To Determine the Association of Gag Reflex with Types of Soft Palate   A Case-Control Study

Shafi Ullah Khan

doi:10.37762/jgmds.13-2.857

Authors

Shafi Ullah Khan Khyber College of Dentistry, Peshawar

DOI:

https://doi.org/10.37762/jgmds.13-2.857

Keywords:

Gag Reflex, Soft Palate, Impression Recording, Prosthodontic Treatment

Abstract

ABSTRACT

OBJECTIVES

This study aimed to assess the association between the gag reflex and soft palate types.

METHODOLOGY

This case-control study was conducted in Khyber College of Dentistry, Peshawar. The study included 120 participants divided equally into gag reflex (case=60) and non-gag reflex (control=60) groups. Gag reflex was categorized according to Dickinson and Fiske's Gagging Severity Index. Grade 1 was considered normal and allotted to the control group. Grade 2 was considered mild gagging; Grade 3, moderate; and Grades 4 & 5, severe. The soft palate was categorized according to the House classification into Class I, Class II, and Class III. Sodium Alginate impressions were recorded for patients; those who experienced gagging during impression-taking were included in the case group, while those who did not were included in the control group.

RESULTS
Of 120 patients, 39.2% were male, and 60.8% were female. Compared to the control group, gag was significantly associated with Soft Palate type II (Odds Ratio: 4.97; 95% CI: 2.24 to 11) and Soft Palate type III (Odds Ratio: 5.88; 95% CI: 1.0 to 33.36). Also, a significant association of the gag reflex was observed with motion sickness (p=0.001), Gastro-esophageal Reflux Disease (p<0.001), and Mouth breathing (p=0.005). Age, gender, and education were not associated with the gag reflex.

CONCLUSION

There is a significant association between the gag reflex and soft palate type, motion sickness, and GERD.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Author Biography

Shafi Ullah Khan, Khyber College of Dentistry, Peshawar

Assistant Professor,
Department of Prosthodontics,
Khyber College of Dentistry, Peshawar

References

Kamran M, Qamar R. An easy and effective way to reduce gagging during orthodontic impression recording. Pak Orthod J. 2016;8(1):17-20

Park MJ, Byun JS, Jung JK, Choi JK. The correlation of gagging threshold with intra-oral tactile and psychometric profiles in healthy subjects: a pilot study. J Oral Rehabil. 2020;47(5):591-598. https://doi.org/10.1111/joor.12937 PMID: 32017145 DOI: https://doi.org/10.1111/joor.12940

Goyal G. Gag reflex: causes and management. Int J Dent Med Res. 2014;1(3):163-166

Dickinson CM, Fiske J. A review of gagging problems in dentistry. I. Aetiology and classification. Dent Update. 2005;32(1):26-28. https://doi.org/10.12968/denu.2005.32.1.26 PMID: 15739858

Kanlieva T, Georgiev K, Abadjiev M. Different methods for the management of the gag reflex during prosthetic treatment. Int Bull Otorhinolaryngol. 2022;4:13-17 DOI: https://doi.org/10.14748/orl.v18i4.9065

Karibe H, Okamoto A, Kato Y, Shimazu K, Goddard G. Reliability, validity, and sex differences in a quantitative gag reflex measurement method. J Oral Rehabil. 2018;45:798-804. https://doi.org/10.1111/joor.12667 PMID: 30004169 DOI: https://doi.org/10.1111/joor.12687

Fiske J, Dickinson C. The role of acupuncture in controlling the gagging reflex: a review of ten cases. Br Dent J. 2001;190:611-613. https://doi.org/10.1038/sj.bdj.4801043 PMID: 11453176 DOI: https://doi.org/10.1038/sj.bdj.4801053a

Dickinson CM, Fiske J. A review of gagging problems in dentistry: aetiology and classification. Dent Update. 2005;32(1):26-32 DOI: https://doi.org/10.12968/denu.2005.32.1.26

Ali S, George B, Kirmani U, Al-Saiari AKA, Almasabi FRA, Iqbal Z. Gagging and its management in prosthodontic patients: a review of literature. Biomedica. 2018;34(3):178-183.

Bassi GS, Humphris GM, Longman LP. The aetiology and management of gagging: a review of the literature. J Prosthet Dent. 2004;91(5):459-467. https://doi.org/10.1016/j.prosdent.2004.02.003 PMID: 15153851 DOI: https://doi.org/10.1016/j.prosdent.2004.02.018

Ahmad N, Yunus N, Jafri Z. Etiology and management of gag reflex in the prosthodontic clinic: a review. Int J Oral Health Dent. 2015;1(1):25-28

Mehdizadeh M, Mohammadbeigi A, Sharifinejad A. An overview of new methods in management of gag reflex during dental treatment: a systematic review. J Dent (Shiraz). 2023;24(4):372-381. https://doi.org/10.30476/dentjods.2023.98274.1960 PMID: 38119877 PMCID: PMC10735476

Alamgir K, Saleem T. Prevalence and severity of gag reflex in patients presenting at the department of prosthodontics. Prof Med J. 2024;31(9):1301-1306. https://doi.org/10.29309/TPMJ/2024.31.09.7850. DOI: https://doi.org/10.29309/TPMJ/2024.31.09.8087

Rosted P, Bundgaard M, Fiske J, Pedersen AML. The use of acupuncture in controlling the gag reflex in patients requiring an upper alginate impression: an audit. Br Dent J. 2006;201:721-725. https://doi.org/10.1038/sj.bdj.4814259 PMID: 17128222 DOI: https://doi.org/10.1038/sj.bdj.4814305

Neumann JK, McCarty GA. Behavioral approaches to reduce hypersensitive gag response. J Prosthet Dent. 2001;85(3):305-309. https://doi.org/10.1067/mpr.2001.113848 PMID: 11268352 DOI: https://doi.org/10.1067/mpr.2001.114273

Kaira LS, Dabral E, Kukreja HS. Gagging: a review. Nitte Univ J Health Sci. 2014;4:149-155 DOI: https://doi.org/10.1055/s-0040-1703755

Mariyam A, Verma AK, Saurabh C, Naeem A, Anuj S. Posterior palatal seal (PPS): a brief review. J Sci Innov Res. 2014;3(6):602-605 DOI: https://doi.org/10.31254/jsir.2014.3611

Bindhoo YA, Thirumurthy VR, Jacob SJ, Anjanakurien, Limson KS. Posterior palatal seal: a literature review. Int J Prosthodont Restor Dent. 2011;1(2):108-114 DOI: https://doi.org/10.5005/jp-journals-10019-1020

Verma P, Verma KG, Kumaraswamy KL. Correlation of morphological variants of the soft palate and Need's ratio in normal individuals: a digital cephalometric study. Imaging Sci Dent. 2014;44:193-198. https://doi.org/10.5624/isd.2014.44.3.193 PMID: 25177466 PMCID: PMC4140155 DOI: https://doi.org/10.5624/isd.2014.44.3.193

Halboub E, Sayed BA, Jaafari SA, Abutaleb GK, Arishi TM, Khadhi AH, et al. The possible association between the types of soft palate and gag reflex: a preliminary study. Braz Dent Sci. 2023;26(2):1-8. https://doi.org/10.4322/bds.2023.e3675. DOI: https://doi.org/10.4322/bds.2023.e3628

Kassab NH, Al-Saffar MT. Gagging: a problem in prosthetic dentistry and its medical treatment. Al-Rafidain Dent J. 2005;5(2):168-173 DOI: https://doi.org/10.33899/rden.2005.45498

Meshni AA. Gag reflex: a comparative study among different prosthodontic treatment modalities. Oral Health Dent Manag. 2017;16(4):1-4

Goyal S, Goyal M, Balkrishnan D, Hegde V, Aparna. The posterior palatal seal: its rationale and importance—an overview. Eur J Prosthodont. 2014;2(2):41-47 DOI: https://doi.org/10.4103/2347-4610.131972

Pisulkar SK, Agrawal R, Godbole SR, Jadah V. Addressing the gag reflex: a literature review. Int J Recent Surg Med Sci. 2018;4(1):2-4 DOI: https://doi.org/10.5005/jp-journals-10053-0061

Qamar K, Mumtaz M, Rafique MH, Yaqub K, Nazif A, Hamid T, et al. Beyond the gag reflex: understanding soft palate variation for better dental care. Pak J Health Sci. 2025;6(7):198-202 DOI: https://doi.org/10.54393/pjhs.v6i7.3258

Khan SU, Khalil A, Hakam FA. The relation of posterior vibrating line to the fovea palatinae. J Khyber Coll Dent. 2020;10(1):102-106 DOI: https://doi.org/10.33279/jkcd.v10i01.301

Hamedani S, Farshidfar N. The predicament of the gag reflex and its management in dental practice during the COVID-19 outbreak. J Dent Sci. 2021;16:791-792. https://doi.org/10.1016/j.jds.2020.12.002 PMID: 33614837 PMCID: PMC7892874 DOI: https://doi.org/10.1016/j.jds.2020.06.003

Bhuskute MV. Use of training denture bases and palateless dentures: two strategies for managing severe gag reflex in edentulous patients. Saint Int Dent J. 2020;4:63-66 DOI: https://doi.org/10.4103/sidj.sidj_9_20

Saunders RM, Cameron J. Psychogenic gagging: identification and treatment recommendations. Compend Contin Educ Dent. 1997;18:430-433. PMID: 9477071

Viegas DC, Mourão JT, Roque JC, Riquieri H, Fernandes J, Arrobas FV, et al. Evaluation of the influence of the impression technique, scanning direction, and type of scanner on the accuracy of the final model. Braz Dent Sci. 2021;24:1-13. https://doi.org/10.14295/bds.2021.v24i1.2284 DOI: https://doi.org/10.14295/bds.2021.v24i1.2179

Frisdal A, Trainor PA. Development and evolution of the pharyngeal apparatus. Wiley Interdiscip Rev Dev Biol. 2014;3(6):403-418. https://doi.org/10.1002/wdev.147 PMID: 25243933 PMCID: PMC4318572 DOI: https://doi.org/10.1002/wdev.147