Richard Rosato, D94, sees a path for bringing better oral health to more Americans.  “We have an opportunity to put the mouth back into the body,” says Rosato, president-elect of the American Dental Association (ADA). 

And by that, he means he hopes the connections between oral health and systemic health—particularly involving chronic diseases and childhood wellbeing—can become a more vital part of public conversation and government policy. 

Rosato, an oral and maxillofacial surgeon with three practice locations in New Hampshire, will assume leadership of the 159,000-member ADA at its annual conference—known as SmileCon—in October. A past president of the New Hampshire Dental Society, he has been active in dental leadership and advocacy for most of his career, starting with his term as vice president of his class at Tufts University School of Dental Medicine.

He says Tufts taught him to “innovate around every challenge that comes before you,” a personal motto that’s served him well. It will likely prove useful as he leads the professional organization that represents the majority of the nation’s dentists into an evolving health care landscape heavily influenced by the Make America Healthy Again movement (MAHA).

In contrast to the widely publicized anti-fluoride views of U.S. Health and Human Services Secretary Robert F. Kennedy Jr., a well-known MAHA proponent, the ADA stands squarely behind the science supporting the addition of fluoride to drinking water and the use of fluoride products to fight cavities.

But fluoride is far from the only issue confronting dentistry and the oral health system at this moment, Rosato says. “There are so many other areas we can work with the administration on if they really are committed to proper nutrition and health care,” such as helping decrease consumption of sugar and other foods that contribute to disease, Rosato says. “The American Dental Association could get behind that.”

Rosato notes barely half of all Americans have access to oral health care. “That's a big area that I think we could work with this administration on if they’re committed to oral health being essential and being part of the overall health of someone's total body.”

In an April guest editorial in the Journal of the American Dental Association, coauthored by Rosato and current ADA president Brett Kessler, the pair cite four areas that will shape the immediate future of oral care for both dentists and patients: reforming dental insurance to lower premiums and out-of-pocket costs, increase annual benefit limits, and expand the scope of public programs such as Medicaid; promoting oral-health literacy; addressing workforce shortages of dentists, hygienists, and other dental team members; and supporting preventive oral care. 

Tufts Now spoke with Rosato about what lies ahead for oral health.

Regarding the four priorities you mention in the JADA editorial, can these all be addressed at once, especially at a time of rapid change in government funding and priorities? What do you think is most likely to gather support?

These four areas are all connected. You can’t talk about prevention without addressing oral health literacy. And you can’t talk about improving access without tackling insurance reform and the workforce shortage. At the federal level, I think dental insurance reform has growing bipartisan interest. That’s a practical place to build support, and the ADA will continue its advocacy efforts in these key areas. I believe the ADA can drive progress on multiple fronts.

The ADA has long supported community water fluoridation. What would you say to a patient who has concerns?

I’d explain that fluoride helps strengthen teeth and prevent cavities, and that its safety has been confirmed through more than 80 years of scientific research. I'd also remind them that good oral hygiene is about more than just one ingredient—it’s about brushing twice a day with fluoride toothpaste, flossing, seeing your dentist regularly, and making informed choices like eating less sugary foods. It’s all about trust, and meeting patients where they are with compassion and credible information.

Community water fluoridation is one of the simplest and most effective ways to support good oral hygiene at a population level, especially for those who need it most like low-income children and people with little access to care. When communities eliminate water fluoridation, we start to see a 25% increase in cavities in low-income children. So we have to understand that if we remove community water fluoridation, we will be committing children, especially the poorest, who don’t have access to all the topical applications that the rest of us might be able to afford, to a life of dental work. We’re going to continue to trust the science, and if the science shows something different, we’ll adjust our recommendations. That’s part of being evidence-based.

In what other ways can the ADA advocate for the benefits of fluoride?

To help ensure communities continue fluoridation where it’s already established, we need to keep showing up. That means supporting local dental societies, equipping them with scientific resources, and helping them build relationships with decision-makers and the public. We also need to debunk misinformation early and often, with facts backed by decades of research.

But fluoride alone isn’t a silver bullet—it’s one tool in a much broader effort to promote lifelong oral health. That’s why the ADA continues to advocate for comprehensive oral health education, preventive care, and access to fluoride through multiple sources—like toothpaste and professionally applied treatments in dental offices.