This pilot study investigated the feasibility of delivering an individualized program of oral home telecare training using PC-based, real-time interactive videoconferencing via the Internet to meet the unique challenges of dental care for people with tetraplegia. A home-based videoconferencing method was tested with two adults with tetraple- gia and an occupational therapist (rehabilitation specialist). As part of the proposed rehabilitation training to improve independence in performing oral hygiene, adaptive devices (a rechargeable oscillating-rotating power toothbrush and a cordless oral irrigator) were introduced to facilitate oral care performance with interactive, Web- based instruction. Training was conducted once a week for 4 weeks. The oral home telecare experience was evaluated using a questionnaire and in- depth interviews after the training. Both subjects were satisfied with the oral home telecare services and were enthusiastic about using the services without major difficulty after having previously experienced barriers to dental care. In addition to their positive perceptions about videoconferencing, the subjects suggested adaptations and identified unexpected potential uses for interactive videoconferencing. The use of interactive videoconferencing as a mode of oral hygiene training may lead to a change in oral hygiene service delivery methods, improving accessibility to geographically dispersed populations with tetraplegia. Oral home telecare offers strategies to decrease physical barriers and communication difficulties that correspond to recommendations to improve the quality of dental health services for people with tetraplegia. © 2009 Special Care Dentistry Association and Wiley Periodicals, Inc.