Poor oral hygiene is a problem for many people with mental retardation who live in state residential facilities. An integrated treatment approach to improve oral hygiene was designed and implemented. The program focused on increasing cooperation with daily oral care. We examined whether individualized oral care plans were more effective in improving the oral hygiene of people living in this facility than generalized staff training in oral care procedures. Oral hygiene ratings of 80 individuals were tracked over a one-year period and analyzed. A modest improvement was found for all people studied, with a greater improvement for those with individualized oral care plans. The need for follow-up data and procedures to ensure follow through of recommendations is emphasized.