We determined the oral health status and treatment needs of the current and future elderly in East York and tested four enrollment strategies for community-based surveys. We selected our sample from the Municipal Composite Report and obtained the data using a multi-item questionnaire and a clinical examination. The examination protocol was based on World Health Organization (WHO) methodology but was expanded to provide tooth surface specific information. Of those contacted by telephone and repeated mailings, 35% participated. The sample appeared representative of the community as determined by a follow-up mail survey of non-respondents. 76% of those examined were dentate and 71% had visited the dentist within the last two years. Nonetheless, 27% had chewing impairment, 15% had discomfort with their teeth and 15% needed care urgently. Treatment needs were highest for the 187 dentate. They required 504 extractions or restorations and 113 denture services. Periodontal care for calculus and pockets was needed by 86% of the dentate. This report shows an apparent contradiction of high dental treatment needs remaining in the context of reported high care-seeking rates.