digestive disorders
Difficulty Swallowing
Essentials for Older People
Chewing, swallowing, tasting, and communicating require intact, coordinated neurologic and muscular function in the mouth, face, and neck. Oral motor function in particular declines measurably with age, even in healthy people. Decline in function may occur in several ways: As people age, the muscles required for chewing decrease in strength and coordination, especially among people with partial or complete dentures. This decrease may lead to a tendency to swallow larger food particles, which can increase the risk of choking or aspiration. With increased age, it takes longer to move food from the mouth to the throat, which increases the likelihood of aspiration. After age-related changes, the most common causes of oral motor disorders are neuromuscular disorders (such as cranial neuropathies caused by diabetes, stroke, Parkinson disease, amyotrophic lateral sclerosis, or multiple sclerosis). Sometimes, treatments can contribute to oral motor disorders. For example, drugs (such as anticholinergics or diuretics), radiation therapy to the head and neck, and chemotherapy can greatly impair saliva production. Reduced saliva production (hyposalivation) is a major cause of delayed and impaired swallowing. In addition to their regular doctor, people with oral motor disorders or dysfunction are also treated by specialists in prosthetic dentistry, rehabilitative medicine, speech pathology, otolaryngology, and gastroenterology. 