<p>This case-based review examines oral health challenges among LGBTQ+ populations and how discrimination and stigma contribute to negative outcomes. Two clinical scenarios illustrate the impact of minority stress and prior negative healthcare experiences on dental anxiety, care avoidance, and treatment outcomes. In one case, a nonbinary patient delayed care due to misgendering, resulting in untreated caries. In another, a transgender man’s bruxism was associated with stress related to repeated use of his deadname. Both cases demonstrate how affirming care, including correct pronoun use, respect for chosen names, and supportive communication, can reduce anxiety and improve clinical relationships.</p><p>A literature review complements these cases by identifying barriers to care and risk factors contributing to oral health disparities. LGBTQ+ individuals report higher rates of substance use, delayed dental visits, and limited access to culturally competent care. Certain subgroups, including bisexual adults, experience poorer oral health and greater barriers to care. These findings highlight the need for inclusive clinical practices, improved provider training, and structural changes such as nondiscrimination policies. Integrating affirming approaches into dental care may improve trust, treatment adherence, and oral health outcomes while promoting more equitable healthcare delivery.</p>