Component 1: Lip Closure: Scoring Examples
Component 1: Lip Closure: Scoring Examples
Component 1: Lip Closure: Scoring Examples
1: Lip Closure
Lip Closure assesses the ability to seal the bolus within the anterior oral cavity. Like all other
components, lip closure is based on what is observable on the MBS video. Score the presence and
location of bolus material seen between or outside of the lip seal on the videofluorographic view. The
scores for this item are based on the location of all or a part of the contrast material seen during any
point of the swallow. While assessing this component is certainly easier in a true clinical situation
wherein you have a direct visual of the patient, this component should only be scored based on what
you see on the MBS video. It is best assessed using both “full screen” mode and using the “frame-by-
frame step" function.
SCORING EXAMPLES:
The following images are intended to help you differentiate between impaired Lip Closure scores 0-4:
(0) Contrast is contained within the oral cavity with no evidence of escape beyond the oral mucosa into
the interlabial space.
(1) A trace amount of contrast outlining the interlabial space but with no progression to the anterior lip:
(2) Escape from the interlabial space or lateral juncture onto but not beyond the vermillion boarder of
the LOWER lip:
(3) Escape of contrast material that progresses beyond the vermillion border of the lower lip to the mid
chin:
(4) Profuse escape between open lips beyond the chin regardless of the bolus consistency or swallow
task:
FREQUENT SCORING ERRORS
The videofluorographic image below shows increased lip density with the lips fully compressed. This
increase in density is similar in appearance to a Lip Closure score of (1), interlabial escape. By moving
forward several frames until the lips decompress, one is able to determine the presence or absence of
contrast. In this case, there is an absence and this individual would receive a Lip Closure score of (0),
no labial escape.