Gagging Problem Assessment: a re-evaluation.

The Gagging Problem Assessment (GPA) is an instrument to evaluate dental gagging. Although the GPA seemed to be reliable and valid in a pilot study, a replication study with more subjects was needed. Based on the pilot study, the number of items was reduced, resulting in the revised version of the GPA (GPA-R). The aims of this study were to replicate the reliability of the GPA-R and to investigate the correlation between dental gagging and general anxiety. Dental gagging patients (n = 59) were compared with a control group (n = 17) at t0 and 3 weeks later. The 'gagging group' also filled in the SCL-90 anxiety scale. Gagging-specific homogenous domains and internal consistency were determined. Stability and distinguishing capacity of the GPA-R were assessed. SCL-90-Anxiety scores were compared with standard values in a non-clinical population. The GPA-R patient part was able to reliably discriminate between the absence or the presence of dental gagging. However, the reliability of the GPA-R-dentist part was insufficient. The GPA-R seems to be sensitive to subtle differences in acts of the dentists. To overcome these problems, more detailed and explicit instructions on how to use the GPA-R should be formulated and more specific gagging stimuli should be included. The 'gagging group' reported 'fear of choking' significantly more often than the control group (P = 0·008). This finding might be important for the treatment of dental gagging. Considering the outcome of our study, development of a new diagnostic gagging tool needs another approach that focuses on gagging severity.