Prevalence and indicators of medication use with potential oral health implications among 4,163 people from the Duke Established Populations for Epidemiologic Studies of the Elderly were studied. Medications were grouped into seven potential oral adverse drug reaction (POADR) categories. Eighty percent of participants were taking at least one medication from any of the seven categories. Drugs with the potential to cause xerostomia were taken by 56.1%, abnormal hemostasis by 51.7%, soft tissue reactions by 23.4%, taste changes by 11.0%, alteration in host resistance by 8.7%, gingival overgrowth by 5.0%, and movement disorders by 2.4% of participants. Race-stratified analyses revealed that medication use with any POADR was significantly associated (p < 0.001) with being female for both races. Among nonblacks, being > or = 75 years old was associated with higher POADR use. Blacks who had a dental visit in the previous six months were more likely to take medications with POADR than those who did not. POADR medication use was not related to place of residence. Elderly often take medications with potential oral health impact.