Numerous impairments cause suffering to the institutionalized elderly person. The medically compromised or severely demented patient, especially one with swallowing difficulties, presents a challenge to the dental practitioner. This paper summarizes typical geriatric dental problems that caregivers in a long-term care (LTC) facility should find recognizable. It also describes palliative and preventive treatment modalities that help improve the quality of life for such institutionalized patients.