As President Donald Trump gets settled into his second term, many industry leaders are wondering which policy changes could affect oral healthcare in the U.S.
Melissa Burroughs, director of public policy at the CareQuest Institute for Oral Health, spoke with Becker's to discuss the policies needed to improve oral care in the U.S. under the Trump administration.
Editor's note: These responses were lightly edited for length and clarity.
Question: In your opinion, are policymakers concerned enough about oral health in the U.S.?
Melissa Burroughs: We've seen a lot of momentum building in the past couple of years and an increase in policymaker attention. There are still a lot of issues that need to be addressed to address our nation's oral health crisis, so I wouldn't say we have enough policy maker attention until those policies are [enacted], but there's a lot of really encouraging momentum.
Q: What are some of the key changes you'd like to see with our new administration that will help advance and improve oral health in the U.S.?
MB: There are a couple of buckets of things. For far too many people in America, good oral health is too expensive and out of reach. We've talked in the past about how too many families are put in the position of having to make impossible trade-offs between getting the dental care they need and putting food on the table or going into debt. When we look at the major themes coming out of this last election, like cost of living and job opportunities, it's clear that oral health is a really important part of that equation.
Some areas we're really focused on for these next couple of years are continuing efforts to address some of the major gaps in dental coverage. There are nearly 70 million people who don't have access to dental insurance in this country. That makes care unaffordable and out of reach. We're really watching any efforts to cut or reshape the Medicaid program. There are millions of people who rely on Medicaid for their dental benefits, and dental benefits are often one of the first things states will cut when there are budget shortfalls or squeezes in the Medicaid program, so that's an issue we're watching closely, and we are looking for Medicaid policies that will advance oral health coverage and access rather than roll it back.
We are also really engaged in the veterans dental care efforts. Veterans who qualify for medical care through [Veterans Affairs] may or may not qualify for dental care, and even those who do qualify for dental care face a number of barriers to accessing that care. There have been a lot of conversations about VA care and ways to improve it in this administration, so we're really watching those opportunities to see if there will be places to advance access to dental care.
We continue to work on Medicare dental issues in the short term that will be continuing to push forward with the medically necessary Medicare dental component. Medicare enrollees now have some dental services covered. They are explicitly tied to improving the outcomes of their medical treatment. This is a really important and cost effective policy that we look forward to working with the Trump administration on continuing to strengthen and move forward.
Q: What can be done to build up champions of oral health initiatives to help advance these policies?
MB: There are a number of members of Congress who care about oral health issues, but there have been other champions in place in the past, some of whom have retired or lost elections. There's clearly a lot of empathy around these issues. We conducted polling last year that showed nine in 10 voters are supportive of adding dental benefits to Medicare [and] nine in 10 voters are supportive of improving oral healthcare through the VA. Those kinds of things really show that there's a lot of political will behind this. It will be important to ensure that oral health is really connected to a lot of the bigger healthcare issues we're talking about. It's certainly a huge issue related to people's pocketbooks and kitchen table discussions that aren't always talked about, so I think breaking through with members who are trying to make life affordable for Americans, including our healthcare, is really a key asset and really building on the momentum we've seen this issue gain in the last several years.
Q: Although we may not see any massive reforms soon to advance oral health in the U.S., what are some incremental changes we could see to make progress?
MB: We aren't likely to see massive reform around eligibility for dental care [for veterans], but we are encouraged by some of the recent conversations around studies that look at some of the additional veteran populations that maybe should be eligible for dental care, and that could really impact their medical outcomes. We also have been encouraged by recent conversations around improving access and reduced wait times and getting people in the door to care. I think there are really some dental implications for that, and that's something we're going to be building out further as discussions progress. We also know there are conversations that might be broader about the VA and how it's run, and that's not what we're wading into, but we recognize that may impact oral health access in one way or another.
Q: How does CareQuest plan to advocate for water fluoridation as debate around this practice grows?
MB: The first thing to say is that there is 75 years of research and thousands of studies really underscoring the safety and efficacy of fluoride as a tool for advancing oral health, and that's something that is really an important step in ensuring that we don't exacerbate the overall crisis our nation already faces. We're really thinking about ways to ensure communities and lawmakers receive accurate information about water fluoridation. This reinvigorated discussion also is even more important to advance policies that improve access to oral health prevention and care. We know this is a very hot debate right now, and it really just underscores the need to ensure we're addressing the oral health crisis in every way we can.
Q: We know that oral healthcare is closely linked to other conditions, including diabetes, Alzheimer's and heart disease. What role could educating the public and policymakers about the medical-dental link play in advancing oral health policies?
MB: The overall health impact of oral health is wide ranging, and it's really important that we consider, not only that core oral health makes the outcomes for those health concerns worse, but also there's a lot of money in our health system that could be saved when you treat oral health as part of that medical treatment. We did some really interesting research that shows if Medicare covered dental, there are millions of dollars that would be saved in diabetes care and heart care as a result of that being in place. So, it's really important that folks continue to see this as a major health issue and also a huge cost to our health system that could be avoided if we were treating the oral health issues up front.