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gag reflex

What are some tips and tricks you use on some one who has a gag reflex and you’re taking x-rays?



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23 Answers

I have been in the dental field for 27 years… the absolute BEST thing I’ve found for gagging with xrays, is a little salt on the tongue, have the patient move it around and swallow… then you should be able to bang out at least 4 btw. With a Full Set.. you have have to apply a few times… just becareful, too much salt can act as an emetic. I’ve worked at practices that patients with severe gagging issues won’t let anyone take their xrays but me because of this trick! GOOD LUCK!!! Let me know how it works!

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I have several tricks I use, but I explain everything before I start. Understanding what is about to happen helps a great deal in diffusing an over active gag reflex no matter the age of the patient. I always let them feel what I am going to put in their mouth. I show them with my finger where it will go in their mouth as well. I also tell them I will set it next to their tongue, not stick way down their throat. 🙂 I always have them take a couple of deep breaths in through their nose and out through their mouths and remind them to not hold their breath when I take the radiograph. I am quick to use a smaller size if their reflex is severe and I get someone to push the button for me so that it is a quick in and out. Another good suggestion is to have children “Growl” deep and low. I have them practice before I take them. It relaxes the floor of the mouth and the tongue,it is also fun and kids especially like doing it. The raising of a leg is also a great trick to help them concentrate on in lieu of being fearful of gagging. All of the above works really well for me. Try it and see for yourself.

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Salt is definitely the way to go! Just a small amount on the tongue makes it so much easier for patients with a gag reflex problem to tolerate having x rays taken. I’ve tried many other tricks in my 38 years of practice but this has worked the best. Patients are amazed at how much easier it is to take x rays!

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Have them breathe deeply through their nose. This distracts them and opens up the airway. Works for me all the time.

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I spray a bit of citacaine on the soft palate to numb it. I also have a few patients that have more of a control issue with it. If I place the sensor they gag like crazy but if I let them place it and then remove their hand when I am ready to expose they do much better. They have been doing it for so long they have even gotten pretty good at proper placement of the sensor!

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I find it helps to move slowly. I always introduce the sensor by pushing on the side of the tongue first and having them bite down very slowly. I have found it helps when taking maxillary PA’s to allow them to hold the XCP in place. This had helped many times. The foot trick sometimes works but not always.

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The first thing I try is having them raise their foot. If taking bwx on right side I tell them to raise left foot and keep it up. The ‘distraction’ works 90%+ of the time. The other -10% I spray with hurricaine, have them swish for 30 seconds, sput it out and that usually works!

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I always explain to the pt. That the reason we gag is because our brain thinks we can’t breath properly due to the obstruction in the mouth. We can show our brain that we CAN breath adequately by breathing deep through the nose. I also say “breath through your nose and wiggle your toes!” Works pretty well for me 🙂

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Have the patient hum. Works ever time. I had a pt who gagged the whole time he was brushing on his fluoride. I went to a cont ed class and the presenter happened to mention the humming technique. I had the pt hum at his next appt and gagging stopped. He loved me!! I use it all the time for gaggers. They have to hum through placement and taking the X-ray. Try it!!

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I usually have the patient raise a leg while I count to ten. Usually concentrating on raising the leg can help them a little. Im usually finished exposing the X-ray much quicker than they think. Sometimes that works.

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Cetacaine spray or rinse supresses the gag reflex for both xrays and cleaning….we have had best result with rinse….

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I place baking soda powder on their tongue and I get by with 4 btw. I had to use a pedo sensor for some shots with fms.

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A 30 second swish with Listerine helps also to diminish the reflex. I have found that telling the patient to ‘close REALLY SLOWLY’ helps as well. I have tried the foot trick and it sometimes works. I always tell gaggers that they can remove the sensor as soon as the ‘beep’ stops, since they are closer than I am! I read an article in which a hygienist used a ‘Sea-Band’ ( for sea sickness) for patients and that worked sometimes for her. I’ve tried it a couple times on severe gaggers, but not sure if it works or if it is a placebo effect happening. I’ve recently been telling gaggers to try my own personal trick of distraction for when I am at the chiropractor’s office and he is working on my neck ( it keeps me from tensing up because I am distracted). I pick a long or difficult word to spell in my head and then use my finger like a pen and ‘write’ that word on my stomach as he is doing the adjustment. Works for me nearly 100% of the time! I usually pick ‘Hanukkah’ because I usually don’t remember how it is spelled, or ‘supercalfragalisticexpialadocious’! He is WAY finished by the time I get that one spelled! LOL! Hope this helps!

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I squirting Listerine on a 2×2, rub it on the films & Rinn. I tell the patients I read that mint is a natural anti – nausea. That has worked with almost every gagger I’ve ever had.

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I agree with above! Moving slowly to place the sensor, breathing deep, lifting a leg up. If those don’t work there is benzocaine spray and/or a pedo size sensor. I also always tell them they can take it out as soon as the beep is over.

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I agree with moving slowly, using salt, (I would assume baking soda would be the same as salt), breathing deeply. I havent had luck with raising a leg. If they have trouble I tell them not to push with their tongues. Just open and close. I sneak the film in. And I keep talking about anything but the xrays!

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1: breathe through the nose and wiggle the toes.
2: raise one foot in the air while doing #1.
3: salt trick
4: rub topical on the roof of mouth/floor of mouth etc….

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Salt…It does wonders

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All my patients are surprised when I tell them that I will cure their gag reflex! Then I simply have them NOT move their tongue at all, and explain that they can’t gag if they do not move it cuz the gagging is from the back of the tongue throat area dropping down! It really works if they will do it! Then they brag on me to the Dr that I am the best and very happy with me! Lol Good luck. I’d never heard if the salt thing b4, I wouldn’t want that, but seems to work for those above, and the leg or growling thing is them concentrating so them they r not moving their tongue, lol.

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After demonstrating how and where the sensor/film will be placed, I ask them to “go to their happy place”, or stare at an object in the room. Then I tell them they will only have to hold it until I count to five, and they may remove it after the “beep”. I ask them to take a deep breath then I place the sensor/film, and begin the count out loud. The understanding plus the diversions help keep the patient from gagging. 🙂

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The leg lift distraction works for me every time. I do use the snap-aray for Lower posterior pa’s too, it’s much more comfortable. It will be interesting to see what it takes when we switch to digital (hopefully soon).

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Agree on the salt trick. Learned it when I first started hygiene and it works like a charm. I also tell patients to breathe through their mouth (almost like a panting dog) instead of their nose, because they really do have to think about it and someone told me that you can’t breathe through your mouth and gag at the same time. Very few times have I been unable to get radiographs using these tricks.

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The DDS I work for has prescription gag reflex lozenges. Let the patient have it completely dissolve on the tongue, and then another one five minutes later. I’m able to get great bwx and clean with a cavitron on patients that have never been able to tolerate it before. Ingredients include sodium chloride, potassium chloride, calcium lactate, magnesium sulfate, silica gel, stevia, acesulfame potassium, sodium bicarbonate, sodium phosphate, and xanthan gum. I really recommend looking into it!

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