Oral care guide for people with dysphagia

Mouth care for people with swallowing problems

People who can’t eat or drink, or who only have limited oral consumption, are at higher risk of poor oral hygiene and need extra help with cleaning their mouths. If they rely on others for mouth care and have trouble swallowing, they are at a higher risk of developing pneumonia. For people with very severe swallowing problems or who can’t eat (nil by mouth), there is a risk of choking on toothpaste or food debris. It’s important to be careful during mouth care.

Basic mouth care guidelines

Because swallowing problems vary, there is no one size fits all approach to mouth care for people with dysphagia. However, here are some general tips that can be adjusted based on your needs.

• Stay as upright as possible during mouth care to prevent food or liquid from going into the lungs.
• Check your mouth: Remove dentures, loose items, or any food stuck in the mouth using a damp, soft cloth.
• If lips are dry or cracked, apply a water-based balm.
• If appropriate, put a small amount of non-foaming toothpaste on a soft toothbrush or electric toothbrush.
• To keep the mouth hydrated, you can dampen the toothbrush or gauze with water or mouthwash.
• Focus on cleaning areas where food and plaque collect first (like gums and chewing surfaces). Try to clean all the surfaces of the teeth.
• If unable to spit, use a damp cloth to remove excess toothpaste and food.
• Brush teeth twice a day, especially after the last meal. If meal supervision is needed, simple mouth care after each meal is important to prevent food from going into the lungs and to avoid mouth infections.
• If appropriate, an electric toothbrush with a suction feature may help. This can make brushing easier and more effective.
• Brush the tongue if it’s coated with a soft toothbrush.
• If your mouth is especially dirty or the gums are bleeding, use a small amount of mouthwash or gel with a toothbrush.
• Use special interdental brushes to clean between the teeth if needed, and follow advice from a dentist or oral health expert.
• Check the mouth for sores or mucus. To remove dried mucus from the mouth, Apply water or water-based gel to a toothbrush, 360 toothbrush or MC3 stick to gently rub and remove the mucus with a damp cloth.

People nearing end of life have specific mouthcare needs. Please see our eating and drinking at end of life for more information.