As a new graduate of dentistry with a passion for expanding dental care access, Lisa Simon, MD, DMD, didn’t expect her year-long residency at a community health clinic to disrupt her career plans. But the experience made her realize that improving access to dental care was going to take more than clinical work or even health research. It was going to take policy change.

Now, with a two-year K12 award from Harvard Catalyst, she is examining a Medicare policy tweak that, for the first time in history, incrementally expanded coverage to include certain dental services. This presented an opportunity to track how dental coverage affects health outcomes, and Simon jumped on it. She’s using her research to advocate for change in federal policies, learning lessons in resilience along the way.

Currently, Simon serves as an assistant professor of medicine at Brigham and Women’s Hospital. We caught up with her as she was awaiting official confirmation from the NIH on two grant applications.

Your broader research aims squarely at influencing federal Medicare policy for dental coverage. Do you consider what you do a form of science activism or advocacy?

That’s a pretty loaded question, especially in January 2025. I think the reason I’ve chosen to focus on this is in part because my career path has led me to have a huge amount of awareness that this is an issue. I think the way to have the most impact on getting people the dental care they need is by changing federal policy.

Many other things are also important, but the fact remains that Medicare is the closest thing we have to universal health insurance. We know it saves lives and makes lives better. We have also proven that not including dental care in Medicare does the opposite, by restricting access to and utilization of dental services. So it seems like an easy fix, if we could just make it work.

You’ve pursued this rare path of doctor, dentist, and health services researcher. What drives you to focus your research on this area?

Fundamentally, it’s my background. After graduating from dental school, I did a one-year dental residency at Cambridge Health Alliance (CHA). My plan at that time was to be a dentist at a federally qualified health center and pursue research on access to dental care on the side.

“My research, just like my clinical life, has centered at that interface: looking at the effects of health policy on dental access and, more broadly, how access to dental care affects people’s lives and health.”

From that experience, I realized two things. One was that if I actually wanted to make a difference in terms of access to dental care, I needed to think much bigger than my own clinic. The second was that I could not address all the health issues or life experiences that people were talking about to me as their dentist because my job was much more procedural. So, I started thinking that being a physician and a dentist would give me the ability to make the impact I wanted to.

The CHA residency gave me a sense of the kind of clinical work I wanted to do as a primary care physician, but more importantly, it showed me the kind of research I wanted to do as a scientist. It helped me realize that understanding both our medical and dental care systems and why they’re separate was the way that I could personally fight for my patients. That was really hard to do as a clinician alone.

Since then, my research, just like my clinical life, has centered at that interface: looking at the effects of health policy on dental access and, more broadly, how access to dental care affects people’s lives and health.

Your previous research was included in Senate testimony by Massachusetts Senator Elizabeth Warren. What was that experience like for you?

Oh, it was totally thrilling. I mean, hearing Elizabeth Warren read anything that I’ve written was like the joy of a lifetime. She’s my hero.

I would hope a lot of scientists and researchers want their work to have impact, however they define that. When it comes to the kind of work that I do, I might never design a drug that’s going to save lives. But if I can build up the little pile on the scale that tips the balance so that a certain policy happens, that is a way to indirectly have a really big impact. I find it really exciting, because it combines both searching for objective truth, which is meaningful, and using that objective truth to advocate for good in the world.

“If I can build up the little pile on the scale that tips the balance so that a certain policy happens, that is a way to indirectly have a really big impact.”

On the flip side though, it means that I have been a part of or advocated for policies that still haven’t happened. Medicare still doesn’t have a dental benefit for adults. I testified before the Senate Health Committee in May in support of Senator Bernie Sanders’ bill to include a Medicare dental benefit –  which was thrilling. But that bill didn’t pass, and we’re in a really different political environment right now.

I’m early in my career, and I hope I’ll see the ebbs and flows of these things. I think part of it is having the same sense of resilience that I imagine many researchers have, where you take your blows and you keep working toward what you care about.

Your K12 zeroes in on a recent incremental expansion in Medicare coverage for dental care in certain cases. Why this research now?

Medicare has never offered a dental benefit. In fact, a codified restriction in the 1965 Social Security Act means that Medicare can’t offer a dental benefit without an act of Congress. But over the last few years, under the Biden administration, the Centers for Medicare and Medicaid Services began expanding what are referred to as medically necessary dental benefits. Essentially, they said dental care is so necessary for certain groups of people that Medicare will reimburse it.

What that means is that more than a million Medicare beneficiaries are now entitled to dental care paid for by Medicare. The groups are very specific, based on diagnostic categories such as receiving chemotherapy, getting an organ transplant, or being on dialysis, to name a few. They’re easy to identify and enumerate, which makes it somewhat easy to use different kinds of econometric models to evaluate the impact of the policy change.

“[This award] gave me funding to achieve research independence much quicker than I had anticipated or hoped for, and it served as a really nice feather in my cap that allows me to work toward other funding.”

This is the first chance to see whether the policy has had any of its intended effects on health outcomes or the dental workforce. That information will tell us either to advocate for the policy to be expanded or to understand the barriers to it working the way it should. It’s a small change in policy, but remember, this is the first time anything related to dental care has happened in Medicare for more than 60 years. It’s hugely exciting, even if the effect we hypothesize is on the smaller side.

What has been the value of this K12 funding to your broader research goals?

It’s been absolutely transformative. It gave me funding to achieve research independence much quicker than I had anticipated or hoped for, and it served as a really nice feather in my cap that allows me to work toward other funding. In fact, I’ve already had successful feedback on two NIH grant applications due in part to the K12.

It’s also a super welcoming mentoring environment, where I’ve gotten to connect with other researchers across our campus – people who are policy wonks like me and other physician scientists, but also people who are doing really distinctive work that I haven’t thought about since med school. We’ve gotten to meet pretty regularly both in person and remotely. Learning from them has been really inspiring.

Hopefully in 20 or 30 years, these will be a bunch of my colleagues who are running divisions or departments or leading in other ways. It will be fun to have known them for that long.

You’re also the mom of a two-year-old. Any secrets to share on work/life balance?

I don’t have a secret. Enjoy everything you do. I had my baby when I was a third-year resident, which was certainly difficult, even with the full support of my program. But you know, my daughter–who’s now 2–says she wants to be a doctor and a dentist. She knows the word stethoscope. She puts medicine on things and pretends to go to work at the hospital. So I think she’d be proud of the work that I do when I’m able to explain it to her one day.

In the meantime, having joy in your life makes everything easier, including the frustrations of tearing your hair out over code or revisions to a paper or a grant application. One of my mentors once said: “Your dissertation will never hug you back”. That feels pretty right.