The role of acupuncture in the treatment of prosthodontic patients with a gagging reflex
Byline: Raghad. Hashim, Reem. Shaltoni, Luma. Kamal, Faten. Khanfar
Aim and Objectives: Hyperactive gag reflex (GR) can be a big obstacle in certain dental procedures especially in making an upper arch impression. Treating those might be a challenge for both the dentist and the patient. Many patients withdraw from treatment because of their inability to cope with the procedure. One of the effective modalities in controlling this phenomenon is the use of Acupuncture. In this trial, Ear acupuncture was used aiming to control hyperactive GR during upper alginate impression. Methods: A total of ten patients aged between 20 and 60 years, with a history of GR on taking dental impressions were selected to be part of this clinical trial. All patients fulfilled the inclusion criteria had an upper dental alginate impression taken (or an attempt made at it) before acupuncture and a second upper alginate impression taken immediately after acupuncture based on traditional Chinese medicine. The gagging severity index used to assess GR before insertion of the acupuncture needle while gagging prevention index was used after the acupuncture and impression taking. Results: Seven patients scored I with the reflex obtunded and the impression taking carried out successfully, one patient scored II with the reflex partially controlled and impression taking still possible, two patients scored III with the reflex partially controlled but with frequent gagging and impression taking still possible. No adverse effects were observed, and patients were fit to leave unescorted. Conclusions: Ear acupuncture was found to be effective in controlling GR in all ten participants in different levels.
Acupuncture has been practiced as a healing art for around 5000 years. It is a Traditional Chinese Medicine (TCM) that has been revitalized in the west over the last 20 years. Acupuncture is defined as the stimulation of specific acupuncture points along the skin of the body using thin needles. [sup] The insertion of those needles into any part of the human body can aid in disease prevention, therapy or maintenance of health. [sup] Acupuncture is suggested in the treatment of TMJ clicking and locking, facial pain, trigeminal neuralgia, dental anxiety, xerostomia, postoperative pain, burning mouth syndrome and as adjunct to local anesthesia. [sup] Probably, the most important application of acupuncture in dentistry is in the control of gag reflex (GR). [sup]
Ear acupuncture is an important part of the TCM based on ancient concepts that consider that the activity of all organs, as well as their diseases, is a manifested in the ear, as a reflex. [sup] Therefore, it is possible to analyze, evaluate, and treat morbid states by ear stimuli. [sup] According to Eitner et al ., [sup] stimulation of an acupuncture point on the ear before undergoing treatment effectively controls the GR, allowing dentist to perform a variety of procedure without compromising the patient's safety and comfort.
The GR is considered a normal, protective, physiological mechanism that occurs to prevent foreign objects from entering the pharynx, larynx, or trachea. [sup] The GR has profound impact on the...