This paper reports the results of a study that investigated changes in the medical and functional status of nursing facility residents over a 2.9‐year period. Sixty‐seven residents from 10 nursing facilities were included in the study, which demonstrated that the residents' medical and functional status deteriorated during this period. These changes adversely affected the residents' ability to receive recommended dental treatment, suggesting that early, definitive, and often aggressive treatment approaches be used in providing services to these individuals.SummaryThis study found that the health status of 67 residents of a long‐term care facility declined markedly over a three‐year period. Based on these findings, we recommend that dental care for institutionalized older adults be provided as soon as possible after problems are diagnosed, and that treatment planning should account for the likelihood that opportunities for the provision of care may decrease with time. However, in the treatment of individual nursing facility patients, the experience and professional judgment of the dentist will continue to be critical in determining an appropriate course of