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Individuals with cognitive disabilities face many barriers to oral care, often suffering from partial or complete edentulism. While the use of implant reconstruction is becoming more common in the general population, such care is still being used infrequently in individuals with intellectual impairment. A pilot project in 1995 surgically placed and restored implant-supported prostheses in six edentulous adults who had varying degrees of cognitive impairment. This report presents the dentists' reconstruction experiences and the patients' follow-up care, and discusses the results in relationship to current literature. Experiences from these patients suggest that behavior during the restorative process, prosthetic complications post placement, and patients' oral hygiene practices should influence patient selection and prosthetic design. Anteriorly placed fixtures and removable designs, which make self-care and repair easier, can be used to treat an edentulous population.