Little is known about the impact of oral health on self-esteem. The purpose of this descriptive study was to identify the frequency of low self-esteem in vulnerable persons who received oral health care at an academic nursing center. Participants (N = 86) completed the Index of Self-Esteem (Hudson, 1982b), answered open-ended questions concerning oral health care practices, and participated in an oral health examination. We found that 53% demonstrated low self-esteem, 67% (n = 58) had minor dental problems, and 33% (n = 28) had major dental problems. Oral health problems were ranked in importance along with cancer, diabetes, high blood pressure, and asthma. Oral hygiene included no tooth brushing, infrequent tooth brushing, flossing, chewing gum, and using mouth wash. This study emphasizes the roles of the community health nurse in assessing oral health (particularly among a vulnerable population), advocating for policy change, and providing education.