gastrointestinal disorders
Dysphagia
Geriatrics Essentials: Dysphagia
Chewing, swallowing, tasting, and communicating require intact, coordinated neuromuscular function in the mouth, face, and neck. Oral motor function in particular declines measurably with aging, even in healthy people. Decline in function may have many manifestations: Reduction in masticatory muscle strength and coordination is common, especially among patients with partial or complete dentures, and may lead to a tendency to swallow larger food particles, which can increase the risk of choking or aspiration. Drooping of the lower face and lips caused by decreased circumoral muscle tone and, in edentulous people, reduced bone support, is an aesthetic concern and can lead to drooling, spilling of food and liquids, and difficulty closing the lips while eating, sleeping, or resting. Sialorrhea (saliva leakage) is often the first symptom. Swallowing difficulties increase. It takes longer to move food from mouth to oropharynx, which increases the likelihood of aspiration. After age-related changes, the most common causes of oral motor disorders are neuromuscular disorders (eg, Diabetic Neuropathy , Oral motor dysfunction is best managed with a multidisciplinary approach. Coordinated referrals to specialists in prosthetic dentistry, rehabilitative medicine, speech pathology, otolaryngology, and gastroenterology may be needed. 