Access to dental care is not equitable in the United States. The dental health of the population varies widely by socioeconomic status. Private dental insurance coverage has peaked at about 40% of the population, and benefits are variable. Dentistry is not included in Medicare and is optional for adults under Medicaid. Inflation is greater than for all goods and services. There is considerable administrative waste, and quality is variable. In this author's opinion, only a national system with universal coverage, one set of benefits, a single payer, a cap on expenditures, and no participation by insurance companies that is increasingly based on salaried consumer-or community-owned group practices with dentist input into decision making can hope to solve the existing problems.