Dental industry leaders are watching closely for signs of renewed federal focus on oral health as the U.S. faces several policy changes that could negatively impact patients.
Melissa Burroughs, senior director of policy at the CareQuest Institute for Oral Health, recently spoke with Becker’s to discuss how the Trump administration can prioritize oral healthcare moving forward.
Editor’s note: Responses were lightly edited for length and clarity.
Question: What actions would you like to see from the Administration for a Healthy America to prioritize oral healthcare?
Melissa Burroughs: Given the Administration for a Healthy America’s focus on improving health and addressing chronic disease, oral health is a really logical disease to include as well, given its implications for heart disease, diabetes and more. We’d love to see this administration continue to focus on oral health prevention and ensuring people who are managing chronic diseases are getting the education and treatment they need. There’s a lot of important work on oral health that had been housed within the CDC, HRSA and within the NIH too, that we don’t know for sure whether it will continue to move forward. A lot of that work includes investments in prevention programs, investments in innovative workforce models, and things that really do need to move forward if we’re going to make America healthy.
Q: Mr. Kennedy has supported topical fluoride applications over consumption of fluoridated water. How feasible is it to ensure that children in underserved areas have access to topical fluoride treatments?
MB: A really important component of this is that Medicaid in every state covers topical fluoride application by pediatricians as well as dental providers. It would really be a good focus for this administration to try to increase kids’ access to topical fluoride, particularly for those who rely on Medicaid, whether they’re getting it in the pediatrician’s office or the dental office, or both, depending on how regularly they’re seeing their various providers. That would be a really important step.
Ideally, if you talk to dentists and pediatricians, they’ll tell you that you should have water fluoridation and topical fluoride applications because they work differently. We would really like to see this administration focus on U.S.-based research of water fluoridation and getting a better understanding of how fluoride is impacting folks in this country. Every study that has been put out thus far on what’s happening here shows that it is safe for our health and effective at improving our oral health. We’d really like to see this administration focus on that within the water fluoridation space, while also improving access to topical fluoride varnish for kids who need it.
Q: How should researchers approach a U.S.-based study on the effects of water fluoridation, and what can be done to ensure these studies are reliable and accurate?
MB: I think the gold standard if you talk to researchers would be a randomized, controlled trial that looks at people who are exposed to water fluoridation at the recommended levels in the U.S., versus people who do not have access to water fluoridation, and what the different outcomes look like for them. That would be the gold standard. There’s also a lot of data out there on health outcomes [with] exposure to water fluoridation over time that could provide a lot of good insights in the short term. We really need to be looking at water systems that are operating at those recommended levels within the U.S. [and] taking part in what we consider community water fluoridation, and that does look very different than in places that have naturally high fluoride in their water, or like they do in Europe, where they don’t need to change the level of fluoride. In some European countries, fluoride is provided through other means, like in milk or in salt, so they’re still providing it for folks in a broad way, but it may not be through the water system.
Q: Do you have any concerns with the plan to fold the National Institute of Dental and Craniofacial Research into a broader research institute within the National Institutes of Health, and can you talk about what risks we may see for dental research if that were to happen?
MB: I think it would be essential for the administration to clarify how oral health research will remain a priority, given that the NIDCR is being folded into a broader Institute. The risk is that you don’t see as many resources being used to understand oral health problems and their solutions. Given how challenging it already can be to get data on oral health issues, this is a really significant concern and we’d really like to hear a clear plan for how oral health research will continue, particularly as we’re facing new threats to worsen our nation’s oral health.
Q: How would you like to see the administration support oral health interoperability with other digital health tools?
MB: Oral health is directly connected to many health outcomes and chronic diseases, everything from heart disease, diabetes, birth outcomes and more, so it’s especially important for a medical provider to understand what their [patients’] oral health status looks like, and how it might be impacting their broader medical outcomes. Similarly, it’s important for oral health providers to understand a patient’s full medical history and how that might impact their oral health … It can only improve the standard of care people get. This administration’s interest in interoperability and data sharing is really a good sign, and we hope that oral health will be part of that conversation.
Q: Now that we are halfway through 2025, what immediate steps would you like to see this administration take before the end of the year to show their commitment to oral health?
MB: The first thing is that we would really like this administration to be thoughtful with any cuts to the Medicaid program and how they will impact oral health and access to care. I think that’s something we really need them to focus on. Similarly, continuing to be thoughtful in using evidence in addressing conversations around water fluoridation. There’s much more the administration can do. We’d really like to see this administration have an explicit place for oral health within the Administration for a Healthy America. We’d really like to see an increased focus on improving access to topical fluoride varnish, both through the pediatrician’s office and the dental office. And we’d like to see that plan for how oral health research will remain a priority, even if the NIH plans to fold the NIDCR into a broader Institute. Communication and transparency is a critical first step. We need to know that oral health is being included as a priority within various parts of HHS, and from there, we’d like to see programs move forward.
Now more than ever, our nation needs policy changes that improve oral health, and there’s a lot more the administration can do to advance it. We appreciate that Secretary Kennedy has stated his commitment to oral health, but we hope to see some clear steps that advance that.
