, knowing about the problem, will try not to accidentally touch the sensitive areas of the oral cavity, more often use a saliva ejector. May try to distract the patient with conversation, play relaxing music.

Suggest to use cofferdam - This is a special latex plate that allows you to isolate the tooth with which dental manipulations will be performed from the rest of the oral cavity. Thus, the soft tissues of the tongue, cheeks and palate are protected from touch.

Your doctor may also prescribe local anesthesia to reduce tissue sensitivity.

In most cases, the gag reflex is well controlled by drugs for the prevention and treatment of seasickness such as Aeron, Dramina and drugs with antiemetic effect, for example, Adaptol, Motilium, Falimint, Cerucalus.

If the patient's nausea attacks are psychogenic in nature, and the above methods do not help suppress the onset of the vomiting reflex, a superficial sedation. As a rule, the inhalation method with the use of nitric oxide for children and intravenous for adults (iopental sodium, propofol, ketamine) is used. Sedation induces a state of drowsiness, helps suppress fears and maximizes patient relaxation. However, in this state, the person remains conscious, can talk, all reflexes are preserved, so this procedure does not eliminate the need for local anesthesia.

If the problem is not in stomatophobia, and surface anesthesia and medication do not have the desired effect, general anesthesia.

How to alleviate your condition on your own

To reduce the level of anxiety, on the eve of the procedure, you can take sedatives such as Afobazol, Novopassit or drink a decoction of herbs that have a sedative effect: chamomile, valerian, mint. Before performing a dental procedure, you need to sprinkle a few grains of salt on your tongue or rinse your mouth with salt water. It is best not to eat anything or drink a lot of fluids.

Once in the dentist's chair and feeling unpleasant symptoms, you can try the following techniques:

• relax the tongue;
• breathe exclusively through the nose;
• to achieve a relaxed state, focus as much as possible on the breathing process;
• think about something pleasant, try to distract yourself with music, watching TV;
• in order not to aggravate the attack of nausea, it is better not to close your eyes;
• Tighten the abdominal muscles as much as possible and sharply raise straight extended legs up;
• clench the fist of the left hand with force.

It is advisable to schedule a visit to the dentist in the afternoon, as the likelihood of a gag reflex increases in the morning.

How to train your body to react less violently

Exists several ways, which can reduce the strength of the PP, or even completely relieve the attacks of nausea.

Exercise to reduce the sensitivity of the mucous membranes

You can reduce the strength of the reflex urge to vomit by regularly stimulating the sensitive areas of the mouth. For example, put a spoon or a toothbrush in your mouth every day, first trying to press it against the palate in the area of ​​the front teeth and trying to suppress the emerging PP.

Having achieved success, you can go a centimeter further and follow the same procedure. Thus, in a few weeks of daily training, you can achieve significant success.

Acupressure

There is a special point on the human body, the stimulation of which can stop nausea. From the transverse fold on the wrist, step back three fingers width and find the place between the two large tendons. During a seizure, press firmly on both sides of the wrist and massage gently for a few minutes. You can also purchase and wear an acupressure bracelet by placing the applicator directly on this point.

Auto-training

If the problem of the emergence of the gag reflex is primarily psychological, it will be useful to master simple techniques of auto-training. Having learned how to use the relaxation method first at home, in a comfortable environment, you can resort to her help in the dentist's chair in the future. The exercise should be performed in a comfortable position with closed eyes, using imagination to achieve a feeling of heaviness, warmth, pulsation, coolness in different parts of the body. The effect can be enhanced by repeating positive attitudes during the exercise.

Meditation

Regularly practicing meditation (focusing on breathing with distraction from any thoughts for 10-15 minutes), a person acquires the ability to control his emotional state at the dentist's appointment, easily discarding frightening and disturbing thoughts.

If a person suffers from an increased gag reflex, this is not yet a reason to avoid visiting the dentist and start the condition of their teeth. You just need to consult a doctor and find the appropriate way to relieve the symptom.