Abstract
Abstract The extreme exaggerated gag reflex can be an enormous obstacle to routine dental treatment. In some patients, extreme gagging may be a learned avoidance reaction; in others, it may act as a defense mechanism which inadequately compensates for an internal psychodynamic conflict. The most frequent areas of conflict encountered are those concerning the symbolic meaning of the mouth, fear of loss of control, and problems in the dependence/independence vector. In the Consultative Outpatient Clinic for Behavioral Dysfunctions at the School of Dental Medicine of Tel Aviv University, a multidisciplinary team of dentists, psychiatrists, and psychologists has been working on treatment modalities for such patients including hypnorelaxation and other hypnotic techniques. Hypnosis is incorporated in the framework of psycho-dynamic, behavioral, relaxation, and suggestive approaches that are integrated in the shaping of the therapeutic strategy. Clinical cases are described and treatment philosophies discussed.
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