Good care is about more than meeting basic needs. It's about comfort, dignity and quality of life — and mouth care sits right at the heart of all three. When someone's mouth is sore, dry or infected, everything gets harder: eating becomes painful, speaking becomes difficult, sleep is disturbed. And for people who can't easily tell us what's wrong, mouth problems often go unnoticed until they're serious.
This is where a Mouth Care Champion comes in. As someone who sees the people you support every day, you're well placed to make sure mouth care actually happens — consistently, and for everyone who needs it. A dentist might see someone once or twice a year. You see them daily. That regular contact is what makes the difference.
The need is real. The Care Quality Commission's Smiling Matters review found that most care homes had no policy to promote and protect oral health, nearly half were providing no staff training to support daily mouth care, and most residents' care plans only partly covered oral health — or didn't cover it at all.¹ That's a gap, and it's one a champion can help fill.
Becoming a champion isn't about becoming an expert in dentistry. It's about being the person who makes sure mouth care doesn't get forgotten — supporting your colleagues, building simple routines, and knowing when to get help. These are skills you can learn, and the core training is free.
What a Mouth Care Champion does
A Mouth Care Champion is the local lead for oral health in their setting. You don't need to be a dentist or a nurse. You need to care about the people you support and be willing to help your colleagues do the same. In practice, the role means:
- Supporting daily routines. Making sure mouth care happens twice a day for everyone who needs support — checking that brushing is recorded, that supplies are stocked, and that staff know how to help people who find it difficult.
- Building colleague confidence. Many care staff feel unsure about mouth care and worry about doing it wrong. You help them feel more confident by sharing what you've learned and being available when questions come up.
- Spotting problems early. You encourage staff to look in mouths regularly and report anything that doesn't look right. Early recognition means earlier treatment and less discomfort.
- Liaising with dental services. You become the link between your setting and local dental services — knowing who to contact when someone needs a review and how to arrange it.
- Keeping records. You help make sure mouth care is documented in care plans and daily records. Good documentation protects the people you support and provides evidence for inspections.²
Making Every Contact Count. Every time you or a colleague supports someone, there's an opportunity to support their oral health too. This approach — known as Making Every Contact Count — means building brief health observations into routine care.³ It doesn't have to be complicated: noticing that someone's mouth looks dry, checking whether dentures are fitting comfortably, asking if there's any pain when eating. Small observations add up, and you see people in moments that dental professionals never will.
How to get started
Becoming a champion is straightforward. Here's how to begin.
Step 1: Complete the training. Health Education England's Mouth Care Matters programme is the best starting point.⁴ It's free, online, and the bite-sized video sessions cover the essentials — oral and general health, brushing, dry mouth, denture care, managing resistance to mouth care, and mouth care at the end of life. When you finish, you can download a personalised certificate of completion: evidence of your training for your employer and for CQC inspections. NHS staff can access it through their Electronic Staff Record (ESR); social care staff may be able to register with an OpenAthens account, and employers can manage funded training and records through Skills for Care's ASC-WDS.⁴
Step 2: Talk to your manager. Once you've trained, speak to your manager about taking on the champion role. Most welcome it, because it helps the setting meet CQC expectations and improves care quality. Explain what you've learned and what the role involves — it doesn't require significant extra time; it's about weaving oral health awareness into what you already do.
Step 3: Assess your setting. Use a self-assessment tool to find the gaps in current practice. NICE publishes a baseline assessment tool alongside its care home oral health guideline (NG48),² letting you review your setting against the national standard — whether you have an oral health policy, whether assessments happen on admission, whether daily mouth care is recorded, whether staff are trained, whether care plans include mouth care, and whether there's access to dental services.
Step 4: Build mouth care into routines. The key to consistency is making mouth care part of existing routines, not an extra task. For most settings that means brushing after breakfast as part of morning personal care, brushing last thing at night, and cleaning dentures — removing them overnight to rest the gums.⁵ Make sure supplies are easy to find and everyone knows where the toothbrushes, fluoride toothpaste and denture products are kept.
A note on equipment. Use a soft, small-headed toothbrush and fluoride toothpaste containing 1,350–1,500ppm (commonly 1,450ppm).⁵ After brushing, the person should spit out the toothpaste but not rinse with water — this keeps the fluoride on the teeth for longer. Foam swabs (the small pink sponges on sticks) are not recommended: the foam head can detach and cause choking, and a national safety alert followed a death where this happened. They're also poor at removing plaque. If someone can't tolerate a toothbrush, a damp piece of gauze can be used, but a soft toothbrush remains the most effective tool.⁶
Supporting your colleagues
Some staff will feel confident straight away; others will need encouragement. The three worries you'll hear most often — and how to answer them:
- "I don't know how to help someone who resists." The managing resistance session of Mouth Care Matters covers this in detail. The key is a gentle, patient approach — try different times, positions and techniques. What matters is doing something, even if it's not perfect. If resistance is new or sudden, treat it as a possible sign of pain rather than simply difficult behaviour, and raise it with a senior colleague.⁴
- "I'm worried about hurting them." A soft toothbrush used gently won't cause harm. In practice, more discomfort comes from not brushing than from brushing carefully — it's the plaque left on the teeth and gums that causes the soreness, infection and bleeding in the first place.
- "There isn't time." Brushing takes two minutes. Built into personal care routines, it doesn't add significant time to the day — and the time saved by preventing pain, infections and hospital admissions far outweighs the few minutes spent on daily care.
Troubleshooting common barriers
When the CQC reviewed why oral health care isn't always delivered well in care homes, the barriers were consistent: the guidance can feel complex, staff turnover is high, and there's often not enough time set aside.¹ Here's how a champion works with each one:
- Time pressure — integrate mouth care into existing personal care routines rather than treating it as a separate task.
- Staff turnover — keep the key messages simple and repeat them regularly; build oral health into induction where you can.
- Lack of leadership support — share the evidence with managers and link it to CQC expectations. A setting that can show trained staff, a policy and good records is in a stronger position at inspection.
- Forgetting — use checklists and visual reminders, and give mouth care a clear place in daily recording.
The settings that improve have one thing in common: someone who keeps oral health on the agenda. That's what a champion does.
The difference you can make
When mouth care is done well, the results are visible. People eat more comfortably, smile more readily and sleep better without the disturbance of mouth pain. Staff notice problems earlier, before they become serious. Families see that their loved ones are being cared for thoroughly.
The national picture shows what's possible. Between the CQC's 2019 review and its 2022 progress report, the proportion of care home providers with a policy to promote and protect oral health rose from 25% to 53%, and the proportion saying staff always or mostly received specific oral health training doubled from 30% to 60%. Awareness of the national guidance improved sharply too — in 2019, 39% of managers weren't aware of it; by 2022 that had fallen to 9%.⁷ These are measurable improvements that make a real difference to people's lives, and they happened because people in settings chose to act. As a champion, you'll be part of that change.
When to get help
You're not expected to manage dental problems yourself — your role is to make sure daily care happens and to recognise when professional help is needed.
Arrange a routine dental review when: someone needs a check-up; someone has persistent mouth pain; dentures are broken, lost or no longer fit; or there are signs of tooth decay or gum disease.
Arrange a prompt review for an ulcer or sore that hasn't healed after three weeks. This is one of the signs a dentist or doctor checks when ruling out mouth cancer, so it must never be ignored — even if the person isn't in pain.⁸
Seek urgent, same-day dental advice for facial swelling, a suspected abscess (painful swelling, sometimes with fever), severe pain not controlled by usual pain relief, or bleeding that won't stop. If there's facial swelling with fever, or any difficulty breathing or swallowing, treat it as a medical emergency and seek immediate help. NHS 111 can advise on urgent dental problems and direct you to the right service.
