Effective Oral Care in Swallowing Disorders
Dysphagia is a swallowing disorder, usually resulting from a neurological or physical impairment which impacts any one of the three phases of the swallow: oral, pharyngeal and esophageal. Some medical conditions that can result in dysphagia can include but are not limited to stroke, Parkinson’s disease, cerebral palsy, or cancer. Some signs and symptoms of dysphagia include:
Inability to control saliva
Gurgly/wet voice after swallowing
Unexplained weight loss
History of frequent episodes of pneumonia
The swallowing mechanism is surprisingly complicated. When one or more of these systems “breaks down”, you may be at risk for aspiration. Diagnostic tests such as videofluoroscopy and fiberoptic endoscopic evaluation of swallowing can be used to help diagnose the problem. Sometimes a diet or liquid modification can help, or a compensatory mechanism (i.e. head positioning) can be implemented, but sometimes “nothing by mouth” (NPO) is recommended and a feeding tube is placed to reduce the risk for developing aspiration pneumonia.
Regardless of the patient’s medical condition, the oral cavity (mouth) becomes moist and regains it’s healthy color as soon as it is cared for—and its care is reflected in the entire body.
How to Perform Good Oral Care:
The first step in taking care of your mouth is making sure you’re your mouth is clean and moist. Clean your mouth before and after meals, in the morning after breakfast and at night before bed.
If you have teeth:
Using a soft bristle toothbrush (electric may be preferable) and toothpaste, brush the inside of the teeth by the tongue, the outside of the teeth, top and bottom of the teeth, and tongue. If possible, swish and spit out the toothpaste. If you are unable to swish and spit use a wet toothette to wipe the toothpaste out of the mouth. Do not swallow toothpaste or mouthwash. Floss or use a water pick to clean between your teeth. Be gentle and be careful to avoid bleeding gums.
If you have no teeth (edentulous):
Using either a toothette or soft toothbrush and toothpaste, clean the gums, tongue and inside of the cheeks. Rinse and spit or use a toothette to wipe the mouth clean.
If you have dentures:
Remove them from the mouth and scrub them with a toothbrush. Follow instructions (above) for those with an edentulous state to clean oral cavity.
You can follow oral care with an oral moisturizer such as Oral Balance (gel or spray) or an alcohol free a moisturizing mouth wash, such as Biotene. Always follow oral care with a lip moisturizer such as Vaniply ointment.
I believe that the oral cavity deserves more credit, and I hope that less people will have aspiration pneumonia by using proper oral care in the future.
Feel free to contact me if you have any questions!