Bolus Texture Testing as a Clinical Method for Evaluating Food Oral Processing and Choking Risk: A Pilot Study

Author:

Bandini Andrea123,Gandhi Pooja14ORCID,Sutton Danielle1,Steele Catriona M.14ORCID

Affiliation:

1. Swallowing Rehabilitation Research Laboratory, KITE Research Institute – Toronto Rehabilitation Institute, University Health Network, Ontario, Canada

2. The BioRobotics Institute, Suola Superiore Sant'Anna, Pisa, Italy

3. Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy

4. Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada

Abstract

Purpose: Choking on food is a leading cause of accidental death in several populations, including children, people with intellectual/developmental disability, and older adults in residential care facilities. One contributor to choking risk is incomplete oral processing and failure to convert food to a cohesive, nonsticky bolus with a maximum particle size that will not block the airway. Clinical tests of mastication do not evaluate properties of chewed food boluses. We characterized expectorated boluses, after oral processing, using methods developed by the International Dysphagia Diet Standardisation Initiative (IDDSI). Method: Seventeen adults without dysphagia (seven women and 10 men), aged 23–55 years, chewed samples of a cracker, a raw baby carrot, and a circular, dome-shaped gummy candy. Chewing metrics were obtained up to the point when the person indicated that they were ready to swallow. The bolus was then either expectorated or swallowed; IDDSI tests were used to characterize the expectorated boluses. Results: Measures of chewing did not differ between spit and swallow conditions. Expectorated cracker and carrot boluses had maximum particle size consistent with IDDSI Level SB6 Soft & Bite-Sized foods or lower. The gummy candy samples remained at IDDSI Level RG7 Regular food consistency. Conclusions: This study suggests that expectorated ready-to-swallow boluses are representative of boluses that are swallowed and that oral processing in adults without dysphagia typically results in boluses at IDDSI's Level SB6 or lower. IDDSI's testing methods provide a practical method for evaluating oral processing by characterizing expectorated ready-to-swallow boluses and may guide food texture recommendations for persons who have increased risk of choking.

Publisher

American Speech Language Hearing Association

Subject

Speech and Hearing,Linguistics and Language,Developmental and Educational Psychology,Otorhinolaryngology

Reference48 articles.

1. Foreign body asphyxiation—an autopsy study

2. An autopsy approach to bolus deaths

3. Dimensions of the normal human trachea

4. Tracheal diameter predicts double-lumen tube size: A method for selecting left double-lumen tubes;Brodsky J. B.;Anesthesia & Analgesia,1996

5. Influences of food hardness on the particle size distribution of food boluses

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