Management of exaggerated gag reflex in dental patients using intravenous sedation with dexmedetomidine

Aleksei P. Reshetnikov, Anton A. Kasatkin, Aleksandr L. Urakov, Dmitrii Y. Baimurzin


Pharmacological sedation is one of the effective ways of prevention of gag reflex development in
patients experiencing anxiety and fright before dental treatment. We are reporting a case where
we could successfully eliminate exaggerated gag reflex (intravenous [IV] Gagging Severity Index) in
a dental patient using IV sedation with dexmedetomidine. IV administration of dexmedetomidine
provided elimination of gag reflex at a depth of sedation for the patient with the Richmond
Agitation‑Sedation Scale score of −2 and −1. The patient received dexmedetomidine 1.0 μg/kg for
10 min and then a continuous infusion of dexmedetomidine 0.4 μg/kg/h. The use of dexmedetomidine
for sedation may be an alternative to other pharmacological agents in patients with dental anxiety
accompanied by exaggerated gag reflex.
Key Words: Dentistry, dexmedetomidine, gagging, sedation

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