Aim The purpose of this study was to examine challenges older people encounter in maintaining satisfactory oral health status.

Method This interpretive qualitative study involved 19 in-depth interviews with participants aged 65 to 87 years. Data were examined using a three-level analytic process. NVivo Qualitative Software assisted data management.

Results Participants in this study didn’t ‘just go’ to the dentist. Much effort went into solving the dilemmas and tensions of maintaining their oral health through a process of option balancing. Balancing personal and financial costs, they continually assessed their ‘bottom line’. They negotiated issues of: dental cost versus service quality; basic treatment versus functionality and social appearance; future living costs versus current dental costs; and ‘how long will it need to last’ versus ‘how long will I live’?

Conclusion Problems exist in the provision of affordable oral health care for the older population in Aotearoa New Zealand. They struggle to afford dental care. They receive little financial support to access oral healthcare services and are dependent on developing their own strategies to enable such care. Health professionals and policy decisionmakers’ challenge is to bridge this gap.