Oral Health Products Inclusion Act: Expanding Access to Preventive Oral Care

The Oral Health Products Inclusion Act represents a significant bipartisan step toward improving Americans’ access to essential oral health products by expanding the eligibility of these items under tax advantaged accounts (HSAs and FSAs). This legislative effort is poised to address long standing gaps in preventive dental care, reduce healthcare costs, and improve health equity across the country.

The Need for Legislative Change

Oral health is a foundational aspect of overall well-being, yet millions of Americans face barriers to maintaining it. Toothbrushes, toothpaste, mouthwash, and dental floss are daily necessities for preventing cavities, gum disease, and other oral health issues. Despite their importance, these products are not currently classified as “qualified medical expenses” by the IRS, making them ineligible for purchase with Flexible Spending Accounts (FSAs) or Health Savings Accounts (HSAs). This exclusion limits the ability of families to use pre-tax dollars for essential oral care, effectively raising the cost of maintaining good dental hygiene.

The consequences of poor oral health extend far beyond the mouth. Untreated dental issues can contribute to chronic diseases such as diabetes, cardiovascular disease, arthritis, Alzheimer’s, COPD, and liver disease. The economic impact is substantial: more than $45 billion in lost work productivity and 34 million lost school hours annually are attributed to emergency dental care visits in the United States. These burdens fall disproportionately on lower-income, less-educated, and rural populations, who are more likely to seek emergency oral care from non-dentists and face greater barriers to preventive services.

Understanding the Oral Health Products Inclusion Act

The Oral Health Products Inclusion Act (H.R. 1219) was introduced in the House of Representatives in February 2025 by a bipartisan group of lawmakers: Rep. Jeff Van Drew (R-NJ), Rep. Bradley Schneider (D-IL), Rep. Nicole Malliotakis (R-NY), and Rep. Jimmy Panetta (D-CA). The bill seeks to amend the Internal Revenue Code to classify over-the-counter oral healthcare products, such as toothbrushes, toothpaste, mouthwash, and dental floss, as qualified medical expenses.

If enacted, this legislation would allow consumers to purchase these preventive oral care products using pre-tax funds from FSAs and HSAs, aligning their eligibility with other over-the-counter medicines and feminine care products, which were made eligible under the CARES Act of 2020. This expansion is designed to empower individuals to take charge of their oral health and, by extension, their overall well-being.

Current Limitations Under IRS Rules

Under current IRS guidelines, only oral care products specifically intended to treat a diagnosed medical condition and containing an active medicinal ingredient are eligible for FSA/HSA reimbursement. For example, toothache relief gels, mouth sore treatments, and therapeutic fluoride rinses marketed for cavity prevention may qualify if they are labeled for medical use and include active ingredients. However, general use products like standard toothpaste, toothbrushes, floss, and cosmetic mouthwashes are excluded, regardless of their role in daily hygiene.

This creates a disconnect between clinical recommendations for daily oral care and the financial tools available to support those behaviors. As a result, many Americans must pay out-of-pocket for these essentials, which can be a significant burden for families already struggling to afford healthcare.

The Rationale for Expanding Eligibility

Expanding FSA/HSA eligibility to include common oral care products is grounded in both public health and economic logic. Preventive oral hygiene is universally recommended by dental professionals as the first line of defense against cavities, gum disease, and more serious health complications. By making these products more affordable and accessible, the legislation aims to:

• Encourage consistent preventive care, reducing the incidence of costly emergency dental visits and chronic disease complications.

• Lower long-term healthcare costs for families and the healthcare system as a whole.

• Address oral health disparities by providing greater support to low-income and rural populations, who are at higher risk for untreated dental problems.

The American Dental Association and the National Dental Association have both endorsed the bill, emphasizing that daily oral care is critical for disease prevention and that improved access to these products can lead to better health outcomes and reduced healthcare costs.

Impact on Underserved Communities

One of the most compelling arguments for the Oral Health Products Inclusion Act is its potential to reduce health disparities. Data show that individuals in lower-income, less-educated, and rural communities face higher rates of untreated oral disease and are more likely to rely on emergency care rather than preventive services. These populations often have limited access to dental professionals and are less able to afford the out-of-pocket costs of oral care products.

By expanding the list of eligible expenses for FSAs and HSAs, the legislation would give these families a new tool to manage their health proactively. This could lead to better oral health outcomes, fewer emergency room visits, and reduced financial strain on both individuals and the broader healthcare system.

Economic and Systemic Benefits

Approximately 60 million Americans already use FSAs and HSAs to manage healthcare expenses, including over-the-counter medicines and feminine care products. Studies have shown that these accounts are associated with reductions in overall healthcare spending, as they incentivize preventive care and allow consumers to make more cost-effective health decisions.

By including oral care products, the Act could further these benefits by:

• Reducing the incidence of preventable dental conditions, thereby lowering the need for expensive restorative treatments.

• Alleviating pressure on emergency healthcare services, which are often used as a last resort for untreated oral health problems.

• Supporting a holistic approach to health, recognizing the interconnectedness of oral and systemic health.

The Role of the FDA and FTC in Oral Health Product Regulation

The expansion of FSA/HSA eligibility for oral care products also intersects with the regulatory roles of the Food and Drug Administration (FDA) and the Federal Trade Commission (FTC). The FDA is responsible for overseeing claims made on product labeling, ensuring that health-related statements are supported by scientific evidence and not misleading to consumers. The FTC, meanwhile, regulates advertising to prevent deceptive or unsubstantiated claims about the benefits or safety of health products.

Manufacturers of oral care products must ensure that their marketing and labeling comply with these standards, particularly as eligibility for tax-advantaged accounts could increase consumer scrutiny and demand. The FTC does not pre-approve health claims but requires that all advertising be truthful and adequately substantiated. Health claims that meet the FDA’s “significant scientific agreement” standard are presumed substantiated under FTC law.

As more oral care products become eligible for FSA/HSA reimbursement, clear and accurate labeling will be essential to help consumers make informed choices and to maintain trust in the system.

Legislative Progress and Outlook

As of May 2025, the Oral Health Products Inclusion Act has been introduced in the House of Representatives and referred to the House Committee on Ways and Means for further consideration. The bill enjoys bipartisan support, reflecting a shared recognition of the importance of preventive oral health and the need to modernize the list of qualified medical expenses.

The legislation builds on the momentum of previous efforts, such as the CARES Act, which expanded FSA/HSA eligibility to include over-the-counter medicines and feminine care products for the first time in 2020. Advocates are hopeful that the same logic—supporting preventive health and reducing long-term costs—will carry the Oral Health Products Inclusion Act to passage.

Stakeholder Perspectives

Support for the bill is broad and includes consumer health organizations, dental associations, and industry stakeholders. The Consumer Healthcare Products Association (CHPA) has praised the legislation as a commonsense step toward empowering Americans to take charge of their health and reducing strain on the healthcare system.

Dental professionals emphasize that daily oral care is the foundation of good hygiene and disease prevention. Making these products more accessible through FSA/HSA eligibility is seen as a practical way to encourage healthy habits and reduce the burden of dental disease.

Lawmakers sponsoring the bill have highlighted its potential to improve quality of life, reduce healthcare costs, and empower individuals to manage their health proactively. By removing financial barriers to essential products, the legislation aims to make preventive care more attainable for all Americans.

What’s Next for Consumers?

If the Oral Health Products Inclusion Act becomes law, consumers with FSAs and HSAs would be able to use their accounts to purchase a wider range of oral care products, including:

• Toothbrushes

• Toothpaste

• Mouthwash

• Dental floss

This change would bring oral care products in line with other preventive health items already eligible for FSA/HSA reimbursement, such as sunscreen, blood pressure monitors, and menstrual products. Consumers would benefit from increased flexibility in managing their healthcare expenses and greater support for maintaining daily oral hygiene.

The Oral Health Products Inclusion Act represents a forward-thinking approach to public health policy, recognizing the essential role of preventive dental care in overall well-being. By expanding FSA and HSA eligibility to include everyday oral care products, the legislation aims to reduce barriers to good oral hygiene, lower long-term healthcare costs, and address persistent health disparities.

As the bill moves through Congress, it has the potential to reshape how Americans access and afford the products they need to maintain healthy smiles and healthier lives. With broad support from healthcare professionals, consumer advocates, and lawmakers, the Oral Health Products Inclusion Act stands as a testament to the power of bipartisan cooperation in advancing preventive health for all.

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