I had a patient earlier this week that has a very very strong gag reflex. We talked a little bit about her homecare as she has generalized bleeding. She is unable to use an electric toothbrush of any kind and even using a manual toothbrush causes her to gag multiple times while brushing. I don’t know what to suggest to her as an interdental aid. At first I thought Waterpik, but I’m not sure she would be able to handle it. Any suggestions?
Maybe she should swish with something that will topically numb her gag reflex. Cognitive therapist that works with phobias could help.
Thanks for your answer – is the topical something that she would be able to use daily? I’m going to suggest a child toothbrush and maybe an ID brush with a very long handle.
She definitely has a phobia of the dentist. My dentist tried to use nitrous on her and it didn’t work at all. I was only able to do her maxillary at her last appt because she had to rinse after I cleaned one surface of each sextant. There’s a bit of a language barrier (I live in German speaking Europe and she speaks Italian), but if necessary there’s an assistant available to me that speaks her language.
I’m thinking about taking in a throat spray for when I clean her mandibular. Something similar to Chloraseptic. But I’m concerned that she will panic simply because she’s unable to feel her throat. At the same time, if it goes well, it would be a breakthrough for her.
Chloraseptic is an option. I do think cognitive behavioral therapy would really help. Sounds like she should be sedated orally or IV sedation……probably best option at this point. How stressful for you.
Thank you Hygenius! I definitely think therapy would be helpful for her – unfortunately I come across this quite often. In this country, children go to a dental clinic at school and many of them have had bad experiences. Which creates an adult patient that unfortunately has many issues.
I think I will try the Chloraseptic product towards the end of her next appt. That way, if she panics and shuts down, I will have almost finished and can finish her SRP very quickly in a third appt if necessary. If she responds positively to the numb throat, it will be great for her!!
Thanks again for your input!!
Your welcome. It’s sad that too many patients are scared at a young impressionable age. So Xanax or some other sedative couldn’t be prescribed?
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