Background of Oral Health Care in Massachusetts Oral health is often considered separate from overall health. However, dental diseases are not only associated but can also lead to heart diseases, stroke, and diabetes. The significance of this correlation is due to the concept that the majority of care in cost excess can be attributed to these medical conditions. Some of the major oral health conditions of concern include tooth decay, gum disease, and oral cancers. As the population begins to shift towards an increase in elderly patients, they are living longer and keeping their teeth longer as well, resulting in an increase in the need for treatment of gum disease and other dental services. These problems can also be a complication of certain medications used to treat systemic diseases. The purpose of this paper is to improve access and quality to oral health care for elderly population in Massachusetts who are residents in Long Term Care facilities. (Clemencia M. Vargas, 2001) The elderly are identified in the U.S. Surgeon General’s report on oral health as one of the most vulnerable populations with regard to poor dental care. In Massachusetts 13.3% of the state’s population are considered seniors, defined as being 65 years of age or older. There are more than 143,000 residents age 85 and older and that number is expected to grow 52% by the 2030. About 45,000 Massachusetts residents live in long term care facilities and there is no one-size-fits-all model of oral health care for this growing population. Many seniors are keeping their natural teeth, which increases the likelihood of dental and periodontal disease. Elderly without teeth still require regular examinations of soft tissue and adjustments of prostheses. All of this increases the need for restorative care which puts a greater burden on the care system. Older adults are more likely to have at least one