DT News - UK - Review leaves researchers gagging for evidence on reflex management

Dental Tribune International

Tue. 20 October 2015

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MANCHESTER, UK/MELAKA, Malaysia: The use of sedatives, acupuncture or behavioural therapies are just some of the strategies recommended to dental practitioners for managing the gagging reflex that can occur in patients during treatment. A wide-scale review conducted by clinicians from the Melaka-Manipal Medical College’s Department of Dentistry in Melaka and published by the Cochrane Oral Health Group in Manchester has recently found no evidence that any of these strategies are in effective at preventing or managing the condition.

After a search for randomised clinical trials evaluating strategies for managing the gag reflex, the researchers only found one study, from Brazil, on the effects of acupuncture at Point P6 versus placebo acupuncture, to be eligible for the review.

Of the other 256 studies they took into consideration, none qualified to be included in the paper owing to bias, irrelevance and several other reasons.

For their review, the Malay researchers consulted Cochrane’s registration database and other medical search engines for clinical trials spanning from 1980 to the present day. Owing to the inconclusive results, they recommended that more studies be conducted on both pharmacological and non-pharmacological interventions, with special emphasis on behavioural modification techniques. Future research should also take into account a more varied population range and factors such as patient satisfaction, they stated. Moreover, more comparable studies are needed in contrast to only trials involving a dummy or a placebo technique.

Although little is known about its prevalence, an exaggerated gag reflex during dental treatment is a problem encountered by many dental practitioners, often during denture try-in sessions. The response can be triggered by a variety of procedures, including third molar removal or intra-oral image taking.

At its most severe, gagging can render dental treatment impossible. According to a 2013 Japanese study, one in five patients who avoid seeing a dentist suffer from the condition.

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