Journal of Traditional Medical Complementary Therapies

.: REVIEW
Çocuk Diş Hekimliğinde Bulantı ve Kusma Refleksinin Yönetimi
Management of Gag Reflex in Pediatric Dentistry
Burcu GÜÇYETMEZ TOPALa, Sıdıka Beril FALAYa
aAfyonkarahisar Sağlık Bilimleri Üniversitesi Diş Hekimliği Fakültesi, Çocuk Diş Hekimliği ABD, Afyonkarahisar, TÜRKİYE
J Tradit Complem Med. 2021;4(2):275-83
doi: 10.5336/jtracom.2020-77025
Article Language: TR
Full Text
ÖZET
 Bulantı ve kusma refleksi (gag refleksi), istenmeyen cisimlerin farinks, larinks ve trakeadan girişini engelleyen orofarenks, dil tabanı ve yumuşak damağın uyarılması sonucu oluşan, nöral bir savunma refleksidir. Bulantı ve kusma genellikle birlikte gelişir, fakat birbirlerinden bağımsız da ortaya çıkabilir. Bu refleksin etiyolojisinde anatomik, tıbbi, iyatrojenik ve psikolojik faktörler rol oynamaktadır. Hasta, sistemik problemleri nedeniyle bulantı-kusma refleksine sahip olabileceği gibi bulantı-kusma refleksi de hastanın tıbbi durumu hakkında fikir verebilir. Bulantı-kusma refleksi, hem erişkinlerde hem de çocuklarda görülebilmektedir. Çocuk hastaların anksiyete düzeyinin, yüksek olması nedeniyle çocuklarda bulantı ve kusma refleksiyle sık karşılaşılmaktadır. Bulantı ve kusma refleksi, hastaların hem oral hijyen alışkanlıklarını hem de diş hekimliği tedavileri sırasındaki kooperasyonlarını oldukça etkilemektedir. Bu reflekse sahip hastalar, dental tedavileri yaptırmaktan kaçınmakta dolayısıyla dental problemleri başlangıç aşamasında yakalamak zorlaşmakta ve daha invaziv tedavilere ihtiyaç artmaktadır. Özellikle çocuk hastalarla ilgilenen diş hekimlerinin, bulantı-kusma refleksinin yönetimiyle ilgili bilgi ve tecrübeleri oral hijyenin idamesinde, tedavilerin başarısında ve çocukta kalıcı davranışların şekillenmesinde önem arz etmektedir. Çocuk hastaların tedavisini üstlenen diş hekimlerinin öncelikli amacı, çocuk hastada iyatrojenik kaynaklı bulantı ve kusma refleksinin oluşumunu önlemek olmalıdır. Bulantı ve kusma refleksinin şiddeti, refleksin yönetim şekli üzerinde belirleyici olmaktadır. Bu makalede, bulantı ve kusma refleksiyle ilgili mevcut çalışmaların derlenmesi ve bu reflekse sahip çocuk hastaların, dental tedavilerinin yönetimiyle ilgili bilgilerin güncellenmesi amaçlanmıştır.

Anahtar Kelimeler: Çocuk diş hekimliği; bulantı; kusma; öğürme
ABSTRACT
 Gag reflex is a neural defense reflex that prevents unwanted objects from entering the pharynx, larynx and trachea, resulting from the stimulation of the oropharynx, tongue base and soft palate. Nausea and vomiting often develop together, but they can occur independently. Anatomical, medical, iatrogenic and psychological factors play a role in the etiology of this reflex. The patient may have gag reflex due to systemic problems, and gag reflex may give an idea about the patient's medical condition. Gag reflex can be seen in both adults and children. Due to the high level of anxiety in pediatric patients, gag reflexes are frequently encountered in children. Gag reflex affect patients' oral hygiene habits and cooperations during dentistry treatments. Patients with this reflex refrain from having dental treatments, so it is difficult to catch dental problems at the initial stage and more invasive treatments are needed. In particular, the knowledge and experience of dentists who treat pediatric patients, about the management of gag reflex is important in the maintenance of oral hygiene, the success of the treatments and shaping of the permanent behaviors in the child. The primary aim of dentists who undertake the treatment of pediatric patients should be to prevent the formation of iatrogenic gag reflex in the pediatric patient. The severity of the gag reflex is decisive on the management style of the reflex. In this article, it is aimed to compile the current studies on gag reflex and to update the information about the management of dental treatment of pediatric patients with this reflex.

Keywords: Pediatric dentistry; nausea; vomiting; gagging
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