The policy battles shaping oral health care
Policy plays a critical role in expanding access to oral health care. At CareQuest Institute for Oral Health, that work is a key part of the organization’s mission to improve oral health. Melissa Burroughs, the institute’s senior director of public policy, spoke with Dental Bite about the biggest issues shaping oral health policy in 2026.
—Interview by Carrie Pallardy, edited by Bianca Prieto
What are the biggest oral health care policy issues on your radar for 2026?
The top things that we're watching in oral health care policy this year include policy issues around fluoride, particularly water fluoridation; changes to Medicaid dental benefits; ACA premiums and then looking forward to the midterm elections and affordability conversations.
On the fluoride front, we're seeing a new wave of state legislation to restrict or ban water fluoridation this year. We're also seeing increased activity at the EPA that could open up a pathway to regulate fluoride federally.
On the Medicaid front, after the federal budget bill last year included nearly a trillion dollars in cuts, the states are now figuring out how to navigate budget pressure, and one of the easiest things for them to look at is Medicaid adult dental benefits, which they only have to provide on an optional basis. States are also looking at implementing the required work reporting requirements in Medicaid. We're really concerned about how these two Medicaid policy tracks could lead to millions of people losing health coverage broadly, which would include their dental benefits.
On ACA premiums, we have seen that it's very unlikely that the more enhanced Affordable Care Act tax credits are going to be extended in any way at this point. With many Americans facing higher premiums, it is going to make it more difficult for families to purchase standalone dental coverage as an add-on to their health insurance, if they're able to purchase health insurance at all.
Thinking about all three of these issues and looking forward to the midterm elections, we know dental care isn't always a big election issue, but it's very much a part of the broader affordability conversation and a broader healthcare conversation that policymakers and voters are having.
What issues are you most concerned about?
On the one hand, you're seeing rollbacks on access to preventive measures that are broad-based and really available to everyone, but at the same time, you're seeing threats to insurance and the safety net system that ensures that people who may or may not have access to prevention in the run-up to having a need for care. Then, can they actually access care or afford care?
It really is a confluence of all of these issues together, more than being able to prioritize one over the other. The sweeping Medicaid cuts that may be coming, and this wave of activity around fluoride happening at the same time is something that we're really worried about. We're already seeing the need to advance oral health equity in any way possible by both stopping these efforts as much as we can, but also thinking about creative solutions that may help in the meantime.
Do you see any positive policy trends moving forward in 2026?
One issue that's not a new issue but is certainly gaining momentum is dental therapy and increasing the availability of credentialed dental therapists. It's really a potentially high-impact solution for increasing access to affordable routine oral health care, particularly in underserved areas: rural areas and low-income communities.
Another positive issue we're watching and engaging in is veterans’ dental care. There really has been an increase in momentum on Capitol Hill in DC to expand access to dental care for veterans over the past year or two.
The last thing we're really watching on the positive front is the rural health transformation grants. These new federal investments really could reshape rural health infrastructure broadly. Every state was able to put together what they wanted to address through their rural health transformation grant, but several states really did focus on oral health issues.
This conversation has been edited for brevity and clarity.
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Dental Bite is curated and written by Carrie Pallardy and edited by Bianca Prieto
