Dentistry has a long and storied history. In Pakistan, evidence was found of a flint crafted drill to treat tooth decay dating back 7,000 years. Today’s challenge is to understand how and why this ancient skill separated from medicine, and what can be done to fill that “cavity”. This is a very timely topic given October is National Dental Hygiene Month. In the Middle Ages, barber surgeons did tooth extractions in addition to other surgical procedures. As the barber surgeons evolved into the surgical half of what became the practice of medicine, some physicians actually specialized in dentistry. In the 19th century, the first dentistry training programs were created. The Baltimore College of Dental Surgery, established in 1840, was the first dental school in the world, and Harvard established the first doctor of dentistry program in 1867. These programs laid the foundation for today’s divide between dentistry and medicine. Unfortunately, in the 20th century that divide was exacerbated by the move to health insurance that excluded dental benefits. As employer-based health insurance took hold during and following WWII, dental coverage was left behind. Interestingly, WWII veteran dentist Max Schoen was called before the House Unamerican Activities Committee in 1951 for trying to make dental care universally available. Three years later, he worked with the West Coast Longshoremen and Warehousemen’s Union to form what would become Delta Dental, the first and largest dental benefits company in the country. Despite the work of Dr. Schoen and others, when Medicare was created in the 1960s, dental benefits were a specific exclusion. In fact, commercial health insurers have generally excluded dental benefits as well, arguing that because of the deferability of most dental services, they don’t lend themselves to an insurance product. As an exception to this rule, when Medicaid was established, dental benefits for children were included and states were left to decide what, if any dental benefits to provide for adults on Medicaid. Currently, two thirds of states offer only limited, emergency, or no dental benefits for adults.