The elderly in general and the residents of nursing home facilities in particular are increasingly frail, old, and dentate. Dentists should be prepared to manage the oral health needs of elderly clients who are afflicted with complex medical, functional, and dental disabilities. Proper dental management requires a commitment to provide treatment of quality despite myriad obstacles. From the outset of evaluation, there must be recognition of the likelihood of compromised self-care and the development of proactive strategies to address dependence in oral care.