Beyond the Gag Reflex: Understanding Soft Palate Variations for Better Dental Care

Understanding Soft Palate Variations for Better Dental Care

Authors

  • Khezran Qamar Department of Prosthodontics, Lahore Medical and Dental College, Lahore, Pakistan
  • Maryam Mumtaz Department of Prosthodontics, Institute of Dentistry, Combined Military Hospital Lahore Medical College, Lahore, Pakistan
  • Muhammad Hammad Rafique Department of Prosthodontics, Lahore Medical and Dental College, Lahore, Pakistan
  • Khalid Yaqub Department of Prosthodontics, Institute of Dentistry, Combined Military Hospital Lahore Medical College, Lahore, Pakistan
  • Ayema Nazif Department of Prosthodontics, Lahore Medical and Dental College, Lahore, Pakistan
  • Tayyaba Hamid Department of Prosthodontics, Lahore Medical and Dental College, Lahore, Pakistan
  • Sajid Naeem Department of Prosthodontics, Lahore Medical and Dental College, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i7.3258

Keywords:

Frequency, Complete Dentures, Gagging, Gender, Partial Dentures, Soft Palate

Abstract

The gag reflex is a defense process to protect the airway from irritants. In a few patients, exaggerated reflexes jeopardize the dental treatment and compromise the dental procedures. Objectives: To evaluate the potential association of the severity of gag reflex with types of soft palate in patients attending to prosthodontic clinic and to find out the association within gender, age groups.  Methods: A cross-sectional observational study included 250 patients of both genders who needed dentures, were selected. Gag reflex was checked by touching the anterior to posterior part of the maxilla and mandible with a dental mirror while taking impressions. Gag Reflex Index (GRI) was used for the assessment of gag response. The reaction of the patients was recorded on V grades. The types of soft palates were classified via house classification as I, II, and III.  Results: The soft palate forms frequently observed were soft palate drop type I, 60.0% followed by type II, 31.6 % and 8.0 % patients had type III soft palate drop. The gag reflex grade V was 5.6 %, grade IV was 4.8 %, grade III was 8.4%, grade II was 22.0 % and grade I was 59.2%. The association of gag reflex grades with gender and types of soft palate drop was found to be significant, 0.02 and 0.00. However, with different age groups, insignificant results were obtained, p 0.07. Conclusions: The study concluded that the severity of gagging is found more in female patients and patients with type II and III soft palatal anatomy. Dentists need to evaluate different soft palatal types, especially when dealing with female patients needing prosthodontic treatment.

References

Mehdizadeh M, Mohammadbeigi A, Sharifinejad A. An Overview About New Methods in Management of Gag Reflex During Dental Treatment: A Systematic Review. Journal of Dentistry. 2023 Dec; 24(4): 372. doi: 10.30476/dentj.2023.98310.2164.

Meenakshi S, Dureja S, Kavita GC, Pallavi M, Swamy KN, Kottur A, et al. The Gag Reflex: A Hurdle in Dentistry–Literature Review. Journal of Pharmaceutical Research International. 2021 Oct; 33(46B): 224–37. doi: 10.9734/jpri/2021/v33i46B32937.

Hassan H, Rafique A, Andleeb S, Javaid M, Ahmad H, Khalid S. Post-Insertion Complaints Associated with Complete Denture Prosthesis in a Tertiary Care Hospital. Rawal Medical Journal. 2023 Mar; 48(1): 200.

Mortazavi H, Hazrati P, Azadi A. The Main Differential Diagnosis of Swellings in the Posterolateral Part of the Hard Palate: A Mini Review. Journal of Iranian Medical Council. 2023 Aug; 6(4). doi: 10.18502/jimc.v6i4.13439.

Prasad V, Chhodon L, Aravindhan A, Zaidi SJ. Prosthetic Rehabilitation of Patients with Cleft Lip and Palate. Journal of Cleft Lip Palate and Craniofacial Anomalies. 2022 Jul; 9(2): 189–96. doi: 10.4103/jclpca.jclpca_6_22.

Yuan Z, Yuan J, Wang Z, Rong Q. Rehabilitation of Combined Hard and Soft Palate Defects with a Soft Relining Prosthesis: A Clinical Report. The Cleft Palate Craniofacial Journal. 2024 Aug; 10556656241272481. doi: 10.1177/10556656241272481.

Qamar K, Rizvi SH, Yasser F, Aamir H, Ahmed RA, Muzaffar M, et al. Patient Satisfaction with Quality of Dentures at Teaching Hospital of Lahore: Quality Dentures and Patient Satisfaction. Pakistan Journal of Health Sciences. 2024 May; 5(05): 25–9. doi: 10.54393/pjhs.v5i05.1451.

Hassan H, Rafique A, Andleeb S, Javaid M, Ahmad H, Khalid S. Post-Insertion Complaints Associated with Complete Denture Prosthesis in a Tertiary Care Hospital. Rawal Medical Journal. 2023 Mar; 48(1): 200.

Colvenkar S, Reddy V, Thotapalli S, Rani KD, Bharadwaj S, Ali S, et al. A Simple Step-by-Step Technique for the Management of Gagging in Edentulous Patient. Cureus. 2022 Apr; 14(4). doi: 10.7759/cureus.24423.

Ali S, George B, Kirmani U, Al-Saiari AK, Almasabi FR, Iqbal Z. Gagging and Its Management in Prosthodontic Patients: A Review of Literature. Biomedica. 2018 Jul; 34(3): 179.

Mehdizadeh M, Mohammadbeigi A, Sharifinejad A. An Overview About New Methods in Management of Gag Reflex During Dental Treatment: A Systematic Review. Journal of Dentistry. 2023 Dec; 24(4): 372. doi: 10.30476/dentj.2023.98310.2164.

Gali S, Hithyshi GK. Managing a Hyper Gag Reflex Edentulous Patient with Modeling Compound and Training Dentures. Manipal Journal of Dental Sciences. 2020; 5(1): 35–8.

Parakh MK. Gagging and Its Management–A Review. Oral Science International. 2022 Sep; 19(3): 141–6. doi: 10.1002/osi2.1128.

Alamgir K, Saleem T. Prevalence and Severity of Gag Reflex in Patients Presenting at the Department of Prosthodontics. The Professional Medical Journal. 2024 Sep; 31(09): 1301–6. doi: 10.29309/TPMJ/2024.31.09.8087.

Chaturvedi S, Khaled Addas M, Al Humaidi AS, Al Qahtani AM, Al Qahtani MD. A Novel Approach to Determine the Prevalence of Type of Soft Palate Using Digital Intraoral Impression. International Journal of Dentistry. 2017; 2017(1): 3268064. doi: 10.1155/2017/3268064.

Karademir Göceroğlu AH, Ölmez A. Prevalence of Gagging in Children and the Association Between Gagging and Dental Fear: A Cross-Sectional Study. Turkiye Klinikleri Journal of Dental Sciences. 2022 Jul; 28(3). doi: 10.5336/dentalsci.2021-87792.

Manoharan S, Subhashree R, Humar MS. Gag Reflex and Prosthodontic Procedures–A Comparative Study. International Journal of Dentistry and Oral Sciences. 2021 Mar; 8(03): 1829–31. doi: 10.19070/2377-8075-21000363.

Meshni AA. Gag Reflex: A Comparative Study Among Different Prosthodontic Treatment Modalities. Oral Health and Dental Management. 2017; 16(4): 1–4.

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. Brazilian Dental Science. 2023 Mar; 26(2). doi: 10.4322/bds.2023.e3628

Kassab NH, Al-Saffar M. Gagging: A Problem in Prosthetic Dentistry and Its Medical Treatment. Al-Rafidain Dental Journal. 2005 Dec; 5(2): 168–73. doi: 10.33899/rden.2005.45498.

Gucyetmez Topal B, Falay Civelek SB, Tiras M, Yigit T. The Prevalence and Influencing Factors of Gag Reflex in Children Aged 7–14 Years in the Dental Setting. Journal of Oral Rehabilitation. 2023 May; 50(5): 376–82. doi: 10.1111/joor.13432.

Stefos S, Zoidis P, Nimmo A. Managing Gag Reflex During Removable Partial Denture Treatment: A Review and a Clinical Report. Journal of Prosthodontics. 2019 Jul; 28(6): 618. doi: 10.1111/jopr.12957.

Downloads

Published

2025-07-31
CITATION
DOI: 10.54393/pjhs.v6i7.3258
Published: 2025-07-31

How to Cite

Qamar, K., Mumtaz, M., Rafique, M. H., Yaqub, K., Nazif, A., Hamid, T., & Naeem, S. (2025). Beyond the Gag Reflex: Understanding Soft Palate Variations for Better Dental Care: Understanding Soft Palate Variations for Better Dental Care. Pakistan Journal of Health Sciences, 6(7), 198–202. https://doi.org/10.54393/pjhs.v6i7.3258

Issue

Section

Original Article

Plaudit

Most read articles by the same author(s)