Global population projections indicate that the proportion of older people is increasing and will continue to do for the foreseeable future. Many countries are already experiencing the challenges of managing an ageing population including increased pension contributions from workers, rises to national retirement ages, and spiralling healthcare costs. In oral health terms, in addition to simply an ageing population, epidemiological studies have demonstrated significant changes in the oral health of older adults in recent years. As the numbers of edentulous older adults has declined there has been a significant increase in the number of partially dentate elderly. Changing attitudes, improved access to dental care and more effective preventative programmes have meant that large numbers of patients are now retaining natural teeth into old age. However, as older patients retain natural teeth for longer the dental profession is charged with controlling chronic dental diseases in an increasingly challenging oral environment.