A review of gagging problems in dentistry: aetiology and classification.

Some people have a pronounced gag reflex that can be a severe limitation to their ability to accept dental care and the clinician's ability to provide it. It can compromise all aspects of dentistry, from diagnostic procedures to active treatment and can be distressing for all concerned. Many techniques have been described that attempt to overcome the problem. Dentists will undoubtedly see patients with gagging problems and knowledge of a variety of management strategies is necessary to aid the delivery of dental care. This first paper looks at the background to gagging problems and their classification and categorization prior to clinical treatment. The second article will look at the clinical assessment of the patient presenting for dental treatment with a history of gagging problems. It will also review methods used to manage patients with gagging reflexes during dental treatment.     

A review of gagging problems in dentistry: 2. Clinical assessment and management.

A pronounced gag reflex can be a severe limitation to a patient's ability to accept dental care and for a clinician's ability to provide it. It can compromise all aspects of dentistry from diagnostic procedures to active treatment and can be distressing for all concerned. Many 'management' techniques have been described. This paper describes the different categories of treatment used to manage people with pronounced gag reflexes.     

A review of gagging problems in dentistry: 2. Clinical assessment and management

A pronounced gag reflex can be a severe limitation to a patient's ability to accept dental care and for a clinician's ability to provide it. It can compromise all aspects of dentistry from diagnostic procedures to active treatment and can be distressing for all concerned. Many 'management' techniques have been described. This paper describes the different categories of treatment used to manage people with pronounced gag reflexes.     

Relationship between gagging severity and its management in dentistry

The purpose of this study was to investigate how grading according to our new gagging reflex index correlated with patient background and subsequent management. After obtaining institutional approval and informed consent, 110 patients with a gagging problem were enrolled. The patients completed the State–Trait Anxiety Inventory (STAI), the Dental Anxiety Scale (DAS), and a health questionnaire at initial consultation. On the second visit, an intra‐oral examination was carried out and the severity of gag reflex determined according to our new, 5‐level Classification of Gagging Problem (CGP) index: normal gagging but not desensitised (G1 = score 1); mild gagging (G2 = score 2); moderate gagging (G3 = score 3); severe gagging (G4 = score 4); and very severe gagging (G5 = score 5). No difference was found in grade based on age or STAI or DAS scores. The CGP score in male patients was significantly higher than that in female. The management classification method and degree of desensitisation were investigated retrospectively in each patient at 3 months and 1 year after initial consultation. The higher the CGP grade, the more often intravenous sedation or general anaesthesia was required due to difficultly in desensitisation. The present results suggest that determining whether it is possible to examine the molar area without inducing the gag reflex offers the key to deciding the treatment strategy.     

The relationship between obstructive sleep apnoea and dentistry: 1. Aetiology and diagnosis.

Obstructive sleep apnoea is a potentially life-threatening breathing disorder characterized by repeated collapse of the upper airway during sleep, with cessation of breathing. Patients are at risk of severe cardiovascular and respiratory complications secondary to recurrent hypoxia and hypercapnia and the overall quality of life for sufferers and their families may be reduced. This article gives an overview of the aetiology (including pathophysiology), clinical signs and symptoms, diagnosis and treatment. The role dentistry can play in contemporary management of the disorder will be discussed in a second article.     

A clinical survey of gagging patients.

A clinical investigation was carried out on 74 dental patients who were suffering from a severe gagging reflex. The most common stimulating factor was the maxillary denture. Routine history and clinical examination were carried out for each patient, and lateral skull radiographs and an Eysenck Personality Inventory were completed for some of the patients. Treatment consisted of the use of an acrylic resin training base combined with relaxation therapy and heterohypnotic techniques. The results of this ongoing study were: (1) there were no consistent features of the group which differentiated them from control groups; (2) a number of patients were insufficiently motivated and discontinued treatment; and (3) some patients who were declared completely cured suffered relapses.     

Plasma in dentistry: A review of basic concepts and applications in dentistry

Objective. Plasma-related technologies are essential in modern industries. Recently, plasma has attracted increased attention in the biomedical field. This paper provides a basic knowledge of plasma and a narrative review of plasma applications in dentistry. Materials and methods. To review plasma applications in dentistry, an electronic search in PubMed, SCOPUS and Google scholar up to December 2012 was done. This was followed by extensive hand searching using reference lists from relevant articles. Conclusion. There have been attempts to apply plasma technology in various fields of dentistry including surface modifications of dental implants, adhesion, caries treatment, endodontic treatment and tooth bleaching. Although many studies were in early stages, the potential value of plasma for dental applications has been demonstrated. To enlarge the scope of plasma applications and put relevant research to practical use, interdisciplinary research with participation of dental professionals is required.     

Elimination of hypersensitive gagging reaction to dentistry by propofol at subhypnotic doses

We describe a 44-year-old male patient with severe gagging reaction successfully treated without sedative effect by a continuous infusion of propofol. Propofol at subhypnotic doses seemed to be effective in eliminating hypersensitive gagging reaction to dentistry.     

Radiographic examination in pediatric dentistry. A review.

The radiographic examination is an essential part of the diagnosis of dental disease. Radiographs of children reveal many conditions that cannot be discovered by any other method. They help the practitioner to make an early diagnosis of carious lesions and development of eruption problems, and they enable him or her to confirm and evaluate a pathology diagnosed clinically. Moreover, the radiographic examination enables the clinician to establish a therapeutic decision.     

Periodontal diseases in children and adolescents: I. Aetiology and diagnosis

A number of periodontal diseases, some forms of which can be aggressive, can affect children and adolescents. Plaque is the key aetiological agent but local and systemic factors that can modify the response of the periodontal tissues to plaque may be identified from the history and during examination of the child or adolescent. Periodontal screening should be an integral part of the dental examination of younger individuals. It can be used in conjunction with the history and examination to reach a diagnosis, which then forms the basis for future management.