10% of elderly patients are functionally dependents and they therefore need permanent assistance. Orodental alterations may evolve into a pathological state in elderly people, which is increasing in the recent decades. The current study analysed institutionalized patients in the district of Bari (Southern Italy), who have been so far monitored. We assessed 125 elderly institutionalized patients. The assessment has been carried out by an assessment questionnaire aiming at evaluating the patient’s psychophysical health status, objective intraoral test and prosthetic rehabilitations. About 90% of enrolled patients reported a good general health status. The main dental problems are due to the complete lack of specific prevention and treatment programs, together with handicap, presence of systemic diseases and medicines taken. The level of oral hygiene is poor and the conditions of the residual dental elements are precarious because of root caries and periodontal problems. Prostheses are usually old (on average 15) and appear scarcely retentive and unstable. We believe in the need for specific interventions aiming at the various issues emerging from the present study, so as to achieve a smaller prevalence of dental loss, periodontal disease and caries. These relatively simple interventions are now lacking because of the non-demand of treatment from patients and for economical reasons.