Why do I choke at the dentist? - Drews Dental in Lewiston, ME (2023)

Are you afraid of having x-rays or impressions taken at the dentist's office, specifically because it makes you choke?

You are not alone. About 10-15 percent of dental patients suffer from hypersensitive gag reflex (HGR). And, like you, they fear receiving x-rays and impressions. The purpose of this blog post is to explain why you gag and, perhaps more importantly, what you can do to help minimize our gag reflex whenever you're in the dental chair.

Your gag reflex is an involuntary reaction

The gag reflex, or laryngeal spasm, is basically the uncontrolled contraction of the back of the throat when an object touches the roof of the mouth, the back of the tongue, the area around the tonsils, or the back of the throat.

It's an involuntary reflex in the same way your leg kicks when your doctor hits the right spot on your knee with one of those little triangular rubber mallets.

A gag reflex is a built-in safety feature that we as humans have developed to prevent us from gagging when we push food down our throat too quickly. Come on, I know I'm not the only one.

Let's first see what happens when we choke. By pushing objects down the throat toward the mouth opening, the gag reflex expels substances that the brain considers harmful. If we didn't have this protective feature programmed in, our baby's immature digestive system would be overwhelmed.

Why do I choke at the dentist? - Drews Dental in Lewiston, ME (1)In the first few months of a baby's life, this reflex is triggered by any food that a region of the brain stem called the "nucleus tractus solitaire" (which is connected to nerve endings in the mouth) deems too thick for the baby. system. . process.

Starting at 6 or 7 months in babies, the gag reflex slows down, allowing the baby to start swallowing solid or chunky foods.

In older children and adults, the reflex is usually only triggered by the presence of an unusually large object at the back of the throat.

Why do I choke at the dentist? - Drews Dental in Lewiston, ME (2)

However, as I mentioned at the beginning of this blog post, 10-15% of people havehipersensiblegag reflex (HGR) that continues to be activated by substances in the mouth, such as a dental X-ray sensor or impression material.

Suppress the gag reflex

As in most relationships, communication is key. We can't help you combat an exaggerated gag reflex if you're suffering in silence. Please let us know ahead of time because there are ways you can help and things you can do to help avoid that horrible feeling.

What can we do to help?

So what can we do to help you overcome your brain's gag reflex when you're sitting on the chair?

I can say that there is no quick fix that works for everyone. In fact, choking may be due to psychological or physiological factors, or both. But since this reflex is controlled in the region of the brain called the hypothalamus, we can try to "trick" the brain by stimulating other controlled reactions in the same region.

1. Salty swabs

One method I like to use to "trick the brain" is to introduce a strong flavor to help stop the gagging. We place a cotton swab with salt on the tip of the tongue, stimulating the taste sensors. We are basically giving the hypothalamus a second signal. I have had great success using this simple trick.

2. Narcotic pills

A second way to stop gagging is to decrease the brain's ability to process information coming from the mouth. We do this by numbing all sensation of touch in the mouth by having the patient suck on an anesthetic lollipop. Lollipop made with 1% tetracaine. This is the same medical topical anesthetic used after tonsillectomies or for sore throats.

3. Laughing Gas

If you are a serious joker, laughing gas can help you. Sedation by inhalation of nitrous oxidesignificantly reducethe retching/vomiting reaction.

4. Distractions and diversions

We regularly use this last concept for all our patients when making impressions or x-rays. We are basically trying to divert attention from the impression or the placement of the X-ray sensor in the mouth.

We ask you to "point your toes to your nose" because concentrating on those instructions and flexing your muscles helps distract you by sending additional signals to your brain, "tricking the brain" to help you get through the dental procedure.

We also ask patients to squeeze a stress ball, listen to music on headphones, or visualize their happy place (self-hypnosis techniques), which are also great distractions. We use various distractions and diversions throughout the day as it means a better overall experience for everyone.

What can you do to help

So what can you do to help you overcome your brain's gag reflex when you're sitting on the chair?

Again, no single tactic will work for all people all of the time; however, there are things you can do to help your mind (and body) get over the issue at hand, whether you're taking an impression, an X-ray, or any other dental procedure that triggers your gag reflex.

1. Breathe

This sounds simple, but you may be surprised how many people hold their breath during dental procedures. Instead, aim for slow, steady breathing through your nose.

Close your eyes and focus on your breathing. It is good for the body and excellent for relaxing. (Think yoga, meditation, hypnosis). Relaxing really helps. If you are gripping the armrests of the dental chair and tensing, you are more likely to choke.

2. Make a fist

A2008 studysuggests that you can alter your gag reflex by applying pressure to a point on your palm. To test it, simply make a fist with your left hand, squeezing your thumb together.
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We have found patients who place their hands in their laps and massaging the palm of their left hand with their right thumb also helps.

3. Desensitize your tongue

One of the things you can do at home is work on desensitizing our language. When brushing your tongue and working on desensitization, be sure to breathe through your nose to help reduce the gag reflex as well.

We found these instructionshereWhat can help you decrease your gag reflex over time:

Start from the farthest tip of your tongue, then work deeper.

  • As soon as you start to gag, try brushing that area for about 10 seconds, even while gagging. This process is quite unpleasant, but training yourself not to choke naturally involves some nausea. Stop brushing when you feel like you can't anymore; training alone cannot be done in one day.
  • Repeat the process for the next few days, concentrating on the exact same spot. You will notice that you choke less with each repetition. Stay in one place until you can deal with most of the gagging or the gagging stops completely. That part of your mouth is now numb.
  • Get deeper into your mouth using the toothbrush. Try to brush half an inch behind the desensitized spot. Keep moving backwards until you reach the furthest area the brush can reach.

If you have a tendency to choke at the dentist's office, we understand. We know it's beyond your control, and we're here to help with encouragement, fun, a positive attitude, and years of experience in patiently treating patients.

Do you need to have fun during your dental appointments? come to see us
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