Authors: Freddie O’Donald; Molly Smith; Lindsay-Jo Sevier-Guy; Abigail Heffernan.
Journal Reference (Harvard):
O’Donald, F., Smith, M., Sevier-Guy, L.-J., & Heffernan, A. (2025). ‘The effectiveness
of psychological interventions for the management of gagging among dental
patients: a scoping review.’ British Dental Journal.
https://www.nature.com/articles/s41415-025-8861-6
Background
A sensitive gag reflex poses a significant barrier in dental practice: it can prevent or complicate treatments, often leading to avoidance of care. The article by O’Donald et al. investigates how psychological interventions might help manage this reflex among dental patients.
Methods
They conducted a scoping review, systematically searching four databases up to June 2024, and identified 8 studies involving 14 participants overall.
The interventions studied included systematic desensitisation (for example, progressive exposure to gag triggers), hypnotherapy, and applied relaxation techniques. On average, treatments spanned approximately five sessions delivered over a mean of 19.3 weeks.
Results & Conclusion
Importantly, following these psychological programmes all patients were able to tolerate dental treatments; 87.5% reported complete absence of gagging during subsequent dental care, and no adverse effects were reported.
The authors interpret these findings as promising: psychological methods may offer a useful non-pharmacological, non-invasive option for patients whose gag reflex significantly interferes with dental treatment. They point out, however, several important caveats. The included studies were very small, lacked standardised outcome measures, and had no control groups. The review emphasises the need for larger-scale, well-designed trials with standardised outcomes and longer follow-up.
Clinically, the take-home message is that dental practitioners should be aware of the role psychological factors in gagging, such as learned associations, anxiety, sensory triggers, and consider referral or incorporation of psychological techniques for patients with severely sensitive reflexes. The review suggests that in some cases, collaboration between dental and psychology and behavioural specialists may be beneficial. However, because of current evidence limitations, these techniques should be viewed as adjunctive rather than routine standard of care at present.
In summary, this article contributes to dentistry by highlighting a potentially under-utilised pathway of psychological intervention, for managing a difficult barrier in treatment. For dental students and practitioners, the key takeaway is when a patient struggles with gagging, exploring behavioural and psychological methods alongside conventional management may improve tolerance of dental care, but strong evidence is still pending, so treat every scenario case by case, and tailor to individual patients.
Research Summary Written By: Tasfiya Ferdousee, University of Manchester – BDS 3