This brief examines the oral health status of low-income adults, the dental benefits covered by state Medicaid programs, and low-income adults' access to dental care today. It finds improving the oral health of low-income adults involves efforts to expand coverage, strengthen benefits, promote oral health and improve access and care delivery. States that have not yet expanded Medicaid under the ACA have an opportunity to cover millions of poor adults who lack other affordable health coverage options. Independent of the Medicaid expansion, improving state economies may enhance the prospects for expansion of adult dental benefits in Medicaid programs. The progress states have made in increasing children's access to and use of dental care, by building stronger provider networks, leveraging accountability through contracts and investing in care coordination efforts, provides a foundation for similar action for adults in Medicaid. States are also expanding the dental workforce by removing scope-of-practice barriers and through targeted efforts among dental schools to increase diversity among dental students, as under-represented minority students are more likely to provide care to the underserved. Finally, Medicaid programs are implementing a host of payment and delivery reforms in pursuit of higher-quality care, better patient outcomes and reduced costs. A central emphasis of these approaches is more integrated care, sometimes encompassing an expanded range of health and social services and supports, as well as innovative workforce and other strategies for expanding access. These models of care present potential for increasing access to dental care and improving dental care and outcomes for both children and adults in Medicaid.