Gag Reflex

What Is the Gag Reflex?

The gag reflex, also called the pharyngeal reflex, is an automatic body response. It prevents you from choking, swallowing or breathing in something harmful. A lot of things can trigger it, from eating certain foods to brushing your teeth. You might even trigger it by thinking about something gross.

Sometimes, it works just as it should. Other times, it can feel more annoying than helpful. Or you might notice that you gag more or less than the average person. Either way, a healthcare provider can help you manage it if it causes problems.

How does the gag reflex work?

Your gag reflex works on a protective reflex arc. This is a loop of nerve signals that pass by your brain to tell your muscles to move quickly. That’s why you’re not actively thinking about gagging when you do it.

Here’s an example of how it works:

1. A large piece of food touches the back of your tongue or throat.
2. Your sensory nerves send a signal to your brainstem, in the bottom of your brain.
3. Your brainstem sends a signal to your motor nerves.
4. Your motor nerves send a signal to your throat muscles.
5. Your throat muscles tense up.
6. The back part of the roof of your mouth (soft palate) rises.
7. You gag.

Why do we have a gag reflex?

The gag reflex is a built-in protection system. It gets rid of something in your mouth that shouldn’t be there.

It starts working during your first few months of life. Part of your brainstem, called the tractus solitarius, controls it at this age. It reacts when food seems too big or too solid to swallow safely. Around 6 to 7 months, a baby’s gag reflex becomes less sensitive. This change helps babies start eating and swallowing solid foods.

What triggers a gag reflex?

There are two types of triggers that can set off your gag reflex:

• Physical triggers: This is anything that touches sensitive areas of the back of your tongue, the walls of your throat, your uvula or your tonsils. Examples include swallowing pills, using a tongue depressor or dental tools.
• Psychological triggers: Also known as the psychogenic gag reflex, a thought or emotional response may trigger it. Examples include thinking about something touching your throat, feeling strong emotions or gross smells (often linked to vomiting).

Gag reflex triggers and sensitivity are different for each person.

What is a hypersensitive gag reflex?

A hypersensitive gag reflex means that your reflex triggers easily. You might gag more than expected. It can be really bothersome if things like eating larger or sticky foods or brushing your teeth cause you to gag.

Some common causes include:

• Acid reflux
• Anxiety
• Postnasal drip
• Pregnancy/morning sickness
• Sensitivity in your mouth

A healthcare provider can help you manage these.

How to suppress a gag reflex?

If you have a strong reflex, a healthcare provider or dentist may recommend one or more of these helpful techniques:

• Acupressure: This involves gently pressing certain areas of your body, like the palms of your hands, to help calm your reflexes. But research is limited.
• Anti-nausea medications: These may prevent vomiting during treatment.
• Cognitive behavioral therapy: A therapist may help you manage anxiety and learn how to stay calm during triggering procedures.
• Distractions: You might try listening to music, squeezing a stress ball or counting shapes to take your mind off what’s happening.
• Local anesthetic: Your provider may use a spray, gel, lozenge, mouth rinse or injection to numb the area that triggers it.
• Low-level laser therapy: A treatment that uses a small, painless laser light on a spot on your wrist (called the PC6 point) may calm your body and reduce nausea. But research is limited.
• Nitrous oxide: Also called “laughing gas,” this is a safe gas you breathe through a mask. It helps relax your body and weakens your reflex.

Is it OK if I don’t have a gag reflex?

Some people don’t have an active gag reflex, and that’s OK. Research found that this is more common if you smoke or use tobacco products. It’s also more common not to have this reflex if you had an eating disorder with frequent vomiting in the past.

Not having one doesn’t always mean there’s a problem. But in some cases, it can be a symptom of a larger issue, like nerve damage, after a severe brain injury.

Gag reflex test

A gag reflex test is a quick check to see if your reflex is working properly. During the test, your healthcare provider will ask you to open your mouth. Then, they’ll gently touch the back of your throat with a cotton swab or press the back of your tongue with a tongue depressor. While doing this, they’ll watch how your soft palate and throat muscles move.

You’ll know the results right away. If it’s working, you may gag when touched. If you don’t gag, it means the reflex isn’t active.

If your reflex is very strong, the test could make you feel like throwing up. Because of this, the test is only done when it’s really needed.

This test isn’t usually part of a regular check-up. But it may be part of a neurological exam to check how certain nerves in your body are working.