title: Managing endodontic patients with severe gag reflex by glossopharyngeal nerve block technique.
abstract: BACKGROUND
  Gagging is a protective reflex, but when the gag reflex becomes abnormally active, it poses a difficulty for the dentist because it hinders all aspects of dental procedures including diagnosis, radiography, and any form of active procedure.
  
  
  METHODS
  In this case report, to overcome this difficulty the authors used a glossopharyngeal nerve block technique that is used by anesthetists and otolaryngologists, but its endodontic use has gone previously unreported.
  
  
  RESULTS
  Response to gag reflex decreases after successful glossopharyngeal nerve block.
  
  
  CONCLUSIONS
  The glossopharyngeal nerve block technique is a relatively safe, simple, and easy to master technique as compared with general anesthesia for treating a patient with an exaggerated gag reflex. The glossopharyngeal nerve block technique may be used in dental procedures in patients with an exaggerated gag reflex or when performing procedures in the posterior aspect of the mouth. Due caution should be exercised to prevent inadvertent intravascular administration of local anesthetic when using this procedure.
authors.affiliation: Department of Endodontics, Dr B. R. Ambedkar Dental College and Research Institute, Patna, Bihar, India. Electronic address: ankitkgdu@gmail.com.
authors.forename: Ridhi
authors.initials: R
authors.lastname: Garg
authors.affiliation: Department of Orthodontic and Dentofacial Orthopedics, Dr B. R. Ambedkar Dental College and Research Institute, Patna, Bihar, India.
authors.forename: Ankit
authors.initials: A
authors.lastname: Singhal
authors.affiliation: Department of Oral Medicine, Diagnosis and Radiology, Peoples College of Dental Sciences, Bhopal, Madhya Pradesh, India.
authors.forename: Kavita
authors.initials: K
authors.lastname: Agrawal
authors.affiliation: Department of Periodontics, Peoples Dental Academy, Bhopal, Madhya Pradesh, India.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Agrawal
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D003789:Dental Pulp Exposure / Q000628:therapy; D005260:Female; D005683:Gagging / Q000517:prevention & control*; D005930:Glossopharyngeal Nerve / Q000187:drug effects*; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage; D008340:Mandibular Nerve / Q000187:drug effects; D009407:Nerve Block / Q000379:methods*; D012390:Root Canal Therapy / Q000379:methods*
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine
keywords: Anterior tonsillar pillar; glossopharyngeal nerve block; hyperactive gag reflex