Question

I have a problem at the dentist. I have to keep swallowing because of the water that gets into my mouth when I drill. I know from the dentist's reaction that it bothers him. What should I do? The suction device doesn't reach all parts of my mouth, so some of it flows down my throat. This is almost worse than the drilling. J. A. in E. 

Short answer 

Swallowing is a reflex that, once triggered, occurs automatically. The cooling water that enters the oral cavity during drilling can trigger the swallowing reflex. It is therefore essential to use an effective suction device in the right place in the mouth. To ensure that the remaining water that has not been suctioned out cannot trigger the swallowing reflex, the back of the oral cavity must be sealed off tightly with the tongue.

Tooth enamel is the hardest structure in the human body, almost as hard as diamond. Very hard grinding and cutting instruments (drills) made of hardened steel or surfaces coated with diamond grit are required to be able to work on such hard surfaces in a targeted and precise manner. These instruments are rotated by electric motors at up to 200,000 revolutions per minute. Without cooling water, the heat generated during "drilling" would be so high that the tooth substance would burn within seconds and the surface of the drills would also be destroyed. Sufficient cooling water is therefore absolutely essential when working on teeth, as well as during surgical procedures on bone. 

Swallowing is a reflex 

Swallowing is a reflex that is already formed at birth and, once triggered, takes place automatically. The act of swallowing is a complex process that serves to transport solid food and liquids from the oral cavity into the oesophagus without anything entering the airways. The swallowing reflex is triggered by touching the mucous membrane at the base of the tongue and the palatal arches or the back wall of the throat. 

Close tightly with the tongue 

The cooling water that enters the oral cavity during drilling can trigger the swallowing reflex. This can be very unpleasant, as the voluntary suppression of the reflex is very strenuous and only works for a short time. An effective suction device that is used in the right place in the mouth is therefore essential. This requires the assistance of a trained dental assistant. 

To prevent the remaining water that has not been removed by the suction system from triggering the swallowing reflex, you must seal the back of the oral cavity tightly with your tongue. Well-functioning nasal breathing makes it easier to close the mouth tightly. To help, imagine that the residual water in your mouth can even form a small lake. The tongue must prevent the remaining water from "draining" down the throat. You will inevitably keep your tongue still, which will make it easier to suck out the residual water and make the dentist's work easier and prevent you from feeling like you have to swallow. 

Author: Dr. med. dent. Jürg Eppenberger
Published in: Neue Luzerner Zeitung on July 07, 2007