Access to dental care is considered to be one of the major determinants of oral health. Lack of insurance coverage and lower income may eventually prevent these aging baby boomers from accessing dental services. This issue is even more problematic for handicapped and institutionalized seniors. Those who are home-bound, may have difficulty getting to a dental office or community health facility and would definitely benefit from home dental services, which tend to be almost non-existent currently. Although legislative attempts have been made in many States in the US and in the majority of Canadian provinces to enable dental hygienists to practice in non-traditional settings, the issue of payment for services still exists. Until dental care for seniors ultimately falls under the public domain, this issue, will not disappear.