Americans' oral health, along with their life expectancy, has improved dramatically during the 20th century. The 21st century offers dental professionals the opportunity to help patients maintain their oral health for a lifetime. This article describes trends in health and wellness among older adults that will affect use of dental services; reviews risk factors such as chronic diseases, medications, and nursing home placement that will increase oral diseases in older adults; and concludes with opportunities for dental leadership to improve the oral health of aging Americans.