Texture modified diet - puree and bread - dental

Aim

To provide a diet of pureed or mashed foods and bread for patients unable to chew or manage a minced consistency.

Characteristics

Most foods to be mashed or pureed. Soft sliced bread is allowed. This diet texture can be applied to any portion size and most therapeutic diets.

Indications

• painful mouth, gums or tongue (e.g. severe mouth ulcers, or following surgery of the mouth)
• poor dentition or no dentures

Contraindication

Dysphagia.

Nutritional adequacy

Nutritionally adequate, but may be low in dietary fibre. Patients ordered this diet should be monitored regularly to ensure adequate dietary intake.

Precautions

Not designed for patients with dysphagia (see Smooth puree – Dysphagia).

Paediatrics

Suitable for use in paediatrics when combined with an age-appropriate diet.

Specific menu planning guidelines

	Allowed	Not allowed
Hot main dishes	All, pureed and served with gravy Flaked fish with sauce	-
Sauces, gravies	All	-
Starchy vegetables / pasta / rice	All, pureed or mashed	All others
Vegetables	All, pureed or mashed Added milk and margarine may be used to increase energy density	-
Soups	All, pureed	-
Sandwiches	None	-
Salads, dressings	None	-
Breads, cereals	Soft sliced bread Rolled oats, rice cereal, semolina, Weet-Bix™ with hot milk Unprocessed bran may be stirred into moist cereal to increase fibre	Bread with seeds or fruit; bread rolls Other cereals
Spreads	Jam, honey, Vegemite™	Peanut butter
Hot breakfast choices	Scrambled eggs, pureed baked beans or pureed canned spaghetti	All others
Fruit	All fruit, pureed and no seeds	All other fruit
Yoghurt	All smooth yoghurts and yoghurt-like desserts (e.g. Frûche®)	Yoghurt with fruit pieces
Desserts	Smooth custards, mousses, ice-cream, jelly, soft puddings	All others, including cakes and pastries
Milk and cheese	All milk Soft cheeses (e.g. cottage cheese)	Semi-hard and hard cheeses
Beverages	Tea, coffee, cordial, soft drink, milk, fruit juice without pulp/seeds	Beverages with visible pulp, seeds or lumps
Biscuits	Easily crumbled biscuits, e.g. shortbread, Milk Arrowroot™, Milk Coffee™	Hard biscuits and crackers (e.g. Anzac biscuits, Ginger Nut™)
Miscellaneous	Liquid or pudding nutrition supplements Cream, pepper, salt, sugar, sweetener	Dried fruit, nuts, seeds and coconut. Lollies

References

1. Agency for Clinical Innovation. Nutrition standards for adult inpatients in NSW hospitals. Sydney: ACI; 2011.
2. Dietitians Association of Australia. Nutrition manual. 9th ed. Canberra: DAA; 2014.