It’s Time, Right Now, for Policy Leaders to Address America’s Oral Health Crisis

By Melissa Burroughs, Senior Director of Policy & Advocacy at CareQuest Institute 

The reality is both stark and straightforward: People in the US are already facing an oral health crisis — and recent policy changes are likely to make it worse. 

Seventy-two million people in the US already lack dental insurance, and millions more struggle to find affordable care in their area. Many people in the US skip getting care due to cost, go into debt to fund dental care, or go to extremes — like leaving the country or seeing an unlicensed provider to find care they can afford. And despite that current crisis, federal leaders recently passed cuts to the Medicaid program, putting dental coverage even more at risk, especially for adults. Even further, recent efforts to roll back access to fluoride undermine decades of oral health prevention efforts. 

Today, right now, our oral health system is crying out for help.

A new national poll shows that roughly 80% of US adults think the government has a role to play in improving oral health. First and foremost, policy leaders should work to protect the oral health care gains we’ve made — protecting access through Medicaid in light of cuts and ensuring that people can continue to access safe, effective oral health prevention solutions like water fluoridation and fluoride supplements. But there is much more this administration can do to advance oral health. 

This country needs oral health policy solutions, and policy leaders need to address it before it’s too late. 

Here’s what we’re urging US Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr. and HHS to do: 

• Prioritize oral health within health agencies. Following Kennedy’s comments in recent testimony that he is “committed to oral health,” HHS should prioritize oral health within the new Administration for a Healthy America. Oral health is related to many chronic diseases, including heart disease and diabetes, making it a logical and important component in this new agency’s charge to address chronic disease. This is particularly important with recent oral health staff eliminations in the Centers for Disease Control and Prevention and the Health Resources and Services Administration.
• Prioritize oral health prevention. The Secretary has indicated his support for topical fluoride products in recent testimony, including fluoride varnishes and oral health care products. While these products cannot replace the benefits of community water fluoridation, the administration should work to ensure more children, particularly in high need or unfluoridated areas, can get fluoride varnish at their pediatrician and dentist offices. The administration should also ensure that parents understand that fluoride varnish, as well as fluoridated mouthwashes and toothpastes, are safe and effective.
• Improve oral health access for people in rural areas in the US. Recent research shows that 40% of adults living in rural environments have not visited the dentist in more than one year, a significantly higher rate than those not in rural areas. Like many health care fields, dentistry is facing a workforce crisis. The administration should invest in innovative workforce models and supporting the dental workforce, particularly in rural areas, dental deserts, and areas without key preventive measures like water fluoridation, to ensure that everyone can access preventive care.
• Improve oral health integration. For too long, dental care has been siloed from the rest of the health care system, including dental records and dental data. This Administration should ensure that oral health is included in its efforts to improve data sharing, health record interoperability, and digital tools and applications.
• Prioritize oral health research. Oral health is directly connected to overall health, and the Secretary has indicated his interest in advancing research that further demonstrates this connection. This issue should remain a priority at the National Institutes of Health (NIH), and the Secretary should make clear how it will be prioritized when the NIH is slated to eliminate the National Institute for Dental and Craniofacial Research and fold it into a broader institute focus. Additionally, the administration should prioritize research that looks at the impact of water fluoridation in the US, rather than relying on studies that look at the excessively high levels of fluoride found in other countries, and use an evidence-based approach to the FDA’s assessments of fluoride supplements. 

Our country is in desperate need of policy changes to improve oral health, and there is much more the administration can do to promote this cause. While we value Kennedy’s expressed dedication to oral health, we need to see concrete actions that further this commitment.