The current status of geriatric oral health in the United Kingdom is influenced by an historical pattern of care prevalent during the early years of the National Health Service in 1948, when inexpensive oral health care became available to all. At that time, tooth extraction was perceived as an acceptable, and among some people a preferred, approach to oral care. This has left a legacy of edentulism among senior citizens, which affects both oral and general health, in addition to an attitude that places oral health as a low priority. This legacy is now beginning to unwind as cohorts of adults, who have benefited from low-cost dental care for the majority of their lives, are entering their senior years. Many of these young-old retain their natural teeth and have more positive attitudes towards oral health. This paper discusses the impact of this history as well the effect of income on access to care, the influence of the ageing process on adequate oral hygiene and the availability of dentists trained to treat both dentate and edentulous geriatric patients. A brief outlook for the future is also provided.