This paper reviews literature on mouth sticks and presents information from a survey of occupational therapists specializing in the treatment of persons with spinal cord injuries. The review discusses the standards of mouth-stick design that have been established by dentists, but the survey suggests that occupational therapy practice is widely discrepant from these standards. The author suggests increased education for occupational therapists to provide knowledge of the key elements of oral safety, and increased collaboration between occupational therapists and dentists in mouth-stick design, fabrication, and training to assure quality care for all persons who require a mouth stick.