What do I do if my child gags while brushing and flossing?

Overactive Gag Reflex in Children

Gag reflexes are important and help protect us from choking on items or aspirating them. However, an overactive reflex can be troublesome when it comes to visiting the dentist, or brushing and flossing your child’s teeth. In many cases, gagging is a psychological or emotional condition. There is no physical stimulation of the soft palate and the patient is not actually choking. Gagging when something is not even in the mouth or throat is an example of psychological or emotional gagging. In fact, just reading this paragraph could stimulate the more sensitive people! True physiological or functional reflex occurs when children try to eat or when objects in their mouth trigger the reaction. For many children, a stressful event or illness that resulted in a strong gagging reaction can set the stage for a lifetime of emotional reflex incidents.

Although this is a challenging situation for both parents and dental health care providers, there are some strategies that can be applied to reduce a child’s gag reflex reaction.

Reduce the size of objects in the mouth

Reducing the size of any objects in the mouth and the duration of time that they are in the mouth is key. For example, parents who try to floss their children’s teeth with a piece of floss may notice more gagging. Using two adult-sized hands in a child’s mouth is the problem in these cases. Try using a flosser or flossing pick. When using these aids, only the tip of the flosser is in the mouth. Hands and bulky handles are outside of the mouth, making the procedure more comfortable for kids.

Use a child-sized toothbrush

Use a small or child-sized toothbrush when brushing, instead of the more popular large-headed or adult brushes. Although power brushes do an excellent job cleaning teeth, the vibration can trigger a gag reflex in some children. For sensitive children, a manual brush may be the better choice. For many families, it is a matter of trial and error to find out what works best. When flossing or brushing, have your child lean forward, rather than backwards. This will allow gravity to pull toothpaste foam and saliva to the front of the mouth, away from the soft palate. Children also tend to gag less when they brush and floss their own teeth. Encourage your child to brush and floss first, before the parent helps.

Take breaks during brushing and flossing if the child becomes anxious or upset. Oftentimes, anxiety will exacerbate gagging. Allowing the child a chance to stop and take a few deep breaths can help reduce their anxiety and reaction.

When visiting the dentist, inform the dental team about your child’s reflex history. Dental professionals can implement tactics that will help your child have a more pleasant experience. Many times, using alternative materials in tandem with treatment techniques can reduce both emotional and functional triggers. In lieu of large fluoride trays, dental providers can use a swab-on fluoride varnish. Small, digital x-ray sensors can be used when taking images of your child’s teeth. Sitting partially upright in the dental chair, offering several breaks during treatment, and even allowing your child to hold their own suction tip and polisher can help.

If your child’s gag reflex is severe and chronic, speak to your pediatrician about therapy options. If eating and maintaining a child’s oral health is compromised due to a strong reflex, medical intervention can be helpful for the entire family.


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