Magister Chirurgiae Dentium (MChD) / Objectives: Previous studies have indicated that most of the older adult population has poor oral health but only a few of them demand care for their problems. The reason for this discrepancy has never been explained adequately. The obj ectives of the study were, first, to assess the perceived oral health needs (with regards to social, functional and psychological impacts of oral diseases) of older adults aged 55 years and above, second, to assess the oral health status (periodontal disease, dental caries and oral mucosal lesions ) in an adult population aged 55 years and above.Third, compare the relationship between normative and perceived need. Methods: This was a quantitative cross-sectional, descriptive study and consisted of 100 older adults who were randomly selected from three areas in Guguletu. These areas included the home for the aged Ekumphumleni, NYl and NY2 clinics. Participants aged 55 years and above were interviewed using a structured questionnaire consisting of 32 questions and a clinical examination done. Frequency tables were computed and analysed. The relationship between variables like oral health status, perceived need and a variety of socio-demographic variables and measures of psycho-social impact of oral diseases were analysed by using the chi square test and odds ratio. Results: The ability to perceive that they had a problem and the recency of the last visit to the dentist was associated with perceived need for dental care. There was a significant relationship between the presence of symptoms which were painful and perceived need for dental care (mouth, p value=0.015; gums, pvalue=O.OOl; teeth, p value=0.0006) The positive attitude towards dental care and regular dental hygiene was an indicator of positive attitudes towards oral health care. In this study a substantial difference between perceived and normative need was also observed. 88% of the respondents perceived a need for dental care and 99% were assessed as needing treatment (normative need) but only 29% demanded the care. 63% were dissatisfied with their functional ability to chew and expressed a need for dentures. Conclusion: The aim of this study was to assess the oral health status and perceived oral health needs among older adults in Guguletu. The oral health status was poor in most of the participants and the demand for care was low even though perceived need was high. The study has shown that social, functional and psychological factors influence the demand for care in this adult population. The cost for dental care and access to these services are major barriers to the demand of care.Perceived oral health needs and the impact of oral diseases are important influences in the assessment of oral health needs in the elderly. The assessment of oral health needs as perceived by the elderly facilitates the planning and implementation of dental services with special consideration on the cost and accessibility of oral health care.