Journal of Traditional Medical Complementary Therapies

.: REVIEW
Çocuk Diş Hekimliğinde Bulantı ve Kusma Refleksinin Yönetimi
Management of Gag Reflex in Pediatric Dentistry
Burcu GÜÇYETMEZ TOPALa, Sıdıka Beril FALAYa
aAfyonkarahisar Sağlık Bilimleri Üniversitesi Diş Hekimliği Fakültesi, Çocuk Diş Hekimliği ABD, Afyonkarahisar, TÜRKİYE
J Tradit Complem Med. 2021;4(2):275-83
doi: 10.5336/jtracom.2020-77025
Article Language: TR
Full Text
ÖZET
 Bulantı ve kusma refleksi (gag refleksi), istenmeyen cisimlerin farinks, larinks ve trakeadan girişini engelleyen orofarenks, dil tabanı ve yumuşak damağın uyarılması sonucu oluşan, nöral bir savunma refleksidir. Bulantı ve kusma genellikle birlikte gelişir, fakat birbirlerinden bağımsız da ortaya çıkabilir. Bu refleksin etiyolojisinde anatomik, tıbbi, iyatrojenik ve psikolojik faktörler rol oynamaktadır. Hasta, sistemik problemleri nedeniyle bulantı-kusma refleksine sahip olabileceği gibi bulantı-kusma refleksi de hastanın tıbbi durumu hakkında fikir verebilir. Bulantı-kusma refleksi, hem erişkinlerde hem de çocuklarda görülebilmektedir. Çocuk hastaların anksiyete düzeyinin, yüksek olması nedeniyle çocuklarda bulantı ve kusma refleksiyle sık karşılaşılmaktadır. Bulantı ve kusma refleksi, hastaların hem oral hijyen alışkanlıklarını hem de diş hekimliği tedavileri sırasındaki kooperasyonlarını oldukça etkilemektedir. Bu reflekse sahip hastalar, dental tedavileri yaptırmaktan kaçınmakta dolayısıyla dental problemleri başlangıç aşamasında yakalamak zorlaşmakta ve daha invaziv tedavilere ihtiyaç artmaktadır. Özellikle çocuk hastalarla ilgilenen diş hekimlerinin, bulantı-kusma refleksinin yönetimiyle ilgili bilgi ve tecrübeleri oral hijyenin idamesinde, tedavilerin başarısında ve çocukta kalıcı davranışların şekillenmesinde önem arz etmektedir. Çocuk hastaların tedavisini üstlenen diş hekimlerinin öncelikli amacı, çocuk hastada iyatrojenik kaynaklı bulantı ve kusma refleksinin oluşumunu önlemek olmalıdır. Bulantı ve kusma refleksinin şiddeti, refleksin yönetim şekli üzerinde belirleyici olmaktadır. Bu makalede, bulantı ve kusma refleksiyle ilgili mevcut çalışmaların derlenmesi ve bu reflekse sahip çocuk hastaların, dental tedavilerinin yönetimiyle ilgili bilgilerin güncellenmesi amaçlanmıştır.

Anahtar Kelimeler: Çocuk diş hekimliği; bulantı; kusma; öğürme
ABSTRACT
 Gag reflex is a neural defense reflex that prevents unwanted objects from entering the pharynx, larynx and trachea, resulting from the stimulation of the oropharynx, tongue base and soft palate. Nausea and vomiting often develop together, but they can occur independently. Anatomical, medical, iatrogenic and psychological factors play a role in the etiology of this reflex. The patient may have gag reflex due to systemic problems, and gag reflex may give an idea about the patient's medical condition. Gag reflex can be seen in both adults and children. Due to the high level of anxiety in pediatric patients, gag reflexes are frequently encountered in children. Gag reflex affect patients' oral hygiene habits and cooperations during dentistry treatments. Patients with this reflex refrain from having dental treatments, so it is difficult to catch dental problems at the initial stage and more invasive treatments are needed. In particular, the knowledge and experience of dentists who treat pediatric patients, about the management of gag reflex is important in the maintenance of oral hygiene, the success of the treatments and shaping of the permanent behaviors in the child. The primary aim of dentists who undertake the treatment of pediatric patients should be to prevent the formation of iatrogenic gag reflex in the pediatric patient. The severity of the gag reflex is decisive on the management style of the reflex. In this article, it is aimed to compile the current studies on gag reflex and to update the information about the management of dental treatment of pediatric patients with this reflex.

Keywords: Pediatric dentistry; nausea; vomiting; gagging
REFERENCES:
  1. Karakurumer K, Par S, Öztunç H, Özen T. [Gag reflex and its importance in dental radiography]. GÜ Dişhek Fak Derg. 1990;7(2):95-100. [Link] 
  2. Akarslan ZZ. Gag reflex in dentistry: what can we do? Atatürk Üniv Diş Hek Fak Derg. 2016;26(3):503-10. [Link] 
  3. Dickinson CM, Fiske J. A review of gagging problems in dentistry: I. Aetiology and classification. Dent Update. 2005;32(1):26-8, 31-2. [PubMed] 
  4. Aygin D. [Nausea and vomiting]. Yoğun Bakım Hemşireliği Dergisi. 2016;20(1):44-56. [Link] 
  5. Davies AE, Kidd D, Stone SP, MacMahon J. Pharyngeal sensation and gag reflex in healthy subjects. Lancet. 1995;25;345(8948):487-8. [PubMed] 
  6. Katsouda M, Tollili C, Coolidge T, Simos G, Kotsanos N, Arapostathis KN. Gagging prevalence and its association with dental fear in 4-12-year-old children in a dental setting. Int J Paediatr Dent. 2018:7. [PubMed] 
  7. Sewerin I. Gagging in dental radiography. Oral Surg Oral Med Oral Pathol. 1984;58(6):725-8. [PubMed] 
  8. Saita N, Fukuda K, Koukita Y, Ichinohe T, Kaneko Y. Classification of factors formed dental phobia. J Jpn Dent Soc Anesthesiol. 2010;38:596-97. [Link] 
  9. Wright SM. Medical history, social habits, and individual experiences of patients who gag with dentures. J Prosthet Dent. 1981;45(5):474-8. [PubMed] 
  10. Wright SM. The radiologic anatomy of patients who gag with dentures. J Prosthet Dent. 1981;45(2):127-33. [PubMed] 
  11. Watt DM, MacGregor AR. The diagnosis and treatment of problems of edentulous patients. 2nd ed. Bristol: Wright, 1986.
  12. Bloustine S, Langston L, Miller T. Ear-cough (Arnold's) reflex. Ann Otol Rhinol Laryngol. 1976;85(3 pt 1):406-7. [PubMed] 
  13. Saita N, Fukuda K, Koukita Y, Ichinohe T, Yamashita S. Relationship between gagging severity and its management in dentistry. J Oral Rehabil. 2013;40(2):106-11. [PubMed] 
  14. Wright SM. An examination of factors associated with retching in dental patients. J Dent. 1979;7(3):194-207. [PubMed] 
  15. Bassi GS, Humphris GM, Longman LP. The etiology and management of gagging: a review of the literature. J Prosthet Dent. 2004;91(5):459-67. [PubMed] 
  16. Faigenblum MJ. Retching, its causes and management in prosthetic practice. Br Dent J. 1968;3;125(11):485-90. [PubMed] 
  17. Rickards H, Robertson MM. Vomiting and retching in Gilles de la Tourette syndrome: a report of ten cases and a review of the literature. Mov Disord. 1997;12(4):531-5. [PubMed] 
  18. Barsby MJ. The control of hyperventilation in the management of 'gagging'. Br Dent J. 1997;8;182(3):109-11. [PubMed] 
  19. Ramsay DS, Weinstein P, Milgrom P, Getz T. Problematic gagging: principles of treatment. J Am Dent Assoc. 1987;114(2):178-83. [PubMed] 
  20. Newton AV. The psychosomatic component in prosthodontics. J Prosthet Dent. 1984;52(6):871-4. [PubMed] 
  21. Meeker HG, Magalee R. The conservative management of the gag reflex in full denture patients. N Y State Dent J. 1986;52(4):11-4. [PubMed] 
  22. Fish SF. Adaptation and habituation to full dentures. Br Dent J. 1969;1;127(1):19-26. [PubMed] 
  23. Ellis S. Response to intravenous midazolam sedation in general dental practice. Br Dent J. 1996;8;180(11):417-20. [PubMed] 
  24. Murphy WM. A clinical survey of gagging patients. J Prosthet Dent. 1979;42(2):145-8. [PubMed] 
  25. Akkaya N, Karagül S, Kanlı A, Arslan U. [the effect of dental anxiety on gag reflex during intraoral radiography taking]. Hacettepe Diş Hekimliği Fakültesi Dergisi. 2008;32(2):2-9. [Link] 
  26. Katsouda M, Provatenou E, Arapostathis K, Coolidge T, Kotsanos N. The Greek version of the Gagging Assessment Scale in children and adolescents: psychometric properties, prevalence of gagging, and the association between gagging and dental fear. Int J Paediatr Dent. 2017;27(2):145-51. [PubMed] 
  27. Kovats JJ. Clinical evaluation of the gagging denture patient. J Prosthet Dent. 1971;25(6):613-9. [PubMed] 
  28. Conny DJ, Tedesco LA. The gagging problem in prosthodontic treatment. Part II: patient management. J Prosthet Dent. 1983;49(6):757-61. [PubMed] 
  29. Singer IL. The marble technique: a method for treating the "hopeless gagger" for complete dentures. J Prosthet Dent. 1973;29(21):146-50. [PubMed] 
  30. Wilks CG, Marks IM. Reducing hypersensitive gagging. Br Dent J. 1983;22;155(8):263-5. [PubMed] 
  31. Robb ND, Crothers AJ. Sedation in dentistry. Part 2: m anagement of the gagging patient. Dent Update. 1996;23(5):182-6. [PubMed] 
  32. Randall CL, Shulman GP, Crout RJ, McNeil DW. Gagging and its associations with dental care-related fear, fear of pain and beliefs about treatment. J Am Dent Assoc. 2014;145(5):452-8. [PubMed]  [PMC] 
  33. Özcan Ö, Gül Çelik G. [Cognitive behaviour therapy]. Turkiye Klinikleri J Child Psychiatry-Special Topics. 2017;3(2):115-20. [Link] 
  34. Humphris GM, Ling M. Behavioural Sciences for Dentistry. 1st ed. Edinburgh: Churchill Livingstone; 2000.
  35. Chidiac JJ, Chamseddine L, Bellos G. Gagging prevention using nitrous oxide or table salt: a comparative pilot study. Int J Prosthodont. 2001;14(4):364-6. [PubMed] 
  36. Eitner S, Wichmann M, Holst S. A long-term therapeutic treatment for patients with a severe gag reflex. Int J Clin Exp Hypn. 2005;53(1):74-86. [PubMed] 
  37. Kalyon TA. [Acupuncture therapy]. Turk J Phys Med Rehab. 2007;53(2):52-7. [Link] 
  38. Sari E, Sari T. The role of acupuncture in the treatment of orthodontic patients with a gagging reflex: a pilot study. Br Dent J. 2010;22;208(10):E19. [PubMed] 
  39. Thayer ML. The use of acupuncture in dentistry. Dent Update. 2007;34(4):244-6, 249-50. [PubMed] 
  40. Fiske J, Dickinson C. The role of acupuncture in controlling the gagging reflex using a review of ten cases. Br Dent J. 2001;9;190(11):611-3. [PubMed] 
  41. Vachiramon A, Wang WC. Acupressure technique to control gag reflex during maxillary impression procedures. J Prosthet Dent. 2002;88(2):236. [PubMed] 
  42. Schlager A, Offer T, Baldissera I. Laser stimulation of acupuncture point P6 reduces postoperative vomiting in children undergoing strabismus surgery. Br J Anaesth. 1998;81(4):529-32. [PubMed] 
  43. Butkovic D, Toljan S, Matolic M, Kralik S, Radesić L. Comparison of laser acupuncture and metoclopramide in PONV prevention in children. Paediatr Anaesth. 200515(1):37-40. [PubMed] 
  44. Chate RA. Acupuncture for controlling gag reflex? Br Dent J. 2001;24;191(10):537. [PubMed] 
  45. Haghighat A, Kaviani N, Jokar S, Soltani P, Ahmadi A. Evaluation of the effects of acupuncture on P6 and anti-gagging acupoints on the gag reflex. Dent Hypotheses. 2015;6(1):19-22. [Link] 
  46. Ferreira LA, de Oliveira RG, Guimarães JP, Carvalho AC, De Paula MV. Laser acupuncture in patients with temporomandibular dysfunction: a randomized controlled trial. Lasers Med Sci. 2013;28(6):1549-58. [PubMed] 
  47. Whittaker P. Laser acupuncture: past, present, and future. Lasers Med Sci. 2004;19(2):69-80. [PubMed] 
  48. Özgök A. [Hypnosis and anesthesia]. Journal of Anesthesia. 2013;21(1):11-6. [Link] 
  49. Kramer RB, Braham RL. The management of the chronic or hysterical gagger. ASDC J Dent Child. 1977;44(2):111-6. [PubMed] 
  50. Neumann JK, McCarty GA. Behavioral approaches to reduce hypersensitive gag response. J Prosthet Dent. 2001;85(3):305. [PubMed] 
  51. Krol AJ. A new approach to the gagging problem. J Prosthet Dent. 1963;13(4):611-6. [Link] 
  52. Schole ML. Management of the gagging patient. J Prosthet Dent. 1959;9(4):578-83. [Link] 
  53. Kaira LS, Dabral E, Kukreja HS. Gagging a review. Nitte University Journal of Health Science. 2014;4(1):149-55. [Link] 

.: Up To Date

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com