This study explored the personal impact of dental problems in terms of pain, worry, and conversation avoidance, and factors associated with this impact. A self-reported dental health index, comprising three questions asked of participants in the Rand Health Insurance Experiment, was examined. Index reliability was 0.69. One-way analysis of variance and Pearson's product-moment correlations were used to explore the bivariate associations between the index and sociodemographic variables, provider-assessed clinical indicators, and the respondent's report of a toothache. Perceived dental health of the study sample (N = 1,658) was notably lower in the presence of a toothache, increasing numbers of decayed teeth, and worsening periodontal health. Weaker, but statistically significant, associations were observed for sociodemographic factors. Nonwhites and those persons with lower educational and income levels reported more impact. In regression analysis, standardized coefficients indicated that the respondent's report of a toothache and, secondarily, numbers of decayed teeth were the most important explanatory factors. These findings suggest that in the future improved self-reported measures, in addition to clinical indicators, may be an acceptable and cost-effective method of epidemiological data collection and dental health outcome assessment.