The effect of controlled oral hygiene was studied in 35 overdenture patients involving 80 abutments over a period of 3 years. Intensive instruction and motivation in oral hygiene care were carried out prior to prosthodontic treatment and two to four times yearly during the study period. The initial dental and periodontal conditions were very poor, with a mean loss of proximal bone adjacent to the abutments of 62% +/- 17%. During the study period, it was possible to maintain mean plaque index scores of 0.40 to 0.70 and mean gingival index scores of 0.90 to 0.98 adjacent to the abutments. There was spontaneous regression of 4- to 5-mm periodontal pockets, whereas deeper pockets persisted. There was no relationship between the patients’ initial plaque index score and the oral and denture hygiene observed during the study. The results of the study showed that it was possible to maintain teeth as overdenture abutments in elderly patients initially having a poor dental and periodontal status.