Dysphagia Levels

Dysphagia Chart

Older Version:


Level 1 – Pureed (Most impaired)

  • For individuals with moderate to severe swallowing difficulty.
  • Poor jaw or tongue control, and delayed swallow.
  • Pureed allows extra time for the swallow response to trigger.
  • No course textures are allowed.
  • No mastication is allowed.
  • Advance to next level as soon as possible.
  • Examples: pudding, pureed foods, hummus.

Level 2 – Mechanical Soft

  • For individuals with mild to moderate swallowing difficulties.
  • Some rotary chewing with tongue control, but a minimally delayed swallow.
  • Examples: scrambled eggs, meatloaf, well-cooked vegetables, pancakes, mashed potatoes, canned/cooked soft fruits.

Level 3 – Advanced

  • For individuals able to chew with adequate oral motor skills.
  • 1 step down from a regular diet.
  • Examples: bread slices, muffins, moistened cereals, pasta, baked potatoes, soft/ripe fruits, fish.

Level 4 (Regular)

  • Includes all foods.


Spoon-thick (Most impaired)

  • Commercial thickener


  • Nectar thickened with banana, nectar thickened with pureed fruit, regular applesauce with juice, eggnog with baby cereal, creamed soap with mashed potatoes, commercial thickener.


  • Examples: nectars, extra-thick milkshake, extra-thick eggnog, strained creamed soups, yogurt and milk blended, V-8 juice.


  • Examples: water, coffee, tea, milk, hot chocolate, fruit juices, broth, gelatin dessert, ice cream, sherbet.
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