The executive and legislative branches of state government have broad authority that provides the underpinning for the dental health care system. This article describes four principal areas in which policy makers' decisions can improve children's access to dental care: (1) providing and financing health care (ie, providing opportunities for shaping public insurance programs like Medicaid and SCHIP); (2) regulating health providers and facilities (ie, providing levers for policy change in dental practice acts); (3) ensuring the health of the public (ie, states' choices on population-based approaches and providing leadership in oral health); and (4) education and training of the health workforce (ie, state support of dental education that can ensure a dental workforce that meets the needs of the population).