Dental anxiety and hypersensitive gag reflex are common clinical challenges in dentistry and frequently lead to referral for intravenous sedation. Although both conditions may interfere with dental procedures, their potential association with sedative drug requirements remains unclear. This study aimed to evaluate the relationship between dental anxiety, hypersensitive gag reflex, and sedative drug requirements during intravenous dental sedation. In this prospective comparative study, 52 adult patients referred for intravenous sedation were categorized according to the primary indication for sedation as dental anxiety (Group 1, n = 26) or hypersensitive gag reflex (Group 2, n = 26). Dental anxiety and gag reflex severity were assessed using the Modified Dental Anxiety Scale (MDAS) and the Gagging Problem Assessment Questionnaire (GPAQ), respectively. Sedation depth was evaluated using the Ramsay Sedation Scale (RSS). Demographic characteristics, procedure duration, and sedative drug doses were recorded. Group comparisons and correlation analyses were performed. Patients in the dental anxiety group were significantly younger than those in the hypersensitive gag reflex group (p = 0.005). MDAS scores were significantly higher in Group 1, while moderate-to-severe gag reflex responses were more frequent in Group 2 (p < 0.001). No significant differences were observed between groups regarding sedative drug doses or procedure duration. Correlation analysis demonstrated a significant positive association between dental anxiety scores and propofol dose, whereas gag reflex severity was not significantly associated with sedative drug requirements. Dental anxiety was associated with increased propofol requirements during intravenous sedation, whereas hypersensitive gag reflex severity was not associated with sedative dose. These findings suggest that anxiety-related factors may influence sedative requirements, while management of hypersensitive gag reflex may require additional or adjunctive strategies beyond pharmacological sedation.
Akçaalan et al. (Tue,) studied this question.