The presence of tooth root remains is a common clinical finding among elderly patients and may reflect a need for treatment. The scope of this study sought to explore the association between the presence of tooth root remains and self-reported oral health among the elderly. Secondary data from two sanitary districts of Porto Alegre, State of Rio Grande do Sul, were analyzed. A conceptual theoretical model was used in the analysis to assess factors related to self-perceived oral health: gender, age, education, marital status, smoking habit, alcohol consumption, demand for oral health care, participation in community groups, family economic self-sufficiency, oral health service accessed, number of teeth and the presence of tooth root remains. The statistical data were analyzed using Chi-square and Poisson Regression tests (95% CI analysis; α 5%). The sample consisted of 849 elderly individuals with a mean age of 69.7 years (± 7.2); 14.5% of the elderly had tooth root remains and 60.7% reported good self-perceived oral health. According to the hierarchical analysis, the absence of tooth root remains was associated with good oral health perception. The qualification and expansion of health care provided should be considered in order to allow planning actions to ensure the maintenance of good oral health for the elderly.