All of the Following Are Direct Causes of Extensive Plaque

All of the following are direct causes of extensive plaque biofilm and food debris in clients with common neurologic deficits except which one?

A) Lack of self-cleaning mechanisms of tongue, cheek, and lips
B) No sensation of debris in vestibule
C) Consumption of retentive foods
D) Xerostomia from medications
E) Fatigue hindering frequent toothbrushing