Abstract
Gag reflex is a physiologic mechanism that promotes contraction of the muscles of the tongue and pharyngeal walls. Different factors, including intraoral radiographic films and sensors, may trigger this reflex. Patients with severe gag reflex may not be able to tolerate the presence of intraoral radiographic films or sensors during root canal therapy (RCT). This factor may prevent an appropriate intraoral radiograph, which is important in RCT. Different approaches have been used to facilitate dental procedures in patients suffering from severe gag reflex. The use of an extraoral radiographic technique is an alternative method to obtain working length confirmation in patients with severe gag reflex. In this report of 2 cases, the use of an extraoral radiographic technique as an alternative approach during RCT in patients with severe gag reflex associated with phobic behavior and trismus was successfully demonstrated.
Highlights
Gag reflex is a natural response of a human body to eliminate foreign bodies from the pharynx, larynx, or trachea
Stimulation of the soft palate or the posterior third of the tongue may trigger this reflex resulting in contraction of the muscles of the tongue and pharyngeal walls
Periapical radiographs are important during root canal therapy (RCT) because they help the dental professionals to verify the appropriate working length (WL), gutta-percha points adjustment, and presence of voids in the root canal filling before completion of the treatment
Summary
Gag reflex is a natural response of a human body to eliminate foreign bodies from the pharynx, larynx, or trachea. Stimulation of the soft palate or the posterior third of the tongue may trigger this reflex resulting in contraction of the muscles of the tongue and pharyngeal walls. Newman et al have described an alternative extraoral technique to achieve periapical radiographs in patients with trismus or severe gag reflex; this technique is suitable for both mandibular and maxillary molars [6]. This extraoral radiographic technique may be used as an appropriate alternative for satisfactory periapical radiographs in patients who cannot tolerate the conventional technique [7]. In the following report of 2 cases, the extraoral technique was successfully used during RCT in patients with severe gag reflex associated with trismus and phobic behavior
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