Background/Aims: Vitamin D deficiency is common in children with neurodisabilities. Oral vitamin D₃ may not be absorbed appropriately due to dysphagia and tube feeding. The aim of this study was to compare efficacy of vitamin D₃ buccal spray with that of oral drops. Methods: Twenty-four children with neurodisabilities (5–17 years) and vitamin D deficiency (25(OH)D ≤20 ng/mL) were randomized to receive vitamin D₃ buccal spray 800 IU/daily (n = 12) or oral drops 750 IU/daily (n = 12) for 3 months during winter. Results: Both groups had a significant increase in 25(OH)D (z = 150; p < 0.0001). The differences between baseline and final parathyroid hormone measurements did not reach significance in both groups. Markers of bone formation and resorption did not change significantly in both groups. The satisfaction with the formulation was significantly higher in the patients using spray. Conclusion: Vitamin D₃ supplementation with buccal spray and oral drops are equally effective in short-term treatment of vitamin D deficiency in children with neurodisabilities. Buccal spray may be more acceptable by the patients.

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Dysphagia is a growing health issue especially in aging population. It can lead to a high variety of complications. Here we present the case of an old woman who suffered from dementia and dysphagia. She was admitted to our ward and was diagnosed with aspiration pneumonia. We obtained a full swallowing evaluation, after that we decided not to position a percutaneous gastric tube. Oral nutrition is at least as good as enteral for the outcomes of death, aspiration pneumonia, functional status in patients suffering from dysphagia related to dementia.