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Objective. Information regarding health condition, related behavior and utilization of health care services is essential for planning and organization of care delivery. Until recently, only limited information regarding oral health related issues was available in Belgium. This paper illustrates the development and implementation of an Oral Health Data Registration & Evaluation System (OHDRES) in Belgium, including discussion of challenges encountered. Methods. After development of a conceptual plan and pilot phase, the OHDRES was implemented nationwide in 2009-2010. The combined Health Interview (self-administered questionnaire) and Health Examination (standardized oral examination by trained dentist-interviewer at the participant's home)data were supplemented with data on utilization of (oral) health care services. Sampling of Belgian residents (> 5 years)took place using a multi-stage, stratified cluster sampling procedure. Ethical approval was obtained and informed consent was sought from all participants. Results. A total of 2536 households were reached, yielding 3057 respondents (52%). Questionnaire and clinical data were obtained from 90% and 84% of participants. Dentist-interviewers reported difficulties with scoring of periodontal condition and enamel defects. Contacting selected households was the most difficult and time-consuming task for the dentist-interviewers, impacting on retention rate. Conclusion. The first round of the Belgian OHDRES was successfully implemented, after long and complex preparation. The impossibility of integration with the National Health Interview Survey 2009 was a considerable draw-back complicating data collection and limiting opportunities to further data linking and creation of added value. ispartof: Journal of Dental, Oral and Craniofacial Epidemiology vol:1 issue:3 pages:45-54 status: published