Clinical tip: How to help dental patients with a gag reflex

This week's clinical tip, courtesy of CDOCS, is delivered by Dr. Diwakar Kinra and is focused on helping those dental patients who have a gag reflex.

Watch below to learn some of Dr. Kinra's tips and tricks, including one focused on radiographs.

Video transcript

"Hi. My name is Diwakar Kinra, and I'm endodontic faculty at CDOCS, and my tip of the day has to do with gagging.

"Actually, gagging is a really gross thing for me. I mean, if a patient starts gagging, then I start gagging, and the whole experience is kind of negative.

"So you know, most patients, what I'm going to call them are three-star patients, they really don't gag, OK, but then you have the occasional person who gags with radiographs. That's like a two-star case for me, and a one-star case is when it actually compromises dental treatment.

"How can we improve these? How can we fix these? 

"Well, for those of you who have a cone beam, extraoral radiographs is a great way to get these bitewings. So, extraoral bitewings are perfect if you have a cone beam. They work really, really well. For those of you that don't have a cone beam, you can see here my assistants working on each other as an example. This is a great way to get an extraoral PA. 

"So you'll see here, the the radiograph is taken with the sensor outside the mouth, and all you have to do is just flip it when, when you get the actual picture, because it does come in inverse, and it works really, really well.

"And for those of you who where it's compromising dental treatment, one of my favorite things to do is, you know, use this right here. This is Hurricaine spray, and Hurricaine spray works wonderfully on the soft palate, numbs it up. And really, that's where the gag reflex comes. 

"Some people think it comes from the floor of the mouth, but it really doesn't. It comes from that soft palate. So if you can get that soft palate to be removed with any type of sensation, it works really great.

"And then once you place a rubber dam on there, a lot of that sensation that goes towards the oral cavity is gone and you have a great response.

"So, Hurricaine spray, rubber dam and, when needed, use it in a radiograph you're gonna use the extraoral bitewing feature of your cone beam, or you take an extraoral PA, and I usually do that with some type of distraction method like I have a patient lift their left leg or something that really works easy.

"All right, thank you very much. Have a great day."

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