• CHCOHC406A - Provide or assist with oral hygiene

Provide or assist with oral hygiene

This unit describes the skills and knowledge required by workers to provide or assist a client with their oral hygiene needs within the framework of an individualised care support plan and within their designated role and responsibilities


This unit is intended to address skills and knowledge appropriate for workers who provide direct client care in a range of health and community services environments and whose work role requires them to provide hands on provision of or assistance with a client's oral hygiene where the client is unable to do any or all of this task for themselves

This work is carried out to achieve planned outcomes in the client's individual oral health care plan as part of their overall support plan



This unit must be assessed after achievement of either:

HLTIN301C Comply with infection control policies and procedures


CHCOHS312B Follow safety procedures for direct care work

Elements and Performance Criteria



1. Identify client's oral hygiene requirements and work within a person-centred approach to ensure good oral health

1.1 Review individualised care support plan with client and/or supervisor to confirm support requirements to address client's oral hygiene needs

1.2 Work effectively with clients from a diverse range of backgrounds to meet individual preferences in relation to provision of support or assistance with oral hygiene

1.3 Discuss and confirm the client's level of participation in meeting their own oral hygiene preferences and provide information to the client and/or carer or substitute decision maker as required

1.4 Confirm oral hygiene requirements are within scope of own knowledge, skills and work role and seek appropriate assistance where client requirements are outside scope

1.5 Take into account and address potential impacts that provision of oral hygiene may have on the client and address any situations of risk or potential risk associated with the provision of support and confirm actions with supervisor

1.6 Identify oral hygiene products, processes and aids for providing assistance and promoting independence in line with client's individualised care support plan

1.7 Ensure all actions are in line with legislative requirements, standards and organisation guidelines

2. Assist and support clients in their identified oral hygiene needs

2.1 Prepare and use in an appropriate, safe and client preferred manner:

oral hygiene products and aids for teeth and soft tissue

oral hygiene products and aids for dentures

other materials required for oral hygiene

2.2 Inform client of processes to take place

2.3 Provide support or assistance with oral hygiene tasks according to the individualised care support plan, organisation policies and procedures and with awareness of identified individual client preferences or risk, including:


soft tissue care

care of dentures

use of alcohol-free mouthwash

interdental cleaning

2.4 Incorporate standard toothbrush care into procedures

2.5 Where appropriate encourage client to wear, insert and remove own dentures in line with care plan and, where necessary, support and assist clients with care of dentures to industry standards

2.6 Use techniques to improve oral hygiene practices and modified oral hygiene methods and aids where identified as needed

2.7 Use standard precautions and, where necessary, additional precautions to address infection control requirements in all oral hygiene practices

3. Assist and support clients in an appropriate manner

3.1 Provide oral hygiene support or assistance in an appropriate environment

3.2 Use effective communication, appropriatebody language and a caring attitude to facilitate client understanding of, and comfort with, oral hygiene processes taking place

3.3 Clarify and address difficulties in providing support, including client behavioural responses with client and supervisor within organisation protocols

3.4 Use recommended alternative techniques or arrangements in case of client refusal or inability to comply as recommended in the individualised care support plan

3.5 Recognise signs that indicate potential for an oral health problem, including distress or behaviours of concern, especially in clients unable to articulate their symptoms or concerns

3.6 Maintain confidentiality, privacy, dignity and respect of the client within organisation policies and procedures

4. Recognise and report changes in client oral hygiene requirements

4.1 Regularly review oral hygiene techniques being used to ensure oral health is maintained according to the oral health care plan

4.2 Identify variations in oral hygiene support requirements and/or report to supervisor and/or other appropriate personnel

4.3 Work with client and/or supervisor and/or other appropriate personnel to identify required changes to procedures and aids

5. Identify variations in client behaviour and habits and if appropriate undertake visual oral check

5.1 Identify client behaviour and habits that may indicate oral health issues or associated pain or discomfort

5.2 Identify signs and symptoms of potential oral health issues that may indicate variation from normal or warrant attention by an oral health practitioner

5.3 Observe, listen for self-reports and question client and/or carer, and/or other relevant people as required to determine whether the client is experiencing any pain or discomfort that may be associated with oral health issues

5.4 Take into account contributing factors that may produce variation from normal behaviour

5.5 Obtain consent from the client or substitute decision maker to conduct a basic visual oral check and questioning if necessary in line with legislative requirements, organisation guidelines and within own work role

5.6 Ensure comfort of client by developing trust and rapport and working in an appropriate environment and at an optimal time

5.7 Ensure client is in a position which provides visual access to the mouth seeking their assistance to open their own mouth to minimise contact with the mouth using appropriate infection control procedures

5.8 Provide support for client's head or chin if necessary to enhance visual access without creating discomfort for the client

6. Complete reporting and documentation according to organisation policies and procedures

6.1 Document and report oral hygiene practices performed

6.2 Document and report any concerns arising during oral hygiene practices

6.3 Maintain and file documentation

Required Skills

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge:

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

These include knowledge of:

Awareness of the National Oral Health Plan and other relevant state, territory and national government policy and programs

Basic anatomy and physiology underpinning oral health and hygiene, including what is considered healthy and unhealthy

Basic understanding of variations in oral hygiene care support requirements

Basics of oral health and hygiene

Common and specialised equipment, products and aids utilised in provision of oral hygiene care support

Factors that impact on oral health, including:


access to services

accumulation of plaque and calculus

alcohol, licit and illicit drugs and substances and over the counter and herbal treatments

alcohol misuse

bacteria in dental plaque

client education

correct infant feeding practices

diet and nutrition, including fluids


general health and wellbeing

immunosuppressant conditions

medical history

oral piercings

psychological issues, such as fear of being seen without dentures or persisting with ill fitting dentures for satisfaction of others

salivary function


social and cultural determinants of health

susceptible tooth surfaces

transmission of bacteria particularly from parent to child

trauma, such as from seizures

Guidelines for use of relevant technology, including information technology

Impact of certain health conditions and related treatments on oral health e.g. immunosuppressant conditions, HIV, chemotherapy and radiation

Individualised care support plans, including terminology

Infection control standards and guidelines

Methods of communication with clients in accordance with their communication needs

Mobility issues for some clients and the impact this may have on oral hygiene

Occupational health and safety (OHS) issues and procedures, including those related to manual handling

continued ...

Essential knowledge (contd):

Oral side effects of medications, such as metallic taste in the mouth, dry mouth syndrome and ulcers

Organisation requirements for documentation and report writing

Own work role and responsibilities in provision of oral hygiene

Personal safety and security risks associated with provision of oral hygiene care support and strategies to minimise risks

Principles and practices in undertaking technical skills associated with supporting or assisting people to meet oral hygiene care needs

Principles and practices of confidentiality, privacy, respect and dignity

Processes and strategies to support people with and provide oral hygiene care needs

Role of carers and substitute decision makers in relation to oral hygiene decisions and support

Roles of oral health practitioners

Significance of service setting, including specific contexts of supporting oral hygiene care needs in a client care setting and in a client's private home

Signs and symptoms of an allergic reaction

The interaction between oral health and general health

Essential skills:

It is critical that the candidate demonstrate the ability to:

Accurately document activities and observations within organisation policies and procedures

Adhere to own work role and responsibilities within organisation policies and procedures

Carry out effective oral health self-care practices

Communicate effectively with people requiring oral hygiene care support, including use of active listening and questioning skills

Consistently apply standard precautions

Differentiate between healthy and unhealthy oral presentation

Identify and respond to risks associated with providing oral hygiene care support

Identify variations to oral hygiene care support requirements

Liaise and report appropriately to supervisor and/or health practitioners

Obtain and follow relevant information from an individualised care support plan

Provide and/or assist with oral hygiene care support within the individual personal care context

Recognise changes of clients behaviour, habits and physical condition that might indicate potential oral health issues and report accordingly

Reflect on and improve own level and application of skills and knowledge to achieve desirable outcomes and maintain own capabilities

Support a person's direction and participation in provision of oral hygiene care support responding to personal preferences wherever appropriate

Use initiative in finding opportunities to promote oral health care and its interaction with general health

Use processes, aids and equipment appropriately in provision of oral hygiene care support, including tooth brushing, soft tissue cleaning, use of mouthwash, care of dentures, care of crowns, bridges, implants and braces

Use relevant technology, including information technology safely and effectively

In addition, the candidate must be able to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

These include the ability to:

Apply basic problem-solving skills to resolve problems within organisation protocols

Apply literacy and numeracy skills required to fulfill work role in a safe manner and as specified by the organisation

Consistently demonstrate interpersonal skills, including empathy when relating to people from a range of backgrounds and abilities

Work effectively with clients, colleagues and supervisors

Evidence Required

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this unit of competency:

The individual being assessed must provide evidence of specified essential knowledge as well as skills

This unit is best assessed in the workplace or in a simulated workplace under the normal range of conditions

Consistency in performance should consider the particular workplace context

Access and equity considerations:

All workers in health and community services environments should be aware of access, equity and human rights issues in relation to their own area of work

All workers should develop their ability to work in a culturally diverse environment

In recognition of particular issues facing Aboriginal and/or Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on Aboriginal and/or Torres Strait Islander people

Assessors and trainers must take into account relevant access and equity issues relating to factors impacting on Aboriginal and/or Torres Strait Islander clients and communities

Context of and specific resources for assessment:

This unit can be delivered and assessed independently, however holistic assessment practice with other community services units of competency is encouraged

Resources required for assessment include:

access to appropriate workplace where assessment can take place

simulation of realistic workplace setting

Method of assessment:

In cases where the learner does not have the opportunity to cover all relevant aspects in the work environment, the remainder should be assessed through realistic simulations, projects, previous relevant experience or oral questioning on 'What if?' scenarios

Assessment of this unit of competency will include observation of processes and procedures, oral and/or written questioning on essential knowledge and skills and consideration of required attitudes

Consistency of performance should be demonstrated over a range of relevant workplace conditions

Related units:

This unit may be assessed independently or in conjunction with other units with associated workplace application

Range Statement

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Oral hygiene requirements appropriate to the client include care of:


Crowns, bridges, implants, braces and other orthodontic appliances



Soft tissue

Person-centred refers to:

Effective service delivery

Involving clients in discussions about service delivery options and issues

Involving clients in informed decision-making relating to their care/service

Listening to and addressing complaints

Obtaining informed consent

Putting clients, carers and their preferences at the centre of service delivery

Good oral health refers to but may not be limited to:

A person's mouth that has:

breath without offensive odour

inflammation and lesion-free soft tissue

intact and stable teeth without cavities

moist lips without chapping

no build up of food, calculus or plaque

no oral pain

pink, moist, uncoated tongue

watery plentiful saliva

Looking after the whole mouth, including natural and artificial teeth, gums, tongue, lips and inside the cheeks

Oral health related quality of life factors, such as appearance, social interaction and self-esteem

Individualised care support plan may include:

A stand-alone individualised oral health care support plan

Care plan written by an appropriate health practitioner

Oral hygiene care plan

Personal care tasks embedded in a wider individualised plan

Client refers to those living in the community and/or facilities and may include:

Children receiving care, including in children's services

Older persons

Palliative care clients

People in care or health facilities

People with acquired brain injury

People with dementia

People with disabilities

People with mental health issues

Substitute decision maker (in relation to consent) must be:

The person appointed with the right to speak for the client, such as:




health attorneys

medical power of attorney

members of family

other practitioners

parent of child

person responsible

public trustee

Potential impacts may include but not be limited to:

Positive impacts, such as:

able to chew food

clean mouth

improved general health and wellbeing

improved social engagement or interaction

increased self-esteem


Negative impacts, such as:







trauma particularly as a result of poor technique

Situations of risk or potential risk, may include but not be limited to:

Complex care clients, such as those with dementia or parkinson's disease

Emotional reaction from client, such as those related to dementia or anxiety

Infection control

Manual handling

Oral side effects of medication

Physical reaction from client

Pre-existing medical conditions

Reaction to contact with sensitive teeth

Resistance from client

Triggers for seizures

Legislative requirements refers to:

Federal, state or territory legislation that may impact on workers' practices and responsibilities, noting that implementation of the unit of competency must reflect the legislative framework in which a worker operates

Standards may include but not be limited to:

Aged Care Standards

Community Care Common Standards

Disability Service Standards

Home and Community Care (HACC) National Health Standards

Infection Control Standards

National Standards for Mental Health Services

Organisation guidelines may include but are not limited to:

Clinical protocols

Position descriptions

Workplace policies and procedures, including:

infection control


Oral hygiene products and aids for teeth and soft tissue may include but not be limited to:

Alcohol-free mouthwash directed by an oral health practitioner as part of an oral health care plan

Fluoride toothpaste

Interdental brushes

Manual and electric toothbrushes

Modified toothbrushes

Mouth props (if trained in their use)

Saliva substitutes

Soft toothbrush suitable for bending

Specialised aids


Sugar-free gums

Tongue scraper

Tooth remineraliser

Oral hygiene products and aids for dentures may include:

Denture adhesive

Denture brush

Denture disinfection product

Denture labeling kit

Denture soaking products

Denture-friendly cleaner

Named denture storage container (disposable or non-disposable)

Other materials required for oral hygiene may include:

Bowl or hand basin

Cup of fresh water

Disposable gloves

Hand towel to be placed across clients chest

Lip balm


Toothbrushing may include:

Using currently accepted methods to clean:

natural teeth

fixed and removable prostheses

soft tissue

Soft tissue care refers to:

Care of all soft tissue, including:






Care of dentures refers to:

Cleaning, identifying and storing using currently accepted methods taking into account individual needs and preferences in line with the care plan

Use of alcohol-free mouthwash may refer to:

That which is directed by a health practitioner as part of an oral health care plan to enhance oral hygiene

Interdental cleaning refers to:

Cleaning between the teeth

Standard toothbrush care refers to:

Cleaning, storage and replacement of toothbrush to currently accepted standards

Techniques to improve oral hygiene practices may include but are not limited to:


engages clients senses especially sight and touch

engage client first and describe and show toothbrush

mimic brushing of own teeth to provide physical prompt

place brightly coloured toothbrush in client's preferred hand and they may mirror behaviour


if not initiated through bridging, gently bring clients hand and toothbrush to mouth, describing activity and then encourage the client to continue

Hand over hand:

if chaining does not work, place hand over client's hand and start brushing client's teeth so you are doing it together


Techniques to improve oral hygiene practices may include but are not limited to (cont'd):


if hand over hand method is not successful, place a familiar item, such as towel, cushion or activity board, in client's hand while brushing their teeth


if attempts at oral hygiene are not successful tell client you will leave it for now

ask for assistance and perhaps have someone else take over

Modified oral hygiene methods and aids may include but are not limited to:

Appropriate alcohol-free mouthwash and gel

Backward bent toothbrush, or similar implement to retract cheek while brushing with another toothbrush

Bite block

End tufted brush


Hand grip on toothbrush for clients with reduced grip strength

High fluoride toothpaste wiped onto teeth instead of brushing as a short term alternative only

Mouth props for clients who clench or bite or who have difficulty opening mouth (specific training required)

Mouth spray

Mouth swabs

Saliva substitute

Suction swabs

Tongue scraper and/or brush

Standard precautions refer to infection control and may include:

Wash hands before and after oral care

Appropriate use of personal protective equipment (PPE):

eye/facial protection e.g. glasses/face shield




Disposal of PPE

Additional precautions refer to:

Those infection control precautions that should be used, in addition to standard precautions, when these alone might not contain transmission of infection

Appropriate environment may include but is not limited to:

Choosing location where client is most comfortable

Ensuring good lighting

Maintaining client's preferred routines

Turning off competing background noise, such as television or radio

Using aids that may ease client anxiety e.g. hand mirror

Using brightly coloured toothbrush that can be easily seen e.g. for children or for clients with dementia or visual impairment

Effective communication includes but is not limited to:

Active listening and questioning

Always explaining actions and processes and reinforcing with gestures where appropriate

Asking questions that require a yes or no response when oral hygiene practices are being carried out

Giving one instruction or piece of information at a time

Observing client closely as lack of response, signs of frustration, anger, disinterest or inappropriate responses may suggest communication is too complex or that client is uncomfortable

Speaking at appropriate volume, clearly and at clients pace

Using reassuring words and positive feedback

Using words client can understand

Appropriate body language may include but is not limited to:

Being aware of approaching client appropriately e.g. diagonally from the front and at eye level

Gently touching the client on the hand or lower arm to get attention, if necessary

Positioning self at eye level and maintaining eye contact, as appropriate

Being aware that personal space of clients can vary

Being consistent in approach with positive expression and caring language

Caring attitude includes but is not limited to:

Allowing plenty of time for client to respond to questions or instructions

Focusing on building a good relationship before starting oral hygiene

Using the client's name

Using a calm, friendly and non-demanding manner

Working with a person-centred approach

Client behavioural responses may include but are not limited to:

Biting toothbrush


Distress induced vomiting

Fear response


Grabbing or hitting out


Not opening the mouth

Not responding to directions


Verbal aggression

Review may include but not be limited to the following questions and suggestions:

Are the oral hygiene aids appropriate for the client?

Do others e.g. family and/or carer have input?

Has the observed behaviour improved?

Is attitude and approach considerate of client needs?

Is the approach and routine consistent for client?

Is the client more receptive to oral hygiene support?

Is the environment, timing, language and expression right for client?

Report may include:


care plans

case notes

hazard and incident reports


progress reports





Variations in client behaviour and habits may include:

Anxiety around, or avoidance of, specific events

Apparent pain or discomfort in or around the mouth

Behaviours of concern

Change in eating habits

Change in mood or demeanour

Changes in communication


Difficulty with eating, including spitting out food

Hands in the mouth

Inconsistent wearing of dentures


Physical aggression

Refusal to open mouth

Rubbing own teeth or gums

Seemingly normal behaviours e.g. coughing could be indicator that food is in the lungs

Self-harming behaviour

Social isolation or withdrawal

Signs and symptoms of potential oral health issues may include but not be limited to:

Observed and/or reported signs in or around the mouth, such as:

bad breath (halitosis)


broken teeth

brown or discoloured teeth

calculus (mineralised plaque that will not brush off) on teeth particularly at gum line

change in colour or coating of tongue

dry mouth

eruption issues for children

evidence of build up of dental plaque on teeth, particularly at gum line

holes in teeth

lip blisters, sores or cracks

loose or mobile teeth

mouth debris/excessive food left in mouth

mouth ulcers

premature loss of baby teeth

receding or enlarged gums

soft tissue lesions e.g. red or white spots

swelling of face or localised swelling/inflammation


Signs and symptoms of potential oral health issues may include but not be limited to (cont'd):

Issues reported by client and/or others, such as:

tooth sensitivity

refusal of oral care

sore mouth, gums, tongue or teeth

Other observations, such as:

change in appetite

change in demeanour or mood

difficulty eating/speaking

inability to open mouth very wide


refusing to open mouth

weight loss

Observed and/or reported issues with dentures, such as:

broken metal wires/clips on partial denture

calculus on denture

chipped or missing teeth on denture or chipped or broken acrylic (gum) areas on denture

denture movement when client is speaking or eating

refusal or failure to wear denture

sore spots caused by wearing denture

unclean denture

Other relevant people may include but is not limited to:

External health care providers

Other service providers

Personnel internal to the service provider

Contributing factors may include but not be limited to:






Substance misuse

Systemic illness


Not Applicable

Employability Skills

This unit contains Employability Skills

Licensing Information

Not Applicable