Our oral health Improvement work

In addition to clinical care, CDS is contracted by local authorities to provide oral health improvement services to address the needs of their populations. We work predominantly with young children in schools and early years settings to deliver our accredited Healthy Smiles supervised toothbrushing programme, alongside work with vulnerable elderly and other care settings to ensure good oral health advice and practice is available to all.

Our aim is to work with people and communities to raise awareness of good oral health and its impact on wider health and wellbeing.

To find out more about what we do, click on the links below to meet our local oral health teams.

Healthy Smiles

The Healthy Smiles award programme supports services working with young and primary school children to adopt tooth-friendly practices. By implementing the five Healthy Smiles standards, each participating setting helps to;

  • increase the dentist attendance of children in their care
  • promote positive oral health messages to the children, staff and parents
  • reduce the frequency of sugary food and drinks given to the children
  • Free training is provided by the Oral Health Improvement team to support the staff teams taking part in the award. In some settings the Healthy Smiles + accreditation standards will require supervised tooth brushing or a food audit to be completed.

Social care training

We offer a wide range of face-to-face and on-line training for organisations who want to increase their knowledge of oral health to help them support the needs of their residents or customers.

All our training will help residential settings meet CQC best practice standards in oral health care.

Find out more


We have produced many resources to support individuals and groups understand more about managing their oral health, or supporting the oral health needs of others.

Find out more

Frequently asked questions


Is it benefical to use mouthwash?

If you like to use mouth rinses, get one which is alcohol free and contains fluoride. It should be used at a different time to tooth brushing to maximise the effect of the fluoride in it. Rinsing, even with a fluoride rinse immediately after brushing will reduce the beneficial effects of fluoride toothpaste. Fluoride in toothpaste (1,000-1,500ppm) is at a higher concentration compared with fluoride rinses (225ppm) and so is more effective if retained in the mouth, rather than being diluted or washed away by rinses.

Is an electric or manual toothbrush best?

While there is evidence that some powered toothbrushes (with a rotation, oscillation action) can be more effective for plaque control than manual tooth brushes, probably more important is that the brush, manual or powered, is used effectively twice daily.

Thorough cleaning may take at least two minutes.

Which toothpaste is best to use?

For adults any fluoride toothpaste as long as it contains between 1,350-1,500ppm fluoride. You can find the fluoride content on the toothpaste tube/box – generally in the ingredients. Some toothpaste brands will have two types of fluoride at different levels. As long as they come to between 1,350-1,500 when added together then it is ok.

For children, see below.

My gums bleed when I brush, should I stop?

Many people are worried when they notice their gums are bleeding and then brush more gently, or stop altogether. In fact, it is important that you continue to clean regularly and thoroughly if you are to fight the gum disease. If the bleeding does not go away within a few days see your dental team to ask for their advice.

How should I heal an ulcer in my mouth?

If an ulcer lasts more than 3 weeks you should always ask your dental team or doctor for advice. They may be able to tell you the cause and provide treatment, or they may arrange more tests or refer you to a specialist if needed.

Should I brush my teeth after vomiting or morning sickness?

If you have morning sickness (nausea and vomiting), rinse your mouth with plain water after each time you vomit. This will help prevent the acid in your vomit attacking your teeth.

Do not brush your teeth straight away as they will be softened by the acid from your stomach. Wait about an hour before doing so.

Are mercury dental fillings safe when pregnant or breast feeding?

Discuss with your dentist whether any new or replacement fillings should be delayed until after your baby is born. The Department of Health advises that amalgam fillings shouldn’t be removed during pregnancy.

What is tooth decay?

Dental decay happens when the enamel and dentine of a tooth become softened by acid attack after you have eaten or drunk anything containing sugars. Over time, the acid makes a cavity (hole) in the tooth. ‘Dental decay’ is the same as tooth decay and is also known as ‘dental caries’.

What is Gingivitis?

Gingivitis means ‘inflammation of the gums’. This is when the gums around the teeth become very red and swollen. Often the swollen gums bleed when they are brushed during cleaning.

How often should you clean dentures?

The general rule is: brush, soak and brush again. Always clean the denture over a bowl of water or a folded towel in case you drop it. Brush the denture before soaking them, to help remove any bits of food. Using an effervescent (fizzy) denture cleaner will help remove stubborn stains and leave the denture feeling fresher – always follow the manufacturer’s instructions. Then brush the denture again, as you would your own teeth, being careful not to scrub too hard as this may cause grooves in the surface.

Use a small to medium-headed toothbrush and unperfumed soap or denture crème to clean the denture. Make sure you clean all the surfaces, including the surface which fits against the gums. This is especially important if you use any kind of denture fixative.

If you notice a build-up of stains or scale, have the denture cleaned by a dental team. (Either a dentist or a dental technician in a lab).

How will smoking effect my gums and teeth?

People who smoke are more likely to produce bacterial plaque, which leads to gum disease. The gums are affected because smoking causes a lack of oxygen in the bloodstream, so the infected gums don’t heal. Smoking causes people to have more dental plaque and causes gum disease to get worse more quickly than in non-smokers. Gum disease is still the most common cause of tooth loss in adults.

Does drinking alcohol effect my teeth and gums?

Alcoholic drinks such as white wine, beer and cider can be very acidic. This will cause erosion of the enamel on your teeth, possibly leading to pain and sensitivity.

Spirits such as vodka and whiskey are very high in alcohol and will give you dry mouth.

Many mixers and alcopops are high in sugar. This can cause dental decay.

How is smoking and alcohol linked to oral cancer?

Most people know that smoking can cause lung and throat cancer, but many people still don’t know that it is one of the main causes of mouth cancer too. Every year thousands of people die from mouth cancer brought on by smoking.

Drinking alcohol increases your risk of mouth and oropharyngeal cancer. Research shows around 30 out of 100 (30%) of mouth and oropharyngeal cancers are caused by drinking alcohol.

Smoking and drinking together further increases the risk of cancer more than either by itself.

UK guidelines recommend a maximum of 14 units of alcohol a week for both men and women.





At what age should you take your child to the dentist?

Take your child to the dentist when their first milk teeth appear or by the age of 1 year old whichever is soonest. This is so they become familiar with the environment and get to know the dentist. The dentist can help prevent decay and identify any oral health problems at an early stage. Just getting your child to open their mouth for the dentist to take a look is useful practice for the future. If after some encouragement your child will not let the dentist have a look, don’t worry! This appointment will also be an opportunity for you to ask any questions you may have concerning your child’s dental health and check what sort of toothbrush and toothpaste you should be using. Take your child to see the dentist regularly or as often as the dentist recommends.

When should you start brushing your childs teeth?

Start brushing your baby’s teeth with fluoride toothpaste as soon as the first milk tooth appears (usually at around six months, but it can be earlier or later). It’s important to use a fluoride toothpaste, as this helps to prevent and control tooth decay. For children less than 3 years use a fluoride toothpaste containing no less than 1000ppm fluoride. For children over 3 years use a fluoride toothpaste containing more than 1000ppm fluoride.

My child wont spit out the toothpaste after using it, should we stop using it?

If your child does not spit out after brushing, don’t worry – don’t stop using it. Children up to three years of age should use no more than a smear of toothpaste (a thin film of paste covering less than three quarters of the brush). After brushing always encourage your child to spit.

Children aged three to six years should use only a pea-sized blob of toothpaste. Discourage your child from licking the toothpaste off the brush, however if this happens do not then apply more toothpaste to the brush, just encourage them to carry on brushing.

I struggle to get my child to brush their teeth, how can I encourage them?

Make brushing as much fun as possible. Use music or tooth brushing apps, or get them brushing while having a bath. You can also use a 2 minute egg timer so they can time themselves brushing. Some songs you can find on YouTube:

  • Brush along with Budd.
  • Brush bus song.
  • Brush your teeth by busy beavers.
  • This is the way we brush our teeth.

However, this list is not exhaustive; you can also download apps like the Brush DJ onto your phone or smart device.

Shopping for a toothbrush with your child and choosing it together may make it more fun for them. Having one toothbrush for them to chew and one for you to brush their teeth (one to do one to chew) can sometimes make it easier.

Will a dummy or thumb sucking harm my childs teeth?

No, but they will encourage an open bite, which is when teeth move to make space for the dummy or thumb. They may also affect speech development. That’s why you should avoid using dummies after your child reaches 12 months old.

Thumb sucking won’t cause permanent problems as long as the habit stops by the time your child gets their second teeth, but it can be a hard habit to break. Discourage your children from talking or making sounds with their thumb or a dummy in their mouth, and don’t dip dummies in anything sweet, such as sugar or jam.

Should I rinse with water after brushing?

No we advise ‘Spit Don’t Rinse’. Rinsing with lots of water after brushing should be discouraged – spitting out excess toothpaste is preferable.

Rinsing with water, mouthwashes or mouth rinses (including fluoride rinses) immediately after tooth brushing will wash away the concentrated fluoride in the remaining toothpaste, diluting it and reducing its preventive effects.

Is sugar free juice ok to give to my child?

The safest drinks to give your child are milk and water. Some soft drinks contain sweeteners, which are not suitable for young children – ask your dental team if you are not sure. Many flavoured drinks are also acidic which can have damaging effects to teeth. It is always best to keep all flavoured drinks to meal times only.

Is dried fruit a good snack?

Because dried fruit can stick to the teeth it is better to consume it as part of a meal and not as a between-meal snack.

Special care

My child has autism and struggles with the taste and texture of toothpaste, what can we do?

Some children don’t like the taste and texture of toothpaste and may prefer brands which are flavourless or low foaming. If you are really struggling, try brushing the teeth with water first and then rinse the brush and dab some fluoride toothpaste around the teeth. Ask your dentist about the different types of toothpaste available. The most important thing is the right amount of fluoride. Ask your dentist whether your child might benefit from using a higher content fluoride toothpaste, which can be prescribed for children over the age of 10.


I look after someone with additional needs, is there anything we can use to make brushing easier?

For some people, moving their arms or hands can be a problem, which makes effective cleaning difficult. It is important to reach all the areas of the mouth to clean effectively. A toothbrush with a small to medium head size with soft to medium bristles is usually recommended. There are special handgrips and other adaptations which can be fitted to manual toothbrushes to make them easier to hold.

In some cases, electric or ‘power’ toothbrushes are recommended for people with mobility problems. They are also helpful to people with learning difficulties as they can be a novelty and therefore encourage brushing. The dentist or dental team will be able to offer advice and practical help on brushing and general mouth care.