At his last visit Patient X was commended on his good oral hygiene and was informed that the only areas that needed improving was the insides surfaces of the lower back teeth, the surfaces closest to the tongue.
This is an area that is often not cleaned as well as other more accessible areas of the mouth.
The reason for this is mainly down to the tongue getting in the way of the toothbrush and also the fact that some of us have an extremely sensitive gag reflex at the back of the mouth. These reflexes are normal and designed to stop food and liquid entering the windpipe.
Unfortunately these reflexes can also be triggered by the action of the toothbrush in that area and it can initiate a baulking or retching action especially in the morning.
So, back to Patient X. One morning shortly after his dental health check he was dutifully doing as requested and trying to improve the plaque removal in the lower back area. However, he went too far back with his brush towards his throat and triggered his gag reflex. It was so powerful that he abruptly shot forward and injured his back and needed physiotherapy to help fix it!
So my advice is – save your best brushing for later in the day or the night time brush especially in the sensitive area that stimulates a gag reflex. At the end of the day our reflexes are less sensitive and not as easy to trigger.
Also maybe consider doing a warm up before the rigours of the early morning brush up – only joking!