Behavioral Management Of A Child with A Gag Reflex During Pulpotomy:  A Case Report

Laila Fit Ria; Nendika Dyah Ayu Murika Sari

doi:10.55227/ijhet.v5i3.1224

Authors

Laila Fit Ria Faculty of Dentistry, Universitas Muhammadiyah Surakarta, Indonesia
Nendika Dyah Ayu Murika Sari Faculty of Dentistry, Universitas Muhammadiyah Surakarta, Indonesia

DOI:

https://doi.org/10.55227/ijhet.v5i3.1224

Keywords:

Pulpotomy; Pediatric Dentistry; Gag Reflex; Behavioral Management; Enhanced Control

Abstract

Pulpotomy is a vital pulp therapy for primary teeth that aims to preserve radicular pulp vitality. Successful treatment depends not only on the dental condition but also on the child’s cooperation. A pronounced gag reflex may interfere with treatment when instruments stimulate the oral cavity. Behavioral management using enhanced control may help improve patient cooperation and comfort. This case report describes the application of enhanced control in managing a child with a gag reflex during pulpotomy. A 9-year-old boy presented with caries in tooth 75 and sensitivity to cold and heat. Clinical and radiographic examinations revealed a dentinal cavity approaching the pulp chamber, positive pulp vitality, and no pathological signs in the radicular region, leading to a diagnosis of reversible pulpitis. The patient exhibited a gagging response during intraoral instrumentation. Pulpotomy was performed using enhanced control, with a simple signaling system established to communicate discomfort. At the one-week follow-up, no pain, swelling, bleeding, or tooth mobility was observed. Percussion and palpation were negative, and pulp vitality remained positive. Enhanced control facilitated communication, improved cooperation, and supported a more controlled and comfortable pulpotomy procedure in a child with a gag reflex.

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