The Side Biter™ FAQs
Why does the plunger have to be wet to work properly?
The Side Biter™ was engineered to make a very tight fit in the handle to keep all the food inside the biter tip. In order to avoid food loss into the handle and allow the plunger to slide in, it requires some moisture for it to slide in easily. You can use natural food juices, broth, gravy, sauces, butter, water or vegetable oil. The plunger will slide in and lock well when 5 ml (1 teaspoon) or less food is inserted. SEE DEMO VIDEOS.
Can I make this tool cold to use in thermal stimulation with adults?
Yes, The Side Biter™ can be used with frozen juices or food for adult and pediatric patients. The sensory aspect of cold temperature can be very helpful in alerting the oral and pharyngeal muscular to react to tactile stimulation. Level 1 (0 holes) can be filled with juice or water and frozen.
Levels 2 and 3 can be used with frozen foods (i.e., fruit, pancakes, cake).
Avoid ice cream if patient is at aspiration risk for thin liquid.
Make sure to remove the plunger when freezing.
CLICK HERE to see video demonstration of The Side Biter™ with frozen food.
How do you know how much food to load inside The Side Biter™?
The total amount that the patient can get from the biter tips with holes (Level 2 and 3) is 5 ml (1 teaspoon). There should be enough room for the damp plunger to insert, twist and lock at the bottom. If it is too full the pressure of the patient chewing can push on the plunger. You will want to avoid overfilling the biter so the patient can have success chewing, collapsing the biter and eating the food.
Can you give me some ideas about kinds of food that could go into The Side Biter™?
The therapist must use clinical judgement to select the food for the chewing practice using The Side Biter™. The food that the therapist uses will depend on the data from the complete feeding-swallowing assessment for the patient.
Patients who have oral or pharyngeal dysphagia will require precautions for thin liquids and seeds that could leak from the biter tip.
The food should be based upon the patient’s oral and pharyngeal abilities, interest, culture and tolerance.
Be aware of food allergies as well.
Examples of food that I have used in treatment that is gradually released from the biter without excessive liquids includes (but not limited to): pancakes, deli meats, french fries, pasta, cheese, cooked meats, fish, cooked veggies, pie, cake, cookies, muffins, french toast, chicken salad, egg salad, pizza, peanut butter toast, donuts, corned beef hash, scrambled egg, shellfish, tofu, chicken nuggets and hot dogs.
If liquids are not an issue for the patient you can use any food. Fruit and berries can offer flavorful chewing-swallowing practice for those who can tolerate these textures.
What food should I avoid while using The Side Biter™?
The Side Biter™ is not recommended for chewing hard, sharp foods like nuts, seeds, granola, pretzels, popcorn and corn chips. However, crunchy foods can be crushed and used such as cereals, crackers, raw fruit and veggies.
Again, avoid excessively juicy foods if the patient has aspiration risk for thin liquids. These excessively wet, juicy foods include (but not limited to): fruit cocktail, oranges, kiwi, grapes, pears, peaches, berries, pineapple, soups and casseroles.
Does the patient have to be able to hold The Side Biter™?
No, this is not necessary. The clinician can hold the tool for the patient while guiding them to chew, then remove the tool from their mouth so they can activate a swallow.
Ensure that the patient is in a safe seated position prior to use. The clinician can place the biter tip on the biting surfaces of the molars with the holes angled toward desired locations in the mouth: inner cheeks, upper/lower molars or tongue.
See an OT for recommended adaptations to assist the patient in holding the Side Biter. One type that I have used with The Side Biter™ can be found on
Why does Level 1 have ZERO holes?
Level 1 was designed for patients with severe medical complications and aspiration may not be safe eating food but still benefit from chewing practice with actual food inside the tool.
Flavorings can be added to the outside of the “sham bolus” to give the sensory experience of eating in a therapeutic setting. Patients with severe sensory processing impairments or food aversions may be able to accept food into their mouth while chewing from a biter with ZERO holes that does not allow texture or flavors. The patient can experience the look, feel and sound of certain foods without the texture or flavors until they progress in their feeding therapy.