The dental management of patients who received hemodialysis or a kidney transplant has been described. Emphasis has been placed on oral findings as well as on management considerations that are necessary for safe outpatient dental treatment. As with most patients who have systemic disease, emphasis must be on frequent recall examinations and strong preventive measures to minimize the need for extensive dental treatment. Close consultation between dentist and physician is essential for safe dental management of these patients. Few segments of the population need dental services as desperately as do patients receiving hemodialysis or kidney transplants. In this ever-increasing group of patients, dental disease may have consequences much more serious than the loss of function, esthetics, and comfort. Instead, dental problems may compromise the patient's general health and hinder medical efforts to either maintain or replace vital kidney functions.