TIMS University Webinar
Oral Status, Mastication, and Swallowing Performance During MBSS
August 25, 2026 at 8:00 PM EST | 0.1 ASHA CEUS / 1 PDH
Course Instructor
Dr. Reva Barewal
Dr. Reva Barewal is a prosthodontist, clinical researcher, French-trained chef, and founder of Savorease Therapeutic Foods, where she leads the development of functional textures for individuals with dysphagia. She has more than two decades of experience in prosthodontics and oral rehabilitation and has lectured nationally and internationally on prosthodontics, dental implants, and sleep-disordered breathing. She previously held faculty appointments at Oregon Health & Science University in both the School of Dentistry and the School of Medicine.
Her research career includes clinical studies in dental implant stability and peer-reviewed publications examining transitional-food behavior in the oral environment, instrumental swallowing performance across food textures, and the nutritional application of sensory-enhanced foods. Her translational work bridges prosthodontics, swallowing physiology, food science, and neurorehabilitation, with a particular focus on how oral conditions, mastication, and food structure influence swallowing performance.
Disclosures
Financial: Dr. Barewal is the founder and owner of Savorease Therapeutic Foods, which develops functional-texture products for individuals with dysphagia. Products developed by the company may appear in published research and clinical examples presented during this course. She receives compensation as a clinical consultant and speaker.
Nonfinancial: Dr. Barewal serves as a voluntary member of the IDDSI U.S. and Territories Reference Group in an educational capacity.
Course Information
Description
Speech-language pathologists frequently observe prolonged mastication, disorganized bolus preparation, piecemeal transfer, delayed initiation, multiple swallows, or residue during modified barium swallow studies. These findings may reflect neurologic impairment, but oral-phase performance is also influenced by dentition, denture stability, posterior occlusal support, palatal contour, salivary conditions, pain, and the physical demands of the food being tested. Oral-phase impairment is therefore often multifactorial.
Mastication is not simply the mechanical breakdown of food. It is a coordinated sensory-motor activity that regulates force, particle reduction, lubrication, bolus cohesion, and the timing and quality of bolus delivery to the pharynx. When oral preparation is compromised, the pharynx may receive a bolus that is poorly organized, inadequately lubricated, less cohesive, or delivered under greater effort. Delayed initiation, increased residue, repeated clearing swallows, and reduced efficiency may therefore reflect both primary pharyngeal impairment and the downstream consequences of suboptimal oral preparation. Oral and pharyngeal findings should be interpreted as parts of an integrated swallowing system rather than as isolated phases.
This presentation introduces a task-demand approach to interpreting mastication and swallowing performance during MBSS. Participants will examine how absent posterior support, missing or unstable dentures, altered tongue–palate relationships, xerostomia, and differing food structures may influence bite acquisition, chewing rhythm, bolus formation, lingual transport, oral clearance, and downstream pharyngeal observations. Comparisons among puree, high-dissolving functional textures, and conventional solids will illustrate how food selection changes the oral task and may provide additional information about patient performance.
Participants will learn how to integrate oral status, medical history, oral-motor findings, food-texture demand, and instrumental observations; recognize when absent or inadequate dentition limits interpretation; and determine when additional texture trials may be warranted.
Learning Outcomes
Analyze how dentition, denture stability, posterior occlusal support, salivary conditions, and mastication influence oral preparation and downstream swallowing observations during MBSS.
Compare bolus preparation, transport, residue, and clearance across puree, high-dissolving functional textures, and conventional solids to determine how food-texture demand affects observed performance.
Integrate oral and prosthetic status with oral-motor findings to identify likely contributors to observed swallowing performance during MBSS.
Agenda
8:00 - 8:05 PM Introduction and practice gap: why oral status is often underexamined during MBSS
8:05 - 8:15 PM What SLPs need to know about oral status: dentition, posterior occlusal support, denture stability, palatal contour, tongue space, saliva, and pain
8:15 - 8:25 PM Masticatory movement versus effective mastication
8:25 – 8:40 PM What oral-phase impairment can look like downstream
8:40 - 8:55 PM Applying a masticatory assessment framework during MBSS: oral architecture, sensorimotor capacity, and texture demand
8:55 - 9:00 PM Summary and Q&A
Satisfactory Course Completion Requirements
To successfully complete the course, participants must attend the entire live event and submit the post-course survey.
