summaryThe effect of controlled oral hygiene was studied in 31 elderly overdenture patients involving 72 abutments over a period of 5 years. Intensive instruction and motivation in oral hygiene care were carried out prior to prosthodontic treatment and two to four times yearly during the study period. The initial dental and periodontal conditions were very poor, with a mean loss of proximal bone adjacent to the abutments of 61%. During the study period, it was possible to maintain mean plaque index scores of 0.45−0.73 and mean gingival index scores of 0.89−0.95 adjacent to the abutments. There was no relationship between the patients' initial plaque index score and the oral and denture hygiene observed during the study. There was spontaneous regression of 4–5 mm periodontal pockets, whereas deeper pockets persisted. Seven abutments were extracted due to periodontal complications. Caries was a minor problem which could be controlled by hygienic measures, topical fluoride or fillings. The present study has shown that it was possible to maintain teeth as overdenture abutments to a large extent in elderly patients initially having a poor dental and periodontal s