AIM: This work is a critical appraisal of the state of primary oral health care in Nigeria, the largest Black nation on earth, three decades after the Alma-Ata declaration of primary health care. METHODS: A review based on published peer-reviewed journals, documents from international organs like the World Health Organization, internet sources and newspapers, which beams a searchlight on the state of health care in Nigeria. RESULTS: Results show a lot of decay in the primary health care sector and a lack of proper amalgamation defined by affirmative action of the primary oral health care into the mainstream of primary health care. CONCLUSION: Time for massive action, first by the government, and then by the oral health professionals and the public and all stake-holders to ensure that the dream of Alma-Ata does not remain an illusion in Nigeria's oral health care sector.