Common questions

Is bread allowed on IDDSI Level 6?

No. The IDDSI Framework allows no regular dry bread, sandwiches, or toast of any kind at Level 6 Soft & Bite-Sized. Bread can form a sticky, doughy lump that is hard to control in the mouth. For bread at this level, IDDSI points to its Level 5 Minced & Moist sandwich recipe, served with a filling that meets Level 6. Ask your SLP before serving any bread.

Level 6 needs tender, moist pieces no larger than 1.5 cm for adults that squash flat under fork pressure. Fresh bread compresses and springs back instead of squashing, so it does not behave like a Level 6 food.

IDDSI's 2026 update to its detailed definitions (version 2.2) removed “pre-gelled soaked bread” from the Level 5 and Level 6 examples. If you were taught a soaked-bread method before, check with your SLP whether it still applies to your plan.

The rule relaxes at Level 7 Easy to Chew, where IDDSI says bread, sandwiches, and toast that can be cut or broken apart with the side of a fork or spoon can be provided at the clinician's discretion.