Huang Shun-Te
PhD, DDS, Emeritus Professor, Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, and Attending Physician, Division of Special Care Dentistry and Pediatric Dentistry, Kaohsiung Medical University Hospital, and President, Taiwan Association for Dental Health, Taiwan, ROC.
Hu Li Za Zhi. 2020 Aug;67(4):14-23. doi: 10.6224/JN.202008_67(4).03.
Persons with dysphagia have difficulties chewing and swallowing food because of functional, structural, or psychological reasons. Dysphagia may cause choking or the inhalation of food into the trachea and lungs. Patients with dysphagia often induce the coughing reflex when drinking water and brushing teeth and tend to suffer from gum bleeding. As a result, their caregivers tend to reduce the frequency of or discontinue teeth brushing, which promotes the spread of periodontal disease, dental caries, and oropharyngeal secretions colonizing in the oral cavity or throat. When a patient suffers a choking attack or aspiration, bacteria is inhaled into the trachea and lungs, causing aspiration pneumonia. Furthermore, patients with choking issues are often be fitted with nasogastric tubes to facilitate the delivery of nutrients and water. Long-term use of nasogastric tubes also significantly increases the risk of aspiration pneumonia. Adjusting eating posture, improving food texture, conducting swallowing rehabilitation, providing training, and practicing proper oral care are an effective approach to preventing the onset of chewing and swallowing disorders and aspiration pneumonia.
吞咽困难的人由于功能、结构或心理原因,在咀嚼和吞咽食物方面存在困难。吞咽困难可能导致窒息或将食物吸入气管和肺部。吞咽困难的患者在饮水和刷牙时常常引发咳嗽反射,并且容易牙龈出血。因此,他们的护理人员往往会减少刷牙频率或停止刷牙,这会促使牙周疾病、龋齿以及在口腔或喉咙中定植的口咽分泌物扩散。当患者发生窒息发作或误吸时,细菌会被吸入气管和肺部,引发吸入性肺炎。此外,有窒息问题的患者通常会安装鼻胃管以方便输送营养物质和水。长期使用鼻胃管也会显著增加吸入性肺炎的风险。调整进食姿势、改善食物质地、进行吞咽康复训练、提供培训以及实施适当的口腔护理是预防咀嚼和吞咽障碍以及吸入性肺炎发作的有效方法。