The clinical care of adults of any age begins with their first contact at the dental office. Communicating with older adults, one needs to consider changes in their hearing ability and a heightened need for sensitivity to a range of individual differences. A positive first impression of the office from a pleasant interchange in scheduling the first appointment needs to be reinforced with a thorough but personal gathering of medical history and oral assessment at the first appointment. Special attention needs to be paid to identifying the aspects of one’s history that are likely to impact on the older person's oral health and ability to maintain it. Because of the wide range of factors that threaten the maintenance of oral health with increasing age, the dental team needs to develop an approach to prevention specific for each patient.