15 Foods That Can Be Difficult to Manage in Dysphagia

Some foods can be more challenging to manage due to their texture, dryness, or chewing requirements. Below are common examples to be aware of when supporting individuals with dysphagia.

1. Nuts

Hard and dry, requiring strong chewing and control.

2. Bread

Can be fibrous and form a sticky, dense ball in the mouth, making it harder to manage. Read: What IDDSI Level is Bread here.

3. Cornflakes

Crispy and can break into small pieces, which may be difficult to control.

4. Marshmallows

Soft but chewy and sticky, and can be difficult to break down and clear from the mouth.

5. Peanut Butter

Very sticky and can cling to the roof of the mouth or teeth.

6. Chewy Lollies and Candy

Require prolonged chewing and can be both chewy and sticky.

7. Seeds

Tough and fibrous, making them difficult to chew thoroughly.

8. Raw Celery

Stringy texture that can be hard to chew and swallow.

9. Steak

Requires significant chewing and may be difficult to break down fully.

10. Bacon

Often tough and crispy, which can make it harder to manage.

11. Grapes

Smooth and round, which can be harder to control in the mouth. The skin may also be difficult to manage for some individuals.

12. Popcorn

Can leave small pieces that are difficult to clear from the mouth.

13. Crackers and Dry Biscuits

Dry and crumbly, which can break into small pieces and be harder to control.

14. Pineapple

Fibrous and stringy, requiring more effort to chew and swallow.

15. Jelly (e.g. konjac jelly, firm jelly cups)

Smooth but can be slippery and difficult to control in the mouth.

Final Note

Understanding how different foods behave in the mouth is an important part of supporting individuals with dysphagia.

Some foods may appear soft or easy to eat but can still be difficult to manage safely due to factors such as dryness, stickiness, or texture. This is why food choices should always be guided by individual needs and recommendations from a speech pathologist.

It is also important to be mindful of mixed texture foods, such as cereal with milk or soup with solid pieces. These foods can be more challenging because they require the person to manage both liquid and solid at the same time, which can affect swallowing coordination.

Improving awareness of food textures through IDDSI training can help staff and carers make safer choices and support better mealtime safety