Dental care for the physically and mentally handicapped ought to be a normal part of the responsibilities of the pedodontist. In the case of severe handicap, however, it may be difficult to achieve an acceptable standard of care under general practice conditions. An account is given of the regimen followed in the Tokyo Metropolitan Rehabilitation Institute for the Severely Handicapped where a team approach to dental care has been in existence for the past 10 years. Data are presented which demonstrate the incidence of dental disease in various categories of handicap and examples are given of the improvement in the quality of life of the institutionalized handicapped as a result of regular, high quality dental care.