Therapeutic instructions & tips for use of The Side Biter & The Mini Biter
Essential: Complete a comprehensive feeding-swallowing assessment to determine the patient’s level of eating abilities prior to implementing The Gnosh, Inc therapeutic chewing tools. Professional implementation and supervision is required.
Individual Use: It is recommended that these tools be implemented with a skilled dysphagia professional for individual patient use only. Use across patients can spread germs and harm our most fragile patients.
Cleaning: Thoroughly clean tool using the scrub brush using hot soapy water. Wash the handle, plunger and the silicone cylinders using the brush included and hot soapy water prior to and after each use. The tools are dishwasher safe and can be boiled for up to 10 minutes. Air dry each section separately. Store in a clean, dry container labeled with patient identification.
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Therapeutic Instructions:
Important: For best results keep the plunger wet with water, butter, oil, broth or juice. Slide the wet plunger into the handle to press food to the biting tip
1. All Gnosh, Inc chewing and swallowing exercise tools can be used with or without food. The side Biter holds 5 ml and the Mini Biter holds 2.5 ml of food. Therapist selects the biting tip that functionally supports the patient’s level of chewing and swallowing abilities.
2. Therapist cuts (food scissors are very effective) food into strips, adds flavor and moisture to the plunger and the biting tip and inserts food into the silicone cylinder that best supports the patient’s therapeutic chewing and swallowing based upon the professional feeding-dysphagia assessment. Diced or frozen food fits securely in the tip. See aditional videos demonstrating frozen food. Model the exercises that you desire for your patients.
Do not use with nuts, seeds, granola or other sharp foods.
These foods will tear the silicone & enter the mouth
3. For best results keep the plunger wet with water, butter, oil, broth or juice. Slide the wet plunger into the handle to press food to the biting tip. Allow patients to handle the food and participate as much as possible.
4. TWIST the plunger to LOCK plunger tabs securely to the base of tool. This will allow food into the biting tip so that food with slowly come out of the holes. Squeeze the biting tip and/or add food flavors to the outside of the biting tip to entice tongue, lip, jaw and tooth contact to promote licking, sucking, biting and chewing that cues swallowing of flavorful or diced or frozen foods.
5. Prompt patient to look at the food and then position tool onto molar surfaces for chewing practice in skilled feeding-swallowing therapy. Cue the patient to take the biter out of the mouth, sweep tongue and swallow.
6. Allow patients to handle the food and participate as much as possible. Patients can be cued to hold (if able) the tool with diced food inside in place on the molar surfaces or is given professional physical guidance to bite, chew and swallow in skilled dysphagia therapy. 1 teaspoon amount of food fits into the biting tip.
7. Therapist upgrades the biting cylinder levels based upon their skilled assessment of the patient’s oral and pharyngeal abilities. RE-fill the biter as patient tolerates the eating exercises.
8. Therapist trains the patient as they progress through the biting cylinder levels. Levels are upgraded as the patient improves chewing, eating and swallowing skills.
9. Once the therapist has determined safe, effective chewing and swallowing skills, then the patient can progress to other foods and textures (outside the biter) under skilled supervision of a feeding-swallowing clinician.
10. Wash all attachments thoroughly with hot, soapy water using the scrub brush after use. Boil 10 minutes or use dishwasher. Dry all parts SEPARATELY.
IMPORTANT: All tools were designed to be used therapeutically NOT as a spoon or feeder. Prolonged chewing may cause damage to the silicone.
Immediately replace any cylinder or accessory that shows wear or tear. Buy replacement parts HERE, as needed.
Watch Videos on How to Use and Wash the Gnosh, Inc tools HERE
When to Use The Side Biter Level 1
The Side Biter Level 1 is a “sham bolus” cylinder that has no holes. The individual patient who is unsafe to eat food, based upon medical complications can use this with supervision.
The patient can see and feel the food inside during chewing practice in dysphagia therapy. No food flavor or fragments can enter the mouth.
Do not use with nuts, seeds or other sharp foods.
When to Use The Side Biter Level 2
The Side Biter Level 2 cylinder is specially designed to allow a limited flavor and food particles to enter the mouth on one side of the device through 5 holes.
The holes allow limited food information to flow through the soft tip into the mouth as the patient chews on the cylinder. Holes are on one side to allow the therapist to guide the food to molars, inner cheeks or side of the tongue based upon their skilled assessment of patient needs.
Biting tip contains 1 teaspoon of food.
Do not use with nuts, seeds or other sharp foods.
When to Use The Side Biter Level 3
This clear silicone cylinder is specially designed to allow an increased amount of food, but still limited flavor and food particles to enter the mouth of the device through 10 holes.
The 10 holes allows a gradual increased amount, but still limited food information to flow through the soft tip into the mouth as the patient chews on the cylinder. Holes on the cylinder allow the therapist to guide the food to molars, inner cheeks or side of the tongue based upon skilled assessment of patient needs.
Biting tip contains 1 teaspoon of food.
Do not use with nuts, seeds or other sharp foods.