Background In elite sport, the protection of an athlete's health is a priority. However, research indicates a substantial prevalence of oral disease in elite and professional athletes. The challenges to oral health from participation in sport require investigation to identify effective strategies and mitigate risk.

Aim To explore athlete-reported oral health behaviours, risks and potential for behaviour change in a representative sample of elite athletes based in the UK.

Method This was a cross-sectional study. We provided oral health screening for 352 elite and professional athletes from June 2015 to September 2016; 344 athletes also completed a questionnaire.

Results The median age was 25 years (range 18-39) and 236 (67%) were male; 323 (94.2%) said they brush twice daily while 136 (40%) said their most recent dental attendance was within the previous six months. Ninety-seven (28%) would be assessed as high consumers of sugar in their regular diet. The use of sports nutrition products was common with 288 (80%) reporting the use of sports drinks during training or competition but were positive about behaviour changes.

Conclusion Despite reporting positive oral health-related behaviours, athletes have substantial amounts of oral disease. Athletes are willing to consider behaviour change related to daily plaque removal, increased fluoride availability and regular dental visits to improve oral health.