Ordinary table salt dramatically reduces the gag reflex.
What’s good about it
When a patient has a hyperactive gag reflex, salt works very effectively at repressing that reflex. Simply place a pinch of salt on the patient’s tongue, ask them to swallow, then place the film intra-orally and snap away!
The glossopharyngeal nerves are responsible for the gag reflex but also provide taste to the posterior third of the tongue. Supplying an alternative stimulus to those nerves can repress the gag reflex.
I was treating a new patient who had previously refused to open her mouth for a dental examination. She was highly anxious and had a hyperactive gag reflex. I started by placing a pinch of salt on her tongue, then used size 1 radiographs to take bitewings. Dubious at first, she politely obliged. Success—we took the bitewings!
Subsequently, she agreed to try the larger size 2 adult films. She requested salt be placed on her tongue and once again, success in taking regular bitewings was achieved.
What’s not so good
For patients with extremely hyperactive gag reflexes, salt may not work and taking intra-oral radiographs may still be impossible. My first alternative is to use the Kavo Diagnocam which is tolerable for most hyperactive gaggers and has no radiation.
In severe cases, an IAN block can be administered to take a bitewing or periapical radiograph of the lower arch. Alternatively, an OPT can be taken though fine detail is limited.
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