The U.S. Congress has a long history of attending to insurance coverage for children's oral health services while being relatively silent about adult dental care. Yet many adults, made vulnerable by their disabilities and illnesses, are dependent upon governmental programs. This paper contrasts the robust history of federal legislative action in support of children's oral health with the lack of attention to adults' oral health to identify approaches that advocates may consider when engaging Congress in improving oral health for disabled and older adults. It provides a historical context of Congressional action on dental coverage from Medicaid and Medicare in the 1960s through passage of the Affordable Care Act in 2010 and explicates the misconception that Congress has demonstrated about the importance of oral health for adults' well-being and general health. Drivers and strategies for policy change are described and recommendations are made to expand coverage for vulnerable adults.