Potential cuts to Medicaid and bans on water fluoridation could lead to a public health crisis affecting the oral health of residents in rural communities.
The dental industry is facing several threats to advancements in oral health, including opposition to fluoride, potential Medicaid cuts and the recent shuttering of the CDC’s oral health division.
Budget discussions at the federal level have led government officials and healthcare workers to believe that cuts to Medicaid and other safety net programs are likely. Meanwhile, several cities have voted to discontinue water fluoridation, citing contested research that links fluoride to various health issues. Several states are also considering statewide bans, with Utah becoming the first state to pass such legislation in March.
U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. has previously spoken out against water fluoridation, stating in November that the Trump administration would aim to remove fluoride from public water sources. The Trump administration has not yet confirmed that it is a policy priority, but RFK Jr. does plan to celebrate legislation banning water fluoridation during his Make America Healthy Again tour April 7-9.
Barry Lyon, DDS, the dental director for Main Street Children’s Dentistry and Orthodontics and the chief clinical auditor for Dental Care Alliance, spoke with Becker’s about how potential cuts to Medicaid funding and legislation banning fluoride could negatively impact residents in rural communities.
Editor’s note: This Q&A is part of a weekly series featuring Dr. Lyon focused on topics in the dental industry and DSO field. The views expressed are those of Dr. Lyon and do not necessarily reflect those of Main Street Children’s Dentistry and Orthodontics or Dental Care Alliance.
This response was lightly edited for clarity and length.
Dr. Barry Lyon:
Rural Americans face genuine difficulty in finding accessible healthcare. One-fifth of Americans, or approximately 60 million people, live in rural areas. Not only do they have more medical problems than urban residents, those living in rural areas are finding it increasingly difficult to find adequate healthcare because 4% of rural hospitals have closed between 2013 and 2020. When a proposed reduction in Medicaid benefits is coupled with increased difficulty in finding accessible healthcare, those most vulnerable face a healthcare nightmare.
About 28% of rural children depended on public assistance in the past 12 months, and approximately 60% of these children have some level of oral unhealthiness. With approximately 12.9 million children living in rural areas, that means 7.7 million, and likely more, American children have dental disease. If the Trump administration mandates the removal of fluoride from public water supplies, those children living in fluoridated rural areas can expect at least a 20-40% increase in tooth decay. What all of these numbers and percentages mean is that poverty-level children in rural areas will be victims of a public health crisis because someone without a shred of credibility as secretary of Health and Human Services has without any legitimate scientific consensus decided that fluoride should be removed from public drinking water.
Making the government more efficient and reducing waste should not occur at the expense of Americans whose dental problems as children will follow them throughout their entire life.