This study explored how adults aged 65 and older perceive their orofacial appearance (OA). Twenty participants aged 65–79 were purposefully recruited from the Swedish National Study on Aging and Care—Blekinge (SNAC-B) in Karlskrona. Semi-structured interviews were conducted using a pre-developed interview guide, and the data were analyzed through thematic analysis to identify recurring patterns and themes. Four key themes emerged regarding older adults’ experiences of their OA: (i) acceptance of their current orofacial appearance—“you kind of have to like the situation as it is now”; (ii) the gradual decline associated with ageing—“an ageing orofacial appearance, a slow continuous downhill slope”; (iii) appearance concerns shaped by social norms—“looking good for others to fit the social norm”; and (iv) maintaining orofacial appearance—“seemingly without effort.” Participants displayed a dual perspective on their own OA. While societal expectations often favor a youthful appearance, actively striving to appear younger was generally viewed negatively, highlighting the complexity of self-perception in ageing OA. Dental problems were the primary factor that made teeth significantly influence participants’ perceptions of their OA.