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Background
The gag reflex is considered a normal protective physiological mechanism that occurs in order to prevent foreign objects or noxious material from entering the pharynx, larynx or trachea. 1 Gagging is a known hindrance to the dental procedures. Although glossopharyngeal nerve block (GNB) or modified peritonsillar infiltration is successfully used for tonsillectomy or uvulopalatopharyngoplasty for control of gag reflex as well as pain relief, 2 it has not been documented in literature regarding its use in dental procedures. Many dental procedures such as obtaining impression of maxillary and mandibular arches, mapping the posterior vibrating line for complete dentures, preparation of cavity or crown in posterior teeth, extraction of third molar teeth, endodontic treatment of posterior teeth, may cause exaggerated gag reflex, which pose difficulty in performing the procedures successfully. In this case-report, we describe a successful management of a case of exaggerated gag in a fixed partial denture patient.
Case presentation
A 30-year-old patient reported to the department of prosthodontics, for replacement of missing right maxillary first molar. A fixed partial denture was planned for the patient involving second premolar and second molar teeth as abutments. On detailed case analysis, it was discovered that a previous attempt was made to perform the procedure by a dental practioner, which was abandoned as the patient suffered from severe gagging rendering the procedure impossible.
Investigations
Assessment of gagging was done prior to GNB by using gagging severity index. 3
Grade I: very mild, occasional and controlled by the patient.
Grade II: mild, control is required by the patient with reassurance from the dental...