Originally broadcast on Thursday, March 25th
Webinar Description:
Your mouth may be a cesspool of up to 10 trillion bacterial organisms, but the research on how your oral health impacts your overall health is abundant as well!
This oral infection control talk will be general enough for caregivers and people who struggle with dysphagia, while also being advanced enough for speech-language pathologists (SLPs) who specialize in swallowing and swallowing disorders. We will start with an introduction to dysphagia in a person-centered approach, where we balance safety issues (aspiration and airway protection) and efficiency concerns (residue leftover after the swallow) with the person’s goals and quality of life.
SLPs have been learning from research for years that not all aspiration events lead to pneumonia. There is a complex recipe that can brew aspiration pneumonia, and a bacteria-laden-nasty oral cavity is a key ingredient. When aspiration is mixed with bad bacteria from poor oral health (which can be made worse by a dependence on others to disinfect the mouth, dental disease, and dry mouth from many medications or radiation) and put into a vessel/person with a decreased immune response, then the risk for aspiration pneumonia is much higher. The host person’s ability to fight off infection may also be reduced from frailty, bedridden, decreased mobility, poor nutrition/hydration, medications, chronic diseases, acute stressors, and/or acute critical illness. Therefore, we really have to target where we can have the most impact → the mouth.
Research on this dates back to at least 1975 and has supported the use of aggressive oral decontamination to prevent infection. So, why have busy healthcare routines not changed to include thorough oral infection control practices? Is it because we have always viewed cleaning the mouth as “oral care,” similar to combing the hair? It is time we start using the terms: “oral infection control” and “oral decontamination.” Preventative measures are as important for community dwellers as they are for people in institutions. Thorough oral infection control is as crucial for someone who is NPO (not eating by mouth) as it is for the person who wants to consume their favorite foods and drinks despite an “aspiration risk.”
Learner Goals
- Discuss research studies on how good oral hygiene/oral infection control practices can help prevent aspiration pneumonia.
- List characteristics of saliva and a healthy versus altered microbiome (discussing biofilm and gram-negative bacteria).
- Understand how video examples and pictures may strengthen your case to improve oral infection control practices in your home or facility.
- Implement simple tests of the oral cavity that can be performed by caregivers and healthcare providers.
- Perform necessary steps for oral decontamination (when the oral microbiome is already altered) and oral infection control (ongoing preventative measures).
Meet the Presenter: Karen Sheffler, MS, CCC-SLP, BCS-S

Karen Sheffler has over 23 years of experience as a medical speech-language pathologist, specializing in dysphagia since 1995, when she graduated from the University of Wisconsin-Madison. She has had her Board Certification as a Swallowing Specialist (BCS-S) since 2012. In 2014, she started SwallowStudy.com, which is a dysphagia resource for people with difficulty swallowing and professionals. Karen has worked in acute care, rehabilitation centers, skilled nursing facilities, and in home-health care. She currently works at Beth Israel Deaconess Medical Center in Boston and owns her own dysphagia consulting business. She crafts lectures/webinars, performs peer-reviews, and provides dysphagia expert services to companies and law firms. Believing in constant continuing education, she has been awarded the ASHA Award for Continuing Education 7 times. She was awarded the Hormel Health Hero Award in 2019. She is a member of ASHA’s Special Interest Group 13, the National Foundation of Swallowing Disorders (NFOSD), and the Dysphagia Research Society (DRS). Currently, she co-chairs the Public Relations & Communications Committee for the American Board of Swallowing and Swallowing Disorders (ABSSD). She has been promoting IDDSI since 2014, she became an IDDSI champion in 2016, and now she is a member of the US & Territories IDDSI Expert Reference Group (USTIRG).
CEUs: No ASHA CEUs are offered for this webinar.
Cost: FREE. This webinar has been made free to all registrants. We recognize the financial hardship that is impacting many people due to the pandemic. As a non-profit, we feel this too. If you would like to make a donation, please visit our Donation Page.
The NFOSD wants to thank Bracco Diagnostics for their unrestricted educational grant.
