Patients with complicated disease and medication histories are being seen with increasing frequency in the dental office. Many are at high nutritional risk, which can impact their oral health status. Nutrition is an integral part of health promotion and prevention, but it often is a poorly utilized component of preventive dentistry. This article provides the dental hygienist with a systematic approach to determining which patients are in need of nutrition intervention, and discusses screening, assessment, counseling, and referral. Dental hygienists, as part of a multidisciplinary healthcare team, are in an ideal position to identify patients at nutritional and oral health risk, help them attain optimal oral and general health, and improve overall quality of life.