Examination of Changes in the Oral Environment with the Intake of Concentrated Liquid Foods in Four Persons with Severe Motor and Intellectual Disabilities

Abstract

Individuals with severe motor and intellectual disabilities (SMID) commonly present with serious swallowing impairment. Comorbidities such as aspiration pneumonia and difficulties managing nutrition are frequently encountered. In these cases, oral food intake is difficult, and tube feeding is common. Decreased muscle strength can lead to increased severity of the swallowing impairment. Attention should be paid to the form and nutritional aspects of food in order to maintain oral intake. Small amounts of high-density liquid foods are frequently used to compensate for insufficient nutrients and calorie intake. However, many of these products have high sugar content, which might be detrimental to oral health. There are few reports on the effects of high-density liquid food products on the oral cavity, or particularly, the teeth. This comparative study aimed to investigate the dental risks in four subjects who were admitted to our hospital’s ward dedicated to SMID, where high-density liquid food products were administered due to a decline in their systemic functions.

The development of caries following the introduction of a high-density liquid food diet was observed in three of the four subjects. These findings indicate that the consumption of high-density liquid food products could affect the teeth of individuals with SMID. Caries is known to repeatedly develop in patients with irregular dentition due to difficulties in cleaning the oral cavity, an increase in the number of bacteria (owing to eating and swallowing impairments), and the use of a thickening agent. The risk of caries is likely to increase due to a combination of these conditions, eventually leading to worsening of the oral environment.