Putting teeth in CHIP: 1997-2009 retrospective of congressional action on children's oral health.

When Congress reenacted the Child Health Insurance Program (CHIP) in 2009, it incorporated a range of dental provisions that had not been considered when the program was initiated in 1997. This paper posits that this change evidences the establishment of pediatric oral health as a distinct policy issue within Congressional deliberations. During this period, the US Congress received impetus for action on behalf of children's oral health from multiple streams of activity: the Surgeon General's Report, Oral Health in America, policies enacted by states, advocacy by the professions, promotion by policy groups, attention by the press, and actions of federal agencies. The death of 12-year-old Deamonte Driver appears to have created a tipping point for action that dovetailed with Congressional need to reauthorize CHIP. Federal legislative policymaking is a complex process that frequently builds on an issue that has emerged as timely and relevant. Although much remains to be done, children's oral health, cast as a public policy issue of import, is one such idea that appears to have gained traction among members of Congress.