The definition of the crown-to-root ratio, its manifestation as a clinical problem, and associated problems were reviewed. Treatment possibilities were discussed in terms of plaque control, periodontal surgery, occlusal adjustment by selective grinding, splinting, restorative considerations, and extraction. The original guidelines for crown-to-root ratio in the selection of abutments were found to be exceptionally conservative and treatment limiting. New treatment modalities were considered in light of increased understanding of periodontal inflammation and its control. With inflammation controlled and with a carefully designed occlusion, some degree of mobility may be tolerated, thereby permitting the retention of teeth with minimal alveolar support.