Cost is the No. 1 reason why Americans don’t get regular dental care.
That's a lot more than most people can bite off. You may be retired, on a limited income, out of work, or lack dental coverage. One in 3 American adults lack dental insurance.Even with insurance, expensive services can leave you stuck with big out-of-pocket spending.
But it’s possible -- with research, patience, and luck -- to find free or low-cost dental care.
Every state has at least two dental or dental hygiene programs. Alaska has four, and New York has 160. They’re full of students who need hands-on training before they can graduate.
Most schools run clinics where students treat the public at reduced prices. You might pay half or even less for root canals, fillings, and other services, compared with what established dentists charge. Expect your appointment to take longer than usual because licensed supervisors check each step as the student works on you. The upside is that the treatment will be done by the book.
You can search the website for the Commission on Dental Accreditation for a school in your state.
Public Dental Clinics
These are taxpayer-funded clinics run by local or state health departments or by community health centers that get grants from the federal government. Many charge low, fixed prices or sliding fees based on how much you can afford. Most clinics offer exams, cleanings, X-rays, root canals, fillings, crowns, and surgical tooth extractions. Some may have emergency dentists on call.
Some clinics charge sliding fees based on how much you can afford. Others have low fixed prices, such as $15 for a full set of X-rays for kids.The nonprofit group Oral Health America has a website, Toothwisdom.org, with a national directory of affordable dental programs. Search for clinics run by health departments or by federally qualified health centers.
Free Dental Clinics
The need for dental care dwarfs the supply. Many charities, faith-based groups, and professional dental organizations donate dental services. But their waitlists can be long or closed altogether. Some have income cutoffs or serve only seniors or people who have disabilities or medical conditions.
Nonprofit clinics. Some cities have dental clinics that specifically serve people with low incomes, no insurance, or who otherwise can’t afford care.
The Ben Massell Dental Clinic in Atlanta, for example, is staffed by volunteer dentists and specialists who provide a full range of services at no cost. Nashville’s Interfaith Dental Clinic accepts people with low incomes and no insurance on a first-come, first-served basis. Fees are based on your ability to pay.
You can find some of these clinics via United Way’s 211.org website. Others may be listed on state or local directories of free or safety net dental clinics.
Donated services. Some state or national charities use donated labor and materials to give free care. Dental Lifeline operates in all 50 states and accepts people 65 and over, or who have permanent disabilities or serious medical conditions. A related program matches low-income children with volunteer orthodontists for braces and other treatments.
Mission of Mercy, a program run by America’s Dentists Care Foundation, hosts free two-day dental clinics at fairgrounds, high schools, and other places in different states. Some treat adults only, and others take children, too. They usually don’t require proof of income and treat as many people in line as they can. Check the website for dates and locations of upcoming clinics.
Private dentists. Some dentists may handle a few cases a year for free. They may accept referrals from other dentists who are trying to help someone who needs lots of oral treatments but can’t afford them. If you’ve been seeing a dentist for a long time and need help, be upfront about your financial situation and ask if you qualify.
Government Dental Coverage
If you’re unemployed, or you work but earn very little, check if your family can get on Medicaid or the related Children’s Health Insurance Program (CHIP). You may be eligible even if you’re not a parent. In most states, Medicaid charges no monthly premiums. It covers dental care in full for children up to age 19. For adults, about one-third of states offer limited dental benefits, and another third cover extensive dental treatments.
Dental Savings Plans
It’s easy to confuse dental savings plans (also known as dental discount plans) with dental insurance, but they’re very different. Whether insurance or a discount plan -- or some combination of the two -- is right for you will depend on how much dental work you and your family get per year and how much you’re paying out of pocket.
How do dental savings plans work?
When you belong to one, you get a discount of 10% to 60% off services from dentists who are in the plan’s network. You pay a yearly fee (typically less than $150 for a family), and there’s no deductible, meaning you don’t have to have paid a certain amount for the discount to kick in.
Another potential benefit of dental savings plans is that you can use the discount within a few days of signing up. So you can wait to buy one until you need work done.
Who might want a dental savings plan?
It may be a good option for people who don’t have access to dental insurance or who want services that aren’t covered by insurance. This might include older people who don’t have dental insurance under Medicare or younger people who want discounts on something like teeth whitening, which traditional insurance usually doesn’t cover.
You also might think about a dental savings plan if you need dental work that costs more than your dental insurance will pay. (Many dental insurance plans cap their total payout at less than $2,000 a year.) For example, saving 50% on a couple of root canals that cost $1,000 each would add up quickly.
How do I find a dental savings plan?
Some companies offer the plans as part of their employee benefits package, and you can get them through groups and associations, as well as directly from major insurance companies.
If you have a dentist you like, ask them if they take part in one and how much you could save with it. If you’re open to new providers, call a few who are in the plan you’re thinking about to see if the savings would be worth it. Thousands of dentists take part in dental savings plans, and you can usually get a member list from the plan’s sponsor.
While many reputable companies offer dental savings plans, the industry has attracted some fraudsters. Avoid scams by asking to be mailed information before you make a payment, and say no to high-pressure salespeople. You also can check with the Better Business Bureau or your state’s insurance regulator to see if a company has had complaints made against it.
Other Ways to Save Money at the Dentist
Space it out. The twice-a-year dental checkup has been the mainstay for decades. But there’s not much evidence that everyone needs to go that often. In one study, researchers looked at 16 years of insurance claims and found that for most nonsmokers in good health, one visit a year may prevent tooth loss just as well as a checkup every 6 months.
Skip what you can. Before your exam, ask about the plans for your visit and the fees. Check if you can do without a particular service. For example, many insurers pay for bitewing X-rays -- which show cavities between teeth -- every 12 months. The American Dental Association says teens and adults can wait up to 3 years between X-rays if they take good care of their teeth and don’t have any oral problems.
But if you have tooth decay or are likely to get cavities, you may need X-rays as often as every 6 months. If you skip them, they could cost you a tooth or require an expensive root canal or a crown later.
Wise up about wisdom teeth. These teeth at the very back of your mouth usually come in during your late teens or early 20s. Some people never get them, or they have them with no issues. But wisdom teeth often can get impacted when they don’t have space to come out from the gum.
Many dentists recommend taking them out as a way to avoid any problems. But some researchers and public health experts say extraction surgery is not a good idea for otherwise healthy teeth.
Ask your dentist if your wisdom teeth need to come out right away or if you can wait a few months or years. Or get a second opinion. Remember that putting off a needed extraction could make it more complicated and expensive in the end.
Rethink braces. Straightening and aligning teeth is a big-ticket expense that involves many trips to your dentist or orthodontist to adjust your appliance and to check your progress. More often than not, people get braces for cosmetic, not medical, reasons.
Sometimes, a poor bite can keep your or your child’s teeth and jaw from working without pain. Braces can correct that. Other times, you may want to get braces simply to look and feel better. Either way, check if you can pay in installments and if you can skip any services to keep costs down. Be upfront about your money situation, and ask what’s best for you.
Do-it-yourself clear aligners have become very popular but may not be a good choice. Moving your teeth to the alignment you need takes precision. The one-size-fits all approach could damage your teeth, your bite, and/or your jaw.
Do Your Part
It bears repeating: Prevention is the best -- and cheapest -- medicine. Brush and floss every single day. Flossing prevents plaque and the cavities that follow it. Brushing keeps your teeth and gums healthy.
Know the signs when something minor turns serious. Call your dentist if you notice:
- Pain. Eating and chewing should not hurt.
- Your teeth are always sensitive, especially to hot, cold, or sweet foods and drinks.
- Swelling. Even if it doesn’t hurt, swelling inside your mouth could be just irritation but could also signal an infection.
- Bleeding. Your gums shouldn’t bleed every time you brush.
- Bad breath that won’t go away also can mean infection.