Speech Therapy’s Role to Practicing Good Oral Care to Prevent Aspiration Pneumonia
Aspiration pneumonia is inflammation of the lungs and airways to the lungs (bronchial tubes) from breathing in foreign material. Aspiration pneumonia occurs when foreign materials (usually food, liquids, vomit, or fluids from the mouth) are breathed into the lungs or airways leading to the lungs.
This may lead to:
- A collection of pus in the lungs (lung abscess)
- Swelling and inflammation in the lung
- A lung infection (pneumonia)
Causes of Aspiration Pneumonia
Approximately 45 percent of healthy individuals aspirate during sleep, but clinically significant aspiration occurs at an incidence of less than 4 percent.As the population ages and the risk of aspiration and aspiration pneumonia increases in patients with dysphagia, health care providers must be cognizant of its complications.
Dysphagia, aspiration and pneumonia are common in older adults with disorders such as stroke, Alzheimer’s disease, Parkinson’s disease and other neurodegenerative disorders. The occurrence of dysphagia following stroke is approximately 30 percent.
Dysphagia [dis-fa´jah] is the medical term for difficulty swallowing, or the feeling that food is “sticking” in your throat or chest. The feeling is actually in your esophagus, the tube that carries food from your mouth to your stomach. You may experience dysphagia when swallowing solid foods, liquids, or both.
Aspiration pneumonia is more common in males than in females, and it is more common in extremely young or older patients.
Other Risk factors for aspiration or breathing in of foreign material into the lungs are:
- Being less alert due to medicines, illness, or other reasons
- Coma
- Disorders of the esophagus, the tube that moves food from the mouth to the stomach (esophageal stricture, gastroesophageal reflux)
- Drinking large amounts of alcohol
- Medicine to put you into a deep sleep for surgery (general anesthesia)
- In persons 65+
- Poor gag reflex in people who are not alert (unconscious or semi-conscious) after a stroke or brain injury
- Problems with swallowing
Did You Know?
- With the aspiration of food, as many as 100,000,000 bacteria may enter the lungs.
- 70% of people with pneumonia aspirate during their sleep
- Practicing good oral care can decrease mortality due to pneumonia by 50%
What can you do to prevent Aspiration Pneumonia?
- Recognize the signs & symptoms of aspiration
- Practice good oral care
- Brush before meals to cut back on germs in saliva
- Keep the head of your bed should always be at or more than 45 degrees after a meal
- Perform oral care 3 times a day
How are swallowing disorders diagnosed?
A speech-language pathologist (SLP) who specializes in swallowing disorders can evaluate individuals who are experiencing problems eating and drinking. The SLP will:
- take a careful history of medical conditions and symptoms
- look at the strength and movement of the muscles involved in swallowing
- observe feeding to see posture, behavior, and oral movements during eating and drinking
- possibly perform special tests to evaluate swallowing, such as
- modified barium swallow- individual eats or drinks food or liquid with barium in it, and then the swallowing process is viewed on an X-ray
- endoscopic assessment- a lighted scope is inserted through the nose, and then the swallow can be viewed on a screen
What treatments are available for people with swallowing disorders?
Treatment depends on the cause, symptoms, and type of swallowing problem. A speech-language pathologist may recommend:
- specific swallowing treatment (e.g., exercises to improve muscle movement)
- positions or strategies to help the individual swallow more effectively
- specific food and liquid textures that are easier and safer to swallow
Your Speech Therapist is a specialist in Dysphagia and Swallowing Disorders. Find out how a Speech Therapist can help you! May is National Speech and Hearing Month. Let us celebrate to raise public awareness of speech and language disorders that affect 14 million Americans. Contact our therapy department for more information about Speech Language Pathology.