Aim Oral health in old persons is frequently poor; non‐functional prostheses are common and negatively affect quality of life. The objective of this study was to estimate the impact of oral health problems on oral health related quality of life in a sample of home dwelling Mexican elders. Methods Household survey in 655 persons 70 years old and over residing in one county in Mexico City. Variables Oral Health Related Quality of Life (Short version of the Oral Health Impact Profile validated in Mexico‐OHIP‐14‐sp), self‐perception of general and oral health, xerostomia, utilization of dental services, utilization and functionality of removable dental prostheses, dental and periodontal conditions, age, gender, marital status, schooling, depression, cognitive impairment and independence in activities of daily living (ADL). A negative binomial regression model was fitted. Results Mean age was 79.2 ± 7.1 years; 54.2% were women. Mean OHIP‐14‐Sp score was 6.8 ± 8.7, median was 4. The final model showed that men (RR = 1.30); persons with xerostomia (RR = 1.41); no utilization of removable prostheses (RR = 1.55); utilization of non‐functional removable prostheses (RR = 1.69); fair self‐perception of general health (RR = 1.34); equal (RR = 1.43) or worse (RR = 2.32) self‐perception of oral health compared with persons of the same age; and being dependent for at least one ADL (RR = 1.71) increased the probability of higher scores of the OHIP‐14‐sp. Age, schooling, depression, cognitive impairment and periodontal conditions showed no association. Conclusions Oral rehabilitation can improve quality of life, health education and health promotion for the elder and their caregivers may reduce the risk of dental problems. Geriatr Gerontol Int 2017; 17: 744–752.