If both CN IX and X are damaged on one side (not uncommon), stimulation of the normal side elicits only a unilateral response, with deviation of the soft palate to that side no consensual response is seen. This is because the sensory component is intact on both sides, but only the motor nerves supplying one side of the soft palatine and pharyngeal muscles is working, therefore the contraction of the muscles in the reflex is asymmetrical. With one-sided vagal nerve (CN X - motor component) damage, the soft palate will elevate and pull toward the intact side regardless of the side of the pharynx that is touched. In unilateral (one-sided) glossopharyngeal nerve (CN IX - sensory component) damage, there will be no gag response when touching the pharyngeal wall on the same side of the damaged nerve. In certain cases, absence of the gag reflex and pharyngeal sensation can be a symptom of a number of severe medical conditions, such as damage to the glossopharyngeal nerve, the vagus nerve, or brain death. Therefore, more research needs to be carried out regarding these interventions. However, there was no difference when practiced with sedation. Studies showed with very low‐certainty evidence that acupuncture and laser at the P6 point (located in the wrist) reduced gagging without sedation. Īnti-nausea medicines, sedatives, local and general anaesthetics, herbal remedies, behavioural therapies, acupressure, acupuncture, laser, and prosthetic devices can be used to manage exaggerated gag reflex during dental treatment.
There are a variety of ways to desensitize one's hypersensitivity, from relaxation to numbing the mouth and throat to training one's soft palate to get used to being touched.
Hypersensitivity is generally a conditioned response, usually occurring following a previous experience. This hypersensitivity can lead to issues in various situations, such as swallowing a pill or large bites of food, or visiting the dentist. However, on the other end of the spectrum are people with a hypersensitive gag reflex. In contrast, triggering the reflex is sometimes done intentionally to induce vomiting, by those who have bulimia nervosa.Īccording to one study, one in three people lacks a gag reflex.
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Some people, for instance sword swallowers, have learned how to suppress it. Swallowing unusually large objects or placing objects in the back of the mouth may cause the pharyngeal reflex. In very sensitive individuals, much more of the brain stem may be involved a simple gag may enlarge to retching and vomiting in some. However, in that case, the sensory limb of the reflex is the CN V ( trigeminal nerve).
Touching the soft palate can lead to a similar reflex response. The gag reflex involves a brisk and brief elevation of the soft palate and bilateral contraction of pharyngeal muscles evoked by touching the posterior pharyngeal wall. the sensory limb is mediated predominantly by CN IX ( glossopharyngeal nerve).The CNS receives this message and sends an appropriate response via an efferent nerve (also known as a motor neuron) to effector cells located in the same initial area that can then carry out the appropriate response. Generally, a sensory receptor receives an environmental stimulus, in this case from objects reaching nerves in the back of the throat, and sends a message via an afferent nerve to the central nervous system (CNS).
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In a reflex arc, a series of physiological steps occur very rapidly to produce a reflex. The pharyngeal reflex is different from the laryngeal spasm, which is a reflex muscular contraction of the vocal cords. It, along with other aerodigestive reflexes such as reflexive pharyngeal swallowing, prevents objects in the oral cavity from entering the throat except as part of normal swallowing and helps prevent choking, and is a form of coughing. The pharyngeal reflex or gag reflex is a reflex muscular contraction of the back of the throat, evoked by touching the roof of the mouth, back of the tongue, area around the tonsils, uvula, and back of the throat.
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