What is Swallowing Therapy?

Rebecca Harkin

Swallowing therapy is used to treat patients with dysphagia, a condition where people cannot swallow or swallow with great difficulty. Traditional swallowing therapy, typically administered by a speech-language pathologist or occupational therapist, aims to strengthen swallowing muscles and prevent choking. A more novel approach to swallowing therapy involves electrical stimulation of the neck to strengthen the muscles used in swallowing. Patients with swallowing issues often develop dental health problems because food is regurgitated or gets left in the mouth. In some cases, oral hygiene will be taught as a part of dysphagia therapy.

Swallowing therapy is administered to people who experience trouble swallowing.
Swallowing therapy is administered to people who experience trouble swallowing.

The primary goal of swallowing therapy is to help people chew their food, transfer food to the back the throat, and strengthen the swallowing muscles. Swallowing therapy will also teach a patient to avoid the accidental movement of food or liquid into the lungs, called aspiration, and the regurgitation of food. Most exercises will be used to strengthen the muscles in the jaw, tongue, and throat, while other exercises involve practicing breath control during swallowing, how to prevent food from getting trapped in the throat, and how to expel trapped food. Initial swallowing therapy will use the patient’s saliva or small sips of water, and later therapy exercises will use real food. The therapist will also help the patient determine the best consistency of food and learn to use therapeutic feeding utensils and slow-flow cups.

Swallowing therapy includes strengthening exercises for the jaw, tongue and throat.
Swallowing therapy includes strengthening exercises for the jaw, tongue and throat.

An alternative to traditional swallowing therapy is electrical stimulation of the muscles involved in swallowing. In this type of therapy, electrodes are attached about mid-point on the neck. Treatment sessions typically last 30 minutes and involve pulse stimulation of the neck muscles with electrical current while the patient swallows different sizes and textures of food. Electrical stimulation causes the muscles to contract, which increases blood flow to the area and improves muscle strength and stamina. The number of sessions needed depends on the severity of the swallowing problem and the rate of improvement.

A visual examination is often the first step in diagnosing dysphagia.
A visual examination is often the first step in diagnosing dysphagia.

Oral hygiene can deteriorate in patients with dysphagia because food is often regurgitated and the mouth is usually excessively dry. Some swallowing therapy includes learning to maintain proper oral hygiene under these difficult circumstances. Patients are taught to rinse with non-alcohol based mouthwashes to clear the mouth of food. To prevent plaque formation, patients may be taught to rinse and spit with a plaque-fighting, Chlorhexidine solution and brush their teeth with a toothbrush right after eating. Use of an application of water-based lip balms may also be taught to prevent chapped lips and mouth sores for patients with poor tongue control.

Learning proper hygiene, such as brushing one's teeth, is sometimes part of swallowing therapy.
Learning proper hygiene, such as brushing one's teeth, is sometimes part of swallowing therapy.
Patients with dysphagia often experience problems with oral hygiene.
Patients with dysphagia often experience problems with oral hygiene.
A stroke may lead to problems with swallowing, in addition to drooping and paralysis on the affected side of the face.
A stroke may lead to problems with swallowing, in addition to drooping and paralysis on the affected side of the face.
The primary goal of swallowing therapy is to help people chew and transfer food to the back the throat.
The primary goal of swallowing therapy is to help people chew and transfer food to the back the throat.

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