Gagging.

Gagging is a protective reflex to stop unwanted entry into the mouth and oropharynx. Some people have a reduced or absent reflex, while others have a pronounced one. Pronounced gag reflexes can compromise all aspects of dentistry, from the diagnostic procedures of examination and radiography to any form of active treatment. In some patients with marked gagging reflexes, it can lead to avoidance of treatment. Many techniques have been described that attempt to overcome this problem, and a variety of management strategies is necessary to aid the delivery of dental care. This is a review of the etiology of gagging problems, clinical assessment, and their classification and categorization prior to clinical treatment. It discusses as well methods for managing patients with gag reflexes during dental treatment.

Biologic perspectives in restorative treatment.

One of the primary goals of a long term successful restorative therapy is to establish a physiologic periodontal climate that facilitates the maintenance of periodontal health. The contemporary clinician has a host of alternatives for the restoration of teeth. It is now possible to mimic nature and provide restorations that defy detection but the most challenging procedure in clinical dentistry is fabricating a restoration in gingival harmony. Periodontal health is the basis of all restorative dentistry. Because periodontal disease is a major cause of tooth loss in adults, the clinician must be aware of the biological variables relevant to restorative therapy, basic concepts and clinical modes of therapy available, to be able to develop an appropriate diagnosis and treatment plan. A natural looking prosthesis within a healthy periodontium should represent the ultimate goal. This article addresses the interactions between periodontal tissues and restorative procedures. It reviews the essentials of soft tissue management inherent in restorative dentistry that will increase the probability of a successful restoration.