​

 

What is Dysphagia?
Dysphagia is the medical term for swallowing difficulties. It is common in older adults, especially those with cognitive decline, and in people with conditions affecting muscles or nerves involved in swallowing, such as:

• Cerebral palsy

• Parkinson’s disease

• Stroke or head injury

• Head, neck, or esophageal cancer

​

When combined with poor oral health or dependency for oral care, dysphagia increases the risk of aspiration pneumonia. Consistent oral hygiene significantly reduces this risk.

​

Oral Care Management for Dysphagia

Key Principles:

• Use a dry toothbrush to remove plaque; toothpaste is optional, especially if swallowing is difficult.

• Sit the person upright, lower the chin slightly, and place a towel around the chest.

• Remove dentures and clean separately with mild soap and water.

• Moisturize dry lips with balm.

• Consider a mouth prop if the person clenches or struggles to open their mouth.

• Brush twice daily, ideally after the last meal. More frequent brushing is recommended for those at higher aspiration risk.

• Focus on plaque-prone areas: biting surfaces, gum margins, and tongue.

• Use interdental brushes or gauze for tight spaces or if the person cannot spit.

• Allow short breaks to reduce fatigue and encourage spitting if possible.

​

Secretion Management:

• For people with severely impaired swallowing or at end-of-life, dry mouths and thick saliva may occur.

• Apply a water-based oral hydrating gel to soften secretions before removal with damp gauze or a soft toothbrush.

• Massage in a circular motion to loosen deposits safely.

​

Monitoring and Support

• Conduct regular oral health assessments to check for plaque, decay, gum issues, and overall oral hygiene.

• Encourage resident independence in oral care where possible.

• Refer to a dentist if dental problems compromise oral function.

• Follow meal supervision routines to provide oral care after meals for high-risk residents.

 

Tip: Effective plaque removal is achieved mainly through brushing and careful technique, not just toothpaste.

 

​​​​

How often should oral care be carried out?

• Routinely twice a day but as aspiration risk increases, more frequent brushing is preferred

• Where meal supervision is carried out, part of this supervision could include simple oral care after each meal to reduce both oral disease and aspiration of food remnants   (Müller, 2014; van der Maarel-Wierink et al., 2013).

​​

Organise referral to dentist when concerned about compromised oral function due to potential dental problems