On May 8, a bipartisan group of lawmakers reintroduced the Ensuring Lasting Smiles Act (ELSA) to Congress, a bill designed to ensure health insurance coverage for individuals born with congenital anomalies or birth defects. If passed, the legislation would require private health plans to cover medically necessary treatment, including dental and reconstructive procedures that are often denied under current policies.

With broad support from healthcare professionals, patient advocacy groups, and dental organizations such as the American Dental Association (ADA), the bill represents a critical step toward expanding access to essential care for millions of Americans.

What the Ensuring Lasting Smiles Act Would Do

The legislation seeks to close long-standing coverage gaps that leave patients—many of them children—without access to treatments that restore function and improve quality of life. Specifically, the bill would:

• Mandate insurance coverage for inpatient and outpatient care related to congenital conditions that affect the mouth, jaw, teeth, ears, and eyes.
• Ensure that adjunctive procedures such as dental, orthodontic, and prosthodontic services are included when deemed medically necessary by a physician.
• Exclude purely cosmetic procedures, focusing only on services that restore or improve physical function or health outcomes.

Why the Bill Matters

Millions of Americans living with congenital anomalies—such as cleft palate, ectodermal dysplasias, or craniofacial disorders—face significant financial barriers to receiving necessary care. Although these treatments are often considered essential for basic health and functioning, insurance companies frequently classify them as cosmetic, resulting in denied claims or high out-of-pocket costs.

Senator Tammy Baldwin (D-WI), a lead sponsor of the bill, emphasized the urgency:

“Medically necessary care for birth defects can cost thousands of dollars out of pocket, or for others, it is entirely out of reach despite having health insurance.”

The legislation aims to ensure that families no longer have to choose between forgoing treatment and facing financial hardship.

A History of Bipartisan Support

First introduced in previous congressional sessions, the Ensuring Lasting Smiles Act passed the U.S. House of Representatives in 2022 following advocacy by ADA members and its inclusion in ADA Dentist and Student Lobby Day efforts. Despite strong bipartisan support, the bill did not advance through the Senate before the end of the legislative session.

This renewed push, led by Senators Tammy Baldwin and Joni Ernst and Representatives Kim Schrier, M.D., and Neal Dunn, M.D., aims to break through the previous roadblocks and move the bill toward enactment.

Organizations Backing the Legislation

The Ensuring Lasting Smiles Act is backed by a broad coalition of more than 30 national organizations, including:

• American Dental Association (ADA)
• American Academy of Pediatric Dentistry
• American Association of Oral and Maxillofacial Surgeons
• National Foundation for Ectodermal Dysplasias
• American Cleft Palate Craniofacial Association
• TMJ Association
• American Society of Plastic Surgeons
• FACES: The National Craniofacial Association

These organizations agree that existing insurance practices disproportionately harm patients with medically complex dental and facial conditions—many of whom require multi-phase care beginning in early childhood and continuing through adolescence.

Looking Ahead

If passed, the Ensuring Lasting Smiles Act would establish a legal standard for insurers to cover care that is vital to a patient’s health, not just their appearance. For the dental and medical communities, it represents progress toward a more equitable system where function, health, and access matter as much as aesthetics.

Families impacted by congenital conditions, along with their care providers, are hopeful that renewed bipartisan commitment will lead to lasting change.

Dentsply Sirona, a global leader in dental technologies and innovation, has once again been named one of America’s Most Responsible Companies by Newsweek—a recognition that reflects its long-term commitment to sustainability, healthcare equity, and global impact. The announcement comes alongside another major milestone: the opening of a digital dental clinic in an indigenous village in Brazil’s Atlantic Forest.

The initiative, developed in partnership with the nonprofit Amazon Doctors, represents a new chapter in accessible, tech-enabled oral health care for underserved populations.

Recognition for Corporate Responsibility

This is the fourth time Dentsply Sirona has earned Newsweek’s prestigious distinction, which highlights companies demonstrating exceptional environmental, social, and governance (ESG) performance. The ranking credits Dentsply Sirona’s ongoing sustainability program, BEYOND: Taking Action for a Brighter World, and its dedication to expanding access to quality oral healthcare around the world.

“We are proud to receive this recognition,” said Andrea Frohning, Senior Vice President and Chief Human Resources Officer. “It underscores our long-standing commitment to improving access to oral healthcare globally and creating healthy smiles.”

New Clinic Brings Digital Dentistry to Rio Silveira Village

As part of this commitment, Dentsply Sirona has collaborated with the Amazon Doctors to launch the first-ever digital dental clinic in the Rio Silveira village, home to approximately 1,000 indigenous residents on the north coast of São Paulo, Brazil.

The clinic, built in a 70-square-meter facility, is equipped with cutting-edge technology donated by Dentsply Sirona, including:

• A Primescan AC intraoral scanner
• A Sinius dental chair
• Tools for digital impressions, treatment planning, and diagnostics

These tools will enable the clinic to perform around 40 dental procedures per week, including restorative, endodontic, and prosthetic treatments—all tailored to the unique needs of the local community.

Empowering Health Through Long-Term Partnership

Dr. Caio Machado, founder of the Amazon Doctors, emphasized the importance of collaboration in achieving long-term health outcomes:

“By joining forces with Dentsply Sirona, we are improving access to oral health and strengthening the dignity, well-being, and autonomy of indigenous peoples.”

The partnership between Amazon Doctors and Dentsply Sirona spans nearly a decade, during which medical teams have traveled more than 60,000 kilometers across Brazil to provide care. To date, they’ve delivered over 100,000 dental treatments across 52 indigenous communities.

A Broader Commitment to Global Impact

The Rio Silveira project is just one part of Dentsply Sirona’s broader mission. As part of its BEYOND sustainability program, the company has committed to enabling 25 million smiles by the end of 2025 through partnerships with organizations such as:

• Smile Train
• TeamSmile
• Project 32

These partnerships focus on increasing access to dental care for underserved and vulnerable populations globally.

Conclusion

Dentsply Sirona’s latest achievements represent more than industry recognition—they signal real, lasting change in how dental care is delivered across underserved communities. From indigenous clinics in the Brazilian rainforest to global sustainability goals, the company continues to redefine what responsible dentistry looks like in the modern era.

As the BEYOND program continues to scale, Dentsply Sirona reaffirms that technology, access, and empathy must go hand-in-hand to shape the future of oral health worldwide.

Utah has become the first state in the nation to enact a statewide ban on community water fluoridation, a move that has sparked concern among dental and public health experts. The bill, signed into law by Governor Spencer Cox on March 27, 2025, will go into effect on May 7, 2025. The legislation marks a significant departure from a decades-long public health policy intended to reduce dental decay across U.S. communities.

What the Law Says

The new law prohibits the addition of fluoride to public drinking water systems throughout Utah. While the bill does not cite specific health risks, Governor Cox has publicly questioned the impact of fluoridation, pointing to Utah data that he says shows no significant difference in oral health outcomes between communities that fluoridate and those that do not.

Background on Fluoridation

Since 1945, fluoride has been added to municipal water systems across the United States as a preventive measure against cavities. Numerous studies have shown that water fluoridation reduces the risk of tooth decay in both children and adults, particularly in communities with limited access to dental care.

In a 2007 systematic review, researchers found that adults in fluoridated communities experienced a 27% reduction in tooth decay. A 2018 study showed a 30% decrease in cavities among children living in areas with fluoridated water.

Despite this, fluoride has been a topic of ongoing debate, with critics pointing to potential cognitive effects. Some recent studies have raised concerns about elevated fluoride exposure during pregnancy or early childhood and its association with lower IQ scores. However, experts note that the levels referenced in those studies are significantly higher than those used in regulated community water systems.

Expert Concerns

Public health advocates have voiced strong opposition to the Utah ban. Dr. Scott Tomar, a public health dentist and oral epidemiologist at the University of Illinois Chicago, emphasized that fluoride bans could worsen oral health disparities:

“The benefits of community water fluoridation are most pronounced in low-income communities—communities that often have the least access to dental care and to other sources of fluoride.”

Tomar warned that removing fluoride from drinking water could increase the burden of oral disease, particularly among vulnerable populations who rely on public health initiatives for preventive care.

The National Context

Utah’s move may influence other states where similar legislation has been proposed. While water fluoridation remains endorsed by the Centers for Disease Control and Prevention (CDC), American Dental Association (ADA), and World Health Organization (WHO), it faces growing scrutiny from advocacy groups citing potential risks or personal freedom arguments.

Public health organizations worry that a trend of local or state-level bans could undermine decades of progress in cavity prevention.

Looking Ahead

As the law takes effect in May, communities across Utah will need to adjust, and dental professionals may need to recommend alternative sources of fluoride such as prescription toothpaste, mouth rinses, or professional fluoride treatments.

Whether Utah’s decision becomes a national precedent or a cautionary tale remains to be seen—but experts agree that it raises urgent questions about how best to ensure access to affordable, effective preventive dental care.