Health Insurance
Dental Health Report 2024: Costs, Visits and Access Across the US
A healthy smile is an asset that requires investment.
How much do those pearly whites cost? Americans spend an average of $432 a year on dental services, according to the latest ValuePenguin study. However, just 65.9% of adults went to the dentist in the past year.
In addition to reviewing our findings, stick around for tips on utilizing dental insurance to access better or more affordable care.
On this page
- Key findings
- Americans spend an average of $432 yearly on dental services
- 40.3% of dental spending is out of pocket
- 65.9% of U.S. adults visited a dentist in the past year
- Permanent tooth removal is common
- Americans generally have good access to dentistry
- Utilizing insurance to access dental care: Top expert tips
- Methodology
Key findings
- Americans spend an average of $432 a year on dental services. In New Hampshire, that figure is $648 — the highest in the nation. Alaska ($636) and Washington ($582) follow. Texas and Kentucky (both $340) and Mississippi ($341) are at the bottom.
- Out-of-pocket costs account for 40.3% of total dental spending, almost four times higher than the 10.6% out-of-pocket share of total health spending. National dental spending amounts to $165.3 billion, a 0.3% yearly increase. Out-of-pocket expenses are $66.6 billion, up 2.1% annually.
- Nearly 2 in 3 (65.9%) U.S. adults went to the dentist in the past year — consistent with figures over the past decade. Connecticut has the highest rate (73.9%), and Arkansas has the lowest (55.6%).
- More than 2 in 5 adults (40.3%) have had at least one permanent tooth removed. Over half of adults in three states have had a tooth removed: West Virginia (56.5%), Mississippi (51.3%) and Kentucky (51.1%). Conversely, the District of Columbia (29.5%), Utah (33.3%) and Colorado (33.9%) have the lowest percentage of adults without a tooth.
- There are 60.4 dentists per 100,000 Americans, or 202,304 total. The District of Columbia has the highest number of dentists per capita, at 109.4 per 100,000 residents, followed by Massachusetts (80.2) and Alaska (79.5). Conversely, Arkansas (41.2), Alabama (41.7) and Mississippi (43.1) have the lowest rate of dentists.
Americans spend an average of $432 yearly on dental services
Pearly whites cost a pretty penny. As of 2020 — the latest available — Americans spend an average of $432 a year on dental services.
Drilling down by state, those in New Hampshire spend the most, at an average of $648 a year. Alaska and Washington rank second and third, at $636 and $582, respectively.
Affordability may play a role. All three states have median household incomes above the U.S. median of $75,149 annually, meaning residents may have more financial freedom to invest in their dental health.
States with the highest per-capita spending on dental services
Rank | State | Per-capita spending on dental services |
|---|---|---|
| 1 | New Hampshire | $648 |
| 2 | Alaska | $636 |
| 3 | Washington | $582 |
| 4 | South Dakota | $577 |
| 5 | Wyoming | $559 |
| 5 | North Dakota | $559 |
Source: Centers for Medicare & Medicaid Services (CMS) 2020 data, via KFF.
Meanwhile, those in Texas and Kentucky spend just $340 on dental care annually. Following that, those in Mississippi spend $341.
Unlike the top-ranking states, the median household incomes in these three states are below the U.S. median, which may be why residents aren’t as likely to invest in dental care.
Full rankings
States with the highest/lowest per-capita spending on dental services
Rank | State | Per-capita spending on dental services |
|---|---|---|
| 1 | New Hampshire | $648 |
| 2 | Alaska | $636 |
| 3 | Washington | $582 |
| 4 | South Dakota | $577 |
| 5 | Wyoming | $559 |
| 5 | North Dakota | $559 |
| 7 | Massachusetts | $558 |
| 8 | Vermont | $551 |
| 9 | Oregon | $550 |
| 10 | Colorado | $542 |
| 11 | Montana | $520 |
| 12 | Connecticut | $510 |
Source: CMS 2020 data, via KFF.
40.3% of dental spending is out of pocket
Americans are typically responsible for a higher share of dental costs than health costs. In fact, out-of-pocket costs account for 40.3% of total dental spending as of 2022 — the latest available. That’s nearly four times higher than the out-of-pocket share of total health spending, which is 10.6% (also as of 2022).
According to ValuePenguin health insurance expert Divya Sangameshwar, dental insurance is why most Americans spend so much out of pocket for dental care.
"Dental insurance, sadly, doesn’t work like health insurance," she says. "At its core, it offers coverage for basic dental services like cleanings and X-rays. However, anyone needing a lot of dental work will soon discover that any amount over the annual maximum (usually between $1,000 and $2,000) will come entirely out of their pocket. This includes expensive procedures like a root canal, wisdom tooth removal or braces."
Additionally, dental care isn’t often covered by standard health insurance plans, including government-sponsored plans like Medicare.
As of 2022, national dental services spending was $165.3 billion, up 0.3% from 2021. Meanwhile, out-of-pocket expenses totaled $66.6 billion in 2022 — leading to a slightly higher (2.1%) increase from 2021. Overall, dental expenditures represent 3.7% of total national health spending.
Dental services expenditures
Year | Total dental services expenditures | Out of pocket | YoY % change in total dental services expenditures | YoY % change in out of pocket |
|---|---|---|---|---|
| 2000 | $62.1 billion | $28.1 billion | N/A | N/A |
| 2001 | $67.7 billion | $29.7 billion | 9.0% | 6.0% |
| 2002 | $73.6 billion | $32.6 billion | 8.8% | 9.5% |
| 2003 | $76.3 billion | $34.0 billion | 3.6% | 4.4% |
| 2004 | $82.2 billion | $36.3 billion | 7.7% | 6.9% |
| 2005 | $87.2 billion | $38.5 billion | 6.1% | 6.0% |
| 2006 | $91.8 billion | $42.2 billion | 5.2% | 9.6% |
| 2007 | $97.7 billion | $44.7 billion | 6.5% | 6.0% |
| 2008 | $102.8 billion | $47.6 billion | 5.1% | 6.5% |
| 2009 | $103.4 billion | $45.8 billion | 0.6% | -4.1% |
| 2010 | $105.9 billion | $45.3 billion | 2.4% | -0.9% |
| 2011 | $108.0 billion | $46.1 billion | 2.0% | 2.0% |
Source: ValuePenguin analysis of CMS data. Note: Year-over-year calculations are based on unrounded numbers.
Service prices may account for the increase. Between December 2021 and 2022, dental service prices increased by 6.4%, according to Bureau of Labor Statistics (BLS) consumer price index (CPI) data. More recently, dental service prices increased by 3.5% year over year in August 2024.
65.9% of U.S. adults visited a dentist in the past year
As of 2022 — the latest available — nearly 2 in 3 (65.9%) U.S. adults went to the dentist for any reason in the past year. That figure has been fairly consistent over the past decade since it was 67.2% in 2012.
Those who haven’t gone typically cite cost barriers. According to a 2023 KFF survey, 37% of health insurance marketplace enrollees reported delaying or forgoing dental care due to cost.
Where are Americans most likely to regularly see a dentist? In Connecticut, 73.9% of residents have visited a dentist in the past year — the highest by state. That’s followed by Massachusetts (73.2%) and Hawaii (71.9%).
States with the highest rate of adults who visited a dentist in the past year
Rank | State | % of adults who visited a dentist in the past year |
|---|---|---|
| 1 | Connecticut | 73.9% |
| 2 | Massachusetts | 73.2% |
| 3 | Hawaii | 71.9% |
| 4 | Utah | 71.3% |
| 5 | District of Columbia | 70.4% |
Source: Centers for Disease Control and Prevention (CDC) 2022 data. Note: Mississippi wasn’t included due to data suppression.
Meanwhile, Arkansas has the lowest rate of adults who’ve been to the dentist in the past year, at 55.6%. That’s followed by West Virginia (56.6%) and Texas (57.9%).
Full rankings
States with the highest/lowest rate of adults who visited a dentist in the past year
Rank | State | % of adults who visited a dentist in the past year |
|---|---|---|
| 1 | Connecticut | 73.9% |
| 2 | Massachusetts | 73.2% |
| 3 | Hawaii | 71.9% |
| 4 | Utah | 71.3% |
| 5 | District of Columbia | 70.4% |
| 6 | Rhode Island | 70.3% |
| 7 | South Dakota | 69.6% |
| 8 | Michigan | 69.4% |
| 9 | New Hampshire | 69.0% |
| 10 | Idaho | 68.7% |
| 11 | Virginia | 68.5% |
| 12 | Minnesota | 68.4% |
Source: CDC 2022 data. Note: Mississippi wasn’t included due to data suppression.
Permanent tooth removal is common
Americans are no strangers to tooth removal. In fact, 40.3% of adults have had at least one permanent tooth removed. That figure rises to 56.5% in West Virginia, making it the highest by state. That’s followed by Mississippi (51.3%) and Kentucky (51.1%).
States with the highest rate of adults with at least 1 permanent tooth removed
Rank | State | % of adults with at least 1 permanent tooth removed |
|---|---|---|
| 1 | West Virginia | 56.5% |
| 2 | Mississippi | 51.3% |
| 3 | Kentucky | 51.1% |
| 4 | Arkansas | 49.6% |
| 5 | Alabama | 47.8% |
| 5 | Louisiana | 47.8% |
Source: CDC 2022 data.
Meanwhile, those in the District of Columbia are the least likely to have had a tooth removed, at 29.5%. That’s followed by Utah (33.3%) and Colorado (33.9%).
Overall, 11.8% of adults 65 and older have had all their natural teeth extracted. The highest rates are in West Virginia (25.3%), Kentucky (22.5%) and Arkansas (21.9%) — the only states exceeding 20.0%.
States with the highest rate of older adults with all their permanent teeth extracted
Rank | State | % of adults 65 and older with all their teeth extracted |
|---|---|---|
| 1 | West Virginia | 25.3% |
| 2 | Kentucky | 22.5% |
| 3 | Arkansas | 21.9% |
| 4 | Indiana | 18.8% |
| 5 | Mississippi | 18.6% |
Source: CDC 2022 data.
Conversely, Hawaii (5.4%), California (6.9%) and Colorado (7.6%) have the lowest rates.
Visits from the tooth fairy may be free, but how much do adults pay for professional removal? Tooth extraction costs range from $75 to $250 for a simple extraction and $180 to $550 for surgical extraction, according to Dentaly.
Full rankings
States with the highest/lowest rate of adults with at least 1 permanent tooth removed
Rank | State | % of adults with at least 1 permanent tooth removed |
|---|---|---|
| 1 | West Virginia | 56.5% |
| 2 | Mississippi | 51.3% |
| 3 | Kentucky | 51.1% |
| 4 | Arkansas | 49.6% |
| 5 | Alabama | 47.8% |
| 5 | Louisiana | 47.8% |
| 7 | Oklahoma | 47.2% |
| 8 | Tennessee | 46.5% |
| 9 | Florida | 45.8% |
| 10 | South Carolina | 45.2% |
| 11 | Indiana | 44.5% |
| 11 | Ohio | 44.5% |
Source: CDC 2022 data.
States with the highest/lowest rate of older adults with all their permanent teeth extracted
Rank | State | % of adults 65 and older with all their teeth extracted |
|---|---|---|
| 1 | West Virginia | 25.3% |
| 2 | Kentucky | 22.5% |
| 3 | Arkansas | 21.9% |
| 4 | Indiana | 18.8% |
| 5 | Mississippi | 18.6% |
| 6 | Tennessee | 18.3% |
| 7 | Louisiana | 17.2% |
| 8 | North Carolina | 17.0% |
| 9 | Oklahoma | 16.9% |
| 10 | Alabama | 16.7% |
| 11 | Georgia | 16.1% |
| 12 | Ohio | 15.7% |
Source: CDC 2022 data.
Americans generally have good access to dentistry
There were 202,304 dentists across the U.S. in 2023 (the latest available), or 60.4 per 100,000 Americans. By state, the District of Columbia has the highest rate of dentists, with 109.4 per 100,000 residents. That’s followed by Massachusetts (80.2) and Alaska (79.5).
States with the highest rate of dentists per 100,000 residents
Rank | State | Dentists per 100,000 residents | % from national average |
|---|---|---|---|
| 1 | District of Columbia | 109.4 | 81.2% |
| 2 | Massachusetts | 80.2 | 32.8% |
| 3 | Alaska | 79.5 | 31.6% |
| 4 | New Jersey | 77.8 | 28.8% |
| 5 | California | 77.7 | 28.7% |
Source: ValuePenguin analysis of American Dental Association (ADA) 2023 data.
Conversely, Arkansas (41.2) has the lowest rate of dentists. That’s followed by Alabama (41.7) and Mississippi (43.1).
Representation has changed significantly among dentists. In the past 20 years, female representation among dentists has risen by 110.6%. In 2023, 61.2% of dentists were men and 37.7% were women, compared with 81.9% and 17.9% in 2003.
Full rankings
States with the highest/lowest rate of dentists per 100,000 residents
Rank | State | Dentists per 100,000 residents | % from national average |
|---|---|---|---|
| 1 | District of Columbia | 109.4 | 81.2% |
| 2 | Massachusetts | 80.2 | 32.8% |
| 3 | Alaska | 79.5 | 31.6% |
| 4 | New Jersey | 77.8 | 28.8% |
| 5 | California | 77.7 | 28.7% |
| 6 | Hawaii | 77.3 | 28.0% |
| 7 | New York | 72.3 | 19.7% |
| 8 | Washington | 71.0 | 17.5% |
| 9 | Connecticut | 70.1 | 16.1% |
| 10 | Colorado | 69.3 | 14.7% |
| 11 | Illinois | 68.0 | 12.6% |
| 12 | Maryland | 67.9 | 12.4% |
Source: ValuePenguin analysis of ADA 2023 data.
Utilizing insurance to access dental care: Top expert tips
There’s no denying that the cost of dental care can be very high, making it harder for Americans struggling to make ends meet to get the treatment they need. We recommend the following:
- Choose the right plan. If you don’t have dental insurance, compare plans to find one that suits your needs and budget. Consider factors like copayments and network size. Additionally, consider discount dental plans, which offer reduced rates on procedures for a membership fee.
- Know your coverage. Familiarize yourself with what your dental insurance covers, such as preventive, basic and major services. Understand your policy’s annual maximum (the maximum amount the plan will pay in a year) and deductible (the amount you’ll pay out of pocket before insurance kicks in).
- Take care of your teeth. Schedule regular checkups to catch issues early and avoid costly treatments later. Additionally, maintain good oral hygiene in your day-to-day life.
Methodology
ValuePenguin researchers used or analyzed various sources for the Dental Health Report 2024, all the latest available.
- Costs: 2020 data from the Centers for Medicare & Medicaid Services (CMS), via KFF.
- Expenditures: 2000-2022 data from CMS.
- Visits and extractions: 2022 data from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS).
- Access: 2023 data from the American Dental Association (ADA). This includes those in full- or part-time private practice, dental school, the armed forces or other federal services (such as Veterans Affairs), among other employers.