Abstract
Patients with mental disorders are reported to be at a high risk of choking. The provision of health education by a medical team to patients, including management of the oral cavity and nutrition, facilitates self-management of the oral cavity and helps prevent the recurrence of choking and aspiration pneumonia.
The patient was a 65-year-old man admitted to the acute stage ward for treatment of bipolar disorder and alcohol dependence. The patient underwent a dental checkup to be assessed for the risk of food-related aspiration and choking. We diagnosed dysphagia owing to masticatory disturbance caused by his lowered consciousness level and mental state. Symptoms of extrapyramidal tract disorder were noted, and attention was then focused on management of the patientʼs dental hygiene and oral function.
The consumption of bread was prohibited, owing to the associated high risk of aspiration and choking. The patient was advised not to put too much food in his mouth when eating.
However, one month later the patient was readmitted to hospital having choked on his food；2 days later he was diagnosed with aspiration pneumonia.
After improvement in the patientʼs mental state, he became receptive to following medical advice concerning his problem, and a partial set of dentures was made for him.
Twenty-four months from this last choking episode, the patient has had no recurrence of choking or aspiration pneumonia. He is receiving medical treatment at the outpatient clinic. The continuous support of team medical care for neuropsychiatry hospital inpatients is important for preventing the recurrence of choking and aspiration pneumonia.
