Outcome measures are necessary for assessment of the appropriateness, quality, necessity for, and effectiveness of oral health care. With the growing number of older adults in the United States, it is appropriate to reflect on the unique characteristics of this segment of our society and how these characteristics may influence the identification of appropriate outcome measures. Older people often demonstrate multiple acute or chronic oral diseases with interrelated symptoms and clinical findings. Older persons are more likely to take medications with potentially adverse oral health effects. Patients experience a variety of disease processes over many years and have variable access to and experiences with the dental care system. These characteristics make the selection and interpretation of outcomes complex. Limitations of existing measures and considerations for the development of new outcomes measures specifically for older populations are reviewed.