Article: Volume 45 Number 7 Page 609 - July/August 2018

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  Dent Update 2018; 45: 609-616

Restorative dentistry:  Gagging – Bringing Up an Old Problem Part 1: Aetiology and Diagnosis

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Abstract: Gagging is a problem which has plagued dentists and other members of the dental team, including non-dental colleagues, during the course of their careers. Gagging not only has the potential to slow down the progression of the patient’s treatment, but it can often lead to the development of dental fear, anxiety and future avoidance of their scheduled appointments; much to the frustration of both parties. Subsequently, dentists may consider what went wrong with their initial approach and whether anything could have been done differently. However, the gag reflex, particularly when severe, is normally beyond the scope of simple reflective exercises, as this response may just be the tip of a very large psychological iceberg and, as deceptive as it seems, the dentist possibly never stood a fighting chance on his/her own. The first part of this two-part series aims to explore the aetiology and diagnosing the severity of the condition. The second part of the series will focus on the various management approaches which can be taken to overcome this physiological response successfully.

Clinical relevance: Gagging patients are a common occurrence within both general practice and hospital settings. It is important that clinicians are able to identify and categorize patients suffering from this condition correctly at an early stage, before clinical examination, or they will risk exacerbating dental fear and anxiety.

Author notes: Bryan Daniel Murchie, BDS, MJDF RCPS, PGCert(Implant), MSc(Rest Dent), Restorative Dentistry Department, Newcastle School of Dental Sciences. Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4BW, UK.

Objective: To understand the different aetiological factors associated with gagging, including the different categories, and the initial clinical approaches that should be undertaken.