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Rationale: oral health is one of the fundamental steps to general health, well being and a determinant factor for the quality of life. Objective of this cross–sectional study is to assess the oral–systemic health and the treatment needs among the institutionalized people in a homeless center, with high prevalence of co–morbidities and barriers to care. Methods and Results: after getting the informed consent, 51 adults from a community, which is disadvantaged from a socio–economic and medical point of view, were studied: frequently with multiple general diseases treated with medicines that produce oral side effects, a high need of treatment and the lack of a dental office. The subjects were orally examined from a clinical point of view and received a questionnaire with regard to the presence of the health risk factors. General health status and drug treatments of subjects were evaluated based on medical records. Results showed that oral health status of the subjects is precarious, oral hygiene is poor and the subjects are exposed to common risk factors for oral and systemic diseases: tobacco use, alcohol consumption, diet, poor hygiene and history of cancer. Discussion: if their needs are not met, the oral health will be persistently poor and will further deteriorate during their residency, because of increasing care dependency and subsequent lack of adequate oral health care. Despite great achievements in oral and general health of populations, problems still remain in many communities, particularly among underprivileged groups.