ArticleAmerican journal of speech-language pathology2022
Bolus Texture Testing as a Clinical Method for Evaluating Food Oral Processing and Choking Risk: A Pilot Study.
Article in American journal of speech-language pathology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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Who cites it
4 citing papers in PubMed.
- What About Foods? The Influence of Food Texture on the Safety, Timing, Kinematics, and Efficiency of Pharyngeal Phase Swallowing in Healthy Adults.Journal of speech, language, and hearing research : JSLHR · 2026Article
- Automated detection of chewing movements in videofluoroscopic swallowing studies using deep learning for landmark detection and motion analysis.Computers in biology and medicine · 2026Article
- Textural Flow Analysis of United States Commercially Available Baby Foods: Packaging and Delivery Method Comparisons by the International Dysphagia Diet Standardization Initiative Framework.Foods (Basel, Switzerland) · 2025Article
- A Preliminary Study of Vallecular Bolus Aggregation in Healthy Swallowing of Solid Food Boluses.Journal of speech, language, and hearing research : JSLHR · 2024Article
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Authors and funding
4 authors.
Funding
Abstract
purposeChoking on food is a leading cause of accidental death in several populations, including children, people with intellectual/developmental disability, and older adults in residential care facilities. One contributor to choking risk is incomplete oral processing and failure to convert food to a cohesive, nonsticky bolus with a maximum particle size that will not block the airway. Clinical tests of mastication do not evaluate properties of chewed food boluses. We characterized expectorated boluses, after oral processing, using methods developed by the International Dysphagia Diet Standardisation Initiative (IDDSI).
methodSeventeen adults without dysphagia (seven women and 10 men), aged 23-55 years, chewed samples of a cracker, a raw baby carrot, and a circular, dome-shaped gummy candy. Chewing metrics were obtained up to the point when the person indicated that they were ready to swallow. The bolus was then either expectorated or swallowed; IDDSI tests were used to characterize the expectorated boluses.
resultsMeasures of chewing did not differ between spit and swallow conditions. Expectorated cracker and carrot boluses had maximum particle size consistent with IDDSI Level SB6 Soft & Bite-Sized foods or lower. The gummy candy samples remained at IDDSI Level RG7 Regular food consistency.
conclusionsThis study suggests that expectorated ready-to-swallow boluses are representative of boluses that are swallowed and that oral processing in adults without dysphagia typically results in boluses at IDDSI's Level SB6 or lower. IDDSI's testing methods provide a practical method for evaluating oral processing by characterizing expectorated ready-to-swallow boluses and may guide food texture recommendations for persons who have increased risk of choking.
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