الفهرس 
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Abstract
Dissertation Abstract : Background: Gag reflex is very important in preventing unwanted objects from entering the airway. When exaggerated, gag reflex can affect dental treatment quality and can be challenging to the dentist. Aim of this study: To assess gagging problem severity among children and to compare between topical anesthesia and distraction in controlling problematic gagging. Methods : 60 children categorized as gaggers according to the shorter form of the gagging problem assessment-dentist part, modified for children (GPA-de-c/SF), their age ranged from 4-7 years and indicated for pulpotomy treatment were selected from the Pediatric Dental Clinic, Faculty of Dentistry, Mansoura University. They were randomly divided into two equal groups. group (A) received topical anesthetic gel and group (B) received intellectual distraction in the form of game showed on a tablet device. Assessment of gagging severity was done using the gagging severity index (GSI). Improvement in gagging severity was assessed by the gagging prevention index (GPI). Data were collected, tabulated and statistically analyzed. Results : The results revealed that the percentage of gagging severity in the topical anesthesia group was 16.66% mild, 53.34% moderate and 30% severe gagging. The percentage of gagging severity in the distraction group was 13.33% mild, 50% moderate and 36.67% severe gagging. Intellectual distraction was more successful than topical anesthesia in controlling gagging among children as there was statistically significant difference between the two groups in their GPI scores (p value≤0.050). No relationship was found between age and improvement in gagging as there was no statistically significant difference in the gagging improvement among different age groups in both topical anesthesia and distraction groups. Females showed more improvement percentages than males, there was a statistically significant difference between them in the distraction group. Conclusion: Intellectual distraction is a successful means and more effective than topical anesthesia in managing gagging problems among children. Both techniques are more effective in mild and moderate gagging than in severe cases.