Here’s Why You Gag While Brushing Your Teeth

It’s a horrible feeling. You’re a minute into a two-minute tooth brushing session and … uh oh. Suddenly, you’re retching into the sink, trying not to vomit. Again.

Dentist Anne Clemons, DMD, explains why you gag while brushing your teeth and the steps you can take to make your twice-daily cleanings more comfortable.

What causes gagging while brushing teeth?

There are many reasons why brushing your teeth might leave you dry heaving or vomiting. The most common: You have a sensitive gag reflex.

“We have a gag reflex for a reason,” Dr. Clemons explains. “It’s a defense mechanism. It’s our body’s way to avoid choking on or swallowing things that could be dangerous.”

Some of us are born with a hypersensitive gag reflex, while others have little to none. Then, there are people — like sword swallowers and fire eaters — that train their bodies to be less reactive.

Most of us, Dr. Clemons says, are somewhere in the middle: We only gag when doing specific activities, like brushing our teeth.

Other reasons you might gag or vomit while brushing include:

• Brushing technique. “If you’re aggressive — really scrubbing the back of your mouth and tongue or brushing forcefully — that can trigger gagging,” Dr. Clemons notes. “That way of brushing can make your body react like it’s in danger.”
• Your toothpaste. The flavor of your toothpaste may be irritating your throat.
• Smoking. Smoking stimulates saliva production and exposes your airways to chemical irritants. Both side effects can increase sensitivity.
• Illness or allergies. Upper respiratory bugs, allergies, sore throats, sinus infections and more can inflame the soft tissue in your mouth. That swelling can make your gag reflex more reactive.
• Acid reflux. A bad case of garden-variety heartburn bumps up your risk of retching or vomiting because it brings stomach acid up into your esophagus. If you have gastroesophageal reflux disease (GERD), you may have ongoing problems brushing your teeth.
• Pregnancy. If you’re experiencing morning sickness, your gag reflex is already overstimulated. Brushing your teeth is like poking an already-aggravated bear … with a toothbrush.
• Anxiety. Maybe you’re afraid of the dentist. Maybe you’re stressed out. Maybe you just hate dry heaving. Whatever the reason, feeling tense or nervous will up your chances of gagging.
• Trauma. If you’ve experienced dental trauma or other distressing experiences involving your mouth or throat, your brain may be conditioned to see your toothbrush as a threat.
• The structure of your mouth. Cleft lip and palate, Ehlers-Danlos syndrome and Marfan syndrome are some of the many conditions that can affect the size and shape of your mouth. If your mouth is smaller, that means your teeth are crowded together. That malocclusion can raise your risk of gagging while brushing.

Tips to help stop the gag reflex

If practicing good oral hygiene is making you feel sick, you might be tempted to skip it. But Dr. Clemons warns against bypassing your brushing routine. Instead, she recommends seven tips to make brushing more comfortable.

1. Choose a different toothbrush

If you use a large, bulky toothbrush that takes up a lot of space in your mouth, consider ditching it for a child-size toothbrush or an electric toothbrush with a small, circular head.

2. Opt for a milder toothpaste

If you use a toothpaste with a strong flavor, going for something milder may reduce irritation, Dr. Clemons suggests.

3. Change your brushing style

There’s more than one way to clean a tooth.

Instead of a vigorous, back-and-forth approach, place your electric toothbrush head on a single tooth and hold it there for several seconds. Dr. Clemons says the toothbrush head can do most of the work for you.

Don’t have an electric toothbrush? Brushing in small circular motions may be easier on you.

Another recommendation? Slow down. Being slow and deliberate is good for your gag reflex and your teeth.

4. Try to stay calm

Easier said than done, we know. But if there’s a psychological component to your brushing issues, reducing your stress could make all the difference. Dr. Clemons recommends you:

• Distract yourself with music, a video, or a fidget toy
• Focus on your breathing (Fun fact: Breathing through your nose can reduce the stress on your throat, and encourages a relaxed breathing pattern)
• Create a fun or calming ritual you can look forward to
• Use those two minutes to practice mindfulness

5. Brush in stages

There’s no rule that says you have to brush for two minutes continuously. If you start feeling green around the gills 30 seconds in, stop. Take as many breathers as you need to hit that magic two-minute mark.

If two minutes just isn’t happening tonight, that’s OK, too. Some brushing is better than none — and tomorrow’s another day.

6. Experiment with desensitizing your gag reflex

Dr. Clemons recommends getting curious about what sets off your gag reflex. Is one part of your mouth more sensitive? Does a particular brushing angle make your stomach flip? What happens when you spit out your toothpaste or scrape your tongue?

Once you understand what activates your gag reflex, you may be able to retrain it.

“Start by brushing in a safe spot for a few seconds,” she advises. “Then, go to a borderline area and spend a few seconds brushing there before returning to your comfort zone. If you feel OK after, gradually increase that duration with every brushing session.”

7. Talk to your dentist

If fear of gagging keeps you from brushing — or visiting your dentist — let them know.

“There are things we can do to make dental care a bit easier,” Dr. Clemons reassures. “We want to do good work. But we want to do it as quickly, gently and comfortably as we can. If we know what’s going on or what may be triggering your gagging, we can work around it.”

Numbing throat sprays and special positioning can make your dental exam more bearable. In extreme cases, your dentist may offer to use light sedation to reduce your anxiety and suppress your gag reflex.

Final thoughts

Gagging while brushing your teeth is extremely unpleasant. But it’s nowhere near as bad as actually throwing up. How do you brush your teeth after that?

Dr. Clemons recommends washing your mouth out with either water, a diluted mouthwash or a glass of water mixed with a teaspoon of baking soda. Once your mouth’s clean(er), clean your toothbrush — or replace it, if you’d prefer.

Next? Take a break and give your body a chance to recover.

“Digestive acids are strong enough to weaken the enamel on the outer areas of your teeth,” she warns. “If you brush right away, you may increase the damage. Your gag reflex is even more hypersensitive after you vomit anyway. Try again when your stomach’s had time to settle.”