Some health professionals are in favour of products with artificial sweeteners which do not contribute to tooth decay, especially for those people with a tendency towards obesity. Others have concerns about the metabolism of sweeteners – particularly of aspartame – in children with syndromes which may compromise the
phenylalanine-tyrosine-dopamine-serotonin metabolic pathway. Aspartame causes significant increases in plasma phenylalanine, and probably brain phenylalanine, and therefore has the potential to interfere with neurotransmitter production.28There is also some concern that, if people get used to sweet tastes through the
use of artificially sweetened foods, this will not help them to make long-term, permanent, beneficial changes to their diet to reduce high intakes of sugar. Moderation in the use of artificial sweeteners and in the amount of artificially sweetened foods and drinks included in the diet would therefore seem prudent.
Constipation
● All those who support people with learning disabilities should be alert to signs which may indicate
constipation, such as a reluctance to go to the toilet, obvious discomfort, long periods spent in the toilet, a change in eating habits, unexplained diarrhoea, food refusal, or unexplained challenging behaviour.
● To avoid constipation it is important that adults are as mobile as possible, have sufficient fluid and have sufficient fibre in their diet. Children and young people who are constipated should seek advice from a dietitian or medical practitioner on the amount of fluid and fibre appropriate to their needs.
Dysphagia (swallowing difficulties)
● Dysphagia should always be considered when there are unexplained eating or breathing difficulties, changes in eating patterns, distress associated with eating, or recurrent chest infections.
● Those who are at high risk of dysphagia should be assessed for vulnerability and their care plans updated accordingly. The involvement of a speech and language therapist with specialist knowledge of swallowing disorders is critical in creating a management strategy and in training the person himself or herself, as well as his or her family, friends or support staff.
● Medication reviews of a person with dysphagia should take into account swallowing difficulties, as the person may be unable to swallow tablets or other medication or supplements.
Oral health
● All children, young people and adults with learning disabilities should visit the dentist twice a year.
● Cutting down on the amount of sugar eaten, and on how frequently sugary foods and drinks are consumed throughout the day, will help to prevent dental decay.
● Good daily oral hygiene is essential, including brushing the teeth twice a day with fluoride toothpaste. Children under the age of 8 years and anyone who may have difficulty in brushing their teeth independently should be helped when brushing their teeth.
● Support staff should be offered training on the importance of oral health and how to help someone clean their teeth.
● All those who support people with learning disabilities should be alert to changes in behaviour such as loss of appetite, unwillingness to participate in activities, sleeplessness, irritability or self-harm, and should find out if mouth or tooth pain is a possible cause of the behaviour change.
References
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