The CareQuest Institute for Oral Health will continue to advocate for dental care accessibility as the industry faces persistent challenges along with some new obstacles in 2026.
Wade Rakes, the organization’s new CEO, recently spoke with Becker’s to discuss roadblocks to dental care accessibility in the U.S., including Medicaid cuts, fluoride pushback and workforce shortages.
Note: Responses were lightly edited for clarity and length.
Question: What inspired you to take on this new position with CareQuest?
Wade Rakes: I have worked in healthcare now approaching 20 years, and when we think of the whole person, oral health is a leading contributor to a number of things that can be great about health and a number of things that can cause challenges with health. CareQuest leads in this space in so many ways to advocate for improving oral health for all as the resources as well as the mindset to tackle this great challenge of the oral health crisis in America. It’s a unique, special and exciting place to make a difference in the world.
I’ve had the opportunity to really work on growth in this industry, and to be able to take both ideas and solutions and see them implemented at a large scale. So, when you look at where we are at CareQuest today, I am excited about our opportunity to have significantly greater impact, not just in 2026 but for many years to come. The need is there, and we are building a team and continuing to sharpen our areas of expertise in order to make a big difference when it comes to positive health outcomes.
Q: What are some of the top priorities you’re going to be focusing on in 2026 and beyond?
WR: We will continue to take our leading position that access to dental coverage and care is critically important. We will continue to work with stakeholders in states when we look at opportunities for communities that are underserved. We will continue to advocate that [access to dental care] leads to better health outcomes. When we look at the veterans community, millions of veterans who serve this country don’t have access through their VA benefits to oral health, and that’s something we absolutely need to address.
We see with changes in coverage in Medicaid and the health insurance marketplace that millions of folks will potentially see reduction in their services as we get into the years ahead. So, ensuring we make the case that investments in quality oral health have a meaningful impact in reducing adverse health conditions [such as] diabetes and heart disease. Also, if we can continue to advance quality community-based oral health, it reduces the over 1.6 million annual visits to the emergency room. When you look at our focus on advancing quality access and coverage, on reducing unnecessary emergency department use, on seeing that those folks who serve this country’s veterans get covered, and that we continue to show the research behind quality public health interventions to improve oral health, those are things we’re going to continue to see ourselves focused on. We are making great progress. We’ve seen some progress in 2025, but we are already seeing progress as we lean into 2026 in a number of areas.
Q: What are your thoughts on the current state of the oral health landscape in the U.S. right now?
WR: We are at a crisis when we talk about one in five folks not having access to a plan, and that number potentially getting larger. We also know we don’t have enough clinicians to serve individuals, even those who are covered. That’s what’s driving the emergency department use we see. This $4 billion of expense just on emergency department dental [services] is a massive amount of resources that, if directed to prevention, if directed to community-based work, if directed to local dental practices, would have better outcomes for the patient and better outcomes for those of us in communities that ultimately are seeing a decline in our access. We see that solving and addressing oral health issues is essential to overall health, and we will continue to push for oral health parity in the years to come. The data shows that investment in our space leads to outsized positive impact across the health of our community. So, we’ve got a lot of work to do ahead. We’ve got many great partners that we do that work with, but we also have a great degree of excitement and enthusiasm because if we tackle this challenge, our communities will be healthier and folks will have greater quality of life, and that’s the best outcome we can hope for.
Q: Does it seem like the U.S. is headed for a perfect storm of issues due to the challenges facing the dental industry?
WR: Well, we’re at an inflection point. There’s no question that with these coverage changes — particularly in Medicaid and in the health insurance marketplace where we did not see subsidies extended — that there’s going to be a high number of individuals for the first time since the passage of the ACA who are going to see major changes to their coverage, and that’s millions of people. So, just that change in the system is going to accelerate the need for us to find community-based solutions and to focus on prevention in order to deal with that seismic shift in coverage that we’re going to see in the years ahead.
Q: What do you predict as being some of the biggest challenges for oral healthcare leaders as they go into this next year while facing these challenges and the advocacy that’s needed?
WR: Well, it’s continuing to sound the alarm that oral health is a critical part of overall health improvement, and we’ve seen progress in areas like mental health parity, but we have to recognize that there are so many things that contribute to overall health, and oral health is centered among them. The mouth is the gateway, so when you have high quality oral health, it is an indicator of the ability to provide and have great health overall. For those of us in this space, it’s ensuring that we continue to show everyone that an investment in oral health is an investment in overall health, and that trying to sideline it or diminish it puts us at the risks we’ve talked about, billions of dollars spent on emergencies. When you look at the indication of lost work [and] lost school days for children, oral health and oral health investment [are] amazing contributors when it comes to economic growth because if we are able to achieve greater oral health in our communities, kids are in school and folks are able to pursue their profession. You might be able to make it into the office with a sniffle, but any of us who had oral health pain knows that that’s a major impairment to enjoying the quality of life that we all deserve to have.
