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Any special tips for maxillary alginate impressions on extreme gaggers?

So I have a patient in my schedule tomorrow to complete her alginate impressions for an occlusal guard. She has a strong gag reflex and lots of anxiety. She took Xanax and had a driver bring her in to start the impressions last week. The other hygienist at our office was able to get the lower impression and bite registration taken, but the patient basically said that was all she could handle that day. So tomorrow, I get to give the upper a go… In my ten years since graduating, I have never had a patient that needed to be sedated for impressions. Any tips to make it easier on her (and me!) tomorrow?

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1 Answer

Try salt. Put salt on her tongue, like all over. If you have Cetacaine, cover her whole tongue as far back as possible with it. Tell her to breathe through her nose – when you are breathing you physically cannot gag. Tell her that. It’s mind over matter. Distract her. Tell her to lift her foot while holding the opposite hand up touching her thumb to to her finger (making an okay sign). Does that really stop gagging – no, but if she thinks it does, it may work. Some patients have so much anxiety that there’s really nothing you can do. If it takes multiple tries and appointments, so be it. It’s not your fault. I wish you the best of luck. Keep a calm demeanor so hopefully she does to. You got this!

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