Objective: To develop an instrument to measure Oral Health-related Quality of Life (OHQoL) and the changes after dental treatment among older adults in Hong Kong, in order to understand their views on the influences of oral health problems and generate relevant items to design the instrument. Methods: A qualitative study was conducted among adults aged 55 and over. Information on their perceived oral health impacts was collected during semi-structured interviews. A framework approach was used to identify the oral health impacts and to understand the meaning of those impacts on the perception of life satisfaction. Results: A total of 39 participants (average age 72 years) underwent the semi-structured interviews; 20 were seeking dental treatment and 19 had already received dental treatment for 1 to 3 months. In total, 308 statements on oral health impacts were drawn from the participants' descriptions. After four steps of item reduction and refinement, a list of 20 items was generated before being classified into eight domains: Cleansing, Eating, Speaking, Appearance, Social, Psychological, Awareness, and Health and Finance. Conclusion: Older adults in Hong Kong perceive that oral health impacts on different aspects of life. The face validity and content validity of the developed Oral Health Impact on Daily Living (OHIDL) was proved through qualitative study. Keywords: elderly people, framework approach, oral health related quality of life, qualitative study, questionnaire development, semi-structured interview