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swallowing choking issues
Posted: Wednesday, June 21, 2017 7:31 PM
Joined: 9/12/2013
Posts: 3608

Bill mentioned in a post that he has to SIT to take a pill because he chokes if standing up.

When I brush my teeth (standing) I choke on the tooth paste foam, and if I skip the toothpaste then rinsing makes me choke. I have practically inhaled fluids.

Tonight I am going to try sitting while I brush my  teeth and see if that eliminates the choking.

There was something else, chin down? any tips on dealing with problems swallowing appreciated.

Iris L.
Posted: Thursday, June 22, 2017 12:15 AM
Joined: 12/15/2011
Posts: 18713

From what I read when I googled "choking while brushing teeth," there may be mucus in the naso-pharyngeal area and sinuses.  Perhaps you can try to blow your nose and clear your throat and sinuses and rinse before beginning to brush.  Many people have allergies and mucus pools overnight while they sleep.  I know that I can be somewhat congested in the mornings, but I don't have the choking problem.  Now that you mention it, since I began allergy shots, I don't have the morning congestion any more.

Iris L.

Posted: Thursday, June 22, 2017 4:41 AM
Joined: 5/20/2014
Posts: 4408

Head down so water can run out of mouth. Here some tips.

. Maintain proper positioning: During oral care, the individual and staff should be in the same position as during mealtime or standing. If the individual is able to lean safely forward, then this is an option as it will help saliva and excess water flow from the mouth.

 6. Ensure appropriate fluids: Provide liquids during oral care that matches mealtime fluid consistency. 

7. Determine adequacy of dental equipment: Consult with dentist or physician, to determine if the individual would benefit from suction tooth brushing, or other adaptive equipment (nosey cup, collis curve or electric tooth brush). 

8. Additional Brushing Techniques: • A small headed toothbrush or a youth sized brush is preferable. Using this sized toothbrush will improve manipulation within the mouth during brushing. 

• There are three surfaces on the teeth that must be cleaned. Teeth surfaces touching the lips and cheeks, teeth surfaces towards the tongue, and the chewing surfaces of the molar, posterior teeth. A Collis Curve toothbrush may be helpful f in assisting someone who is sensitive to tooth brushing. 

• The toothbrush should be placed at a 45 degree angle against the tooth towards the person’s gum line and brush with short back and forth movements (this technique is most effective at cleaning teeth at the gum line) on all three surfaces of the tooth for at least 5 seconds per tooth. For all teeth surfaces to be thoroughly cleaned tooth brushing should last approximately 2 minutes. 

• Make it a habit to brush one quadrant of teeth, give person time to breathe and swallow and then brush the second quadrant of teeth followed by a break and so on until all 4 quadrants are cleaned. 

• If an individual will not allow brushing for two minutes consistently, take advantage of the occurrences in which they will allow more time inside their mouth with thorough brushing. 

9. People who can help assist with development of proper oral care guidelines: • Dentist and Dental Hygienist: Brushing techniques, medications 

• Occupational Therapist: Adaptive oral care equipment, and individual/staff positioning • Speech Therapist: Adaptive oral care equipment and swallowing techniques/strategies • Nurse: Suction tooth brushing, administration of medications

Posted: Thursday, June 22, 2017 4:45 AM
Joined: 5/20/2014
Posts: 4408

Common Foods Identified as "High Risk" for Choking

  • Hotdogs served whole
  • Chicken on the bone
  • Grapes
  • Peanut butter
  • Peanut butter sandwiches on soft bread
  • Thick chewy bread, e.g. white bread, bagels, pizza, etc.
  • Marshmallows
  • Dry, crumbly foods such as cornbread or rice served without butter, jelly, sauce, etc.
  • Dry meats such as ground beef served without sauce, gravy
  • Whole, raw vegetables served in large bite-sized pieces
  • Whole hard fruits like apples or pears
  • Candy with large nuts
  • Hard nuts

Posted: Thursday, June 22, 2017 7:35 PM
Joined: 9/12/2013
Posts: 3608

I sat down and did not choke.


Thanks for the tips!

 I think it is muscular confusion, where I have to think about fluids in my mouth instead of it just going down or spitting it out - without thought like the old days.

Also confusion about breathing while brushing. I am using a sonicare with tiny head. I still repulsedby the sound of it and the vibration.

Posted: Thursday, June 22, 2017 8:19 PM
Joined: 11/28/2016
Posts: 128

alz+, have you changed toothpaste lately by any chance?

I've had a couple of swallow episodes lately (I'm non-PWD) and I realized that

 1) I wasn't keeping my lips closed and so I was breathing in through my mouth at the same time, which is related to

2) the toothpaste I use (Costco Kirkland brand) has a slight, or so I thought, minty taste.

Breathing through my mouth with the toothpaste bubbling inside made the minty part emphasized and gave me a choking sensation.

I'm going to change back to Sensodyne to see if that makes a difference.