Which outcome best indicates improvement in swallowing safety after therapy aimed at improving oral containment?

• A. Fewer coughing episodes during meals
• B. Increased saliva
• C. Greater appetite
• D. Faster bolus transit

Answer: (A)

Improved swallowing safety after therapy aimed at improving oral containment is shown most clearly by a decrease in coughing during meals. When the bolus is better contained in the mouth, less material spills into the pharynx and airway. Coughing during meals is a common sign that material has entered the airway or caused irritation, prompting a protective reflex. Fewer coughs indicate that airway protection has improved and the swallow is safer.

Other options don’t directly measure safety: more saliva can aid lubrication but doesn’t guarantee safer containment; greater appetite is unrelated to airway protection; faster bolus transit might improve efficiency but could compromise safety if coordination isn’t maintained.