How to Keep Down Dental Costs
Last updated in April 2016
When choosing service providers, especially healthcare providers, you should care most about service quality. But for many patients, especially those without dental insurance, cost matters also. (See our section on dental insurance to help you decide whether to buy it.) Fortunately, you can have both high quality and low cost.
To assess general dentists’ fees, our mystery shoppers called each of the dental practices listed on our Ratings Tables and asked them to provide their fees for several common procedures. The table below shows low, average, and high fees for the procedures we priced. As you can see, some dentists charge more than twice as much as others for identical procedures. For example, prices for a routine examination and cleaning for an established adult patient ranged from $82 to $350; for a new crown (including post and core), prices ranged from $1,026 to $2,310.
|Low, Average, and High Fees Charged by Area Dentists for Some Illustrative Procedures|
|Procedure||Lowest fee||Average fee||Highest fee|
|Comprehensive oral exam for a new adult patient, including cleaning||$82||$173||$257|
|Periodic oral exam for an established adult patient, including cleaning||$82||$202||$350|
|Full-mouth X-rays—complete series, minimum of 14 films including bitewings (digital or conventional)||$90||$160||$300|
|Bitewing X-rays—four films||$48||$83||$140|
|Comprehensive oral exam for a new child patient (10 years old), including cleaning||$70||$148||$208|
|Periodic oral exam for an established child patient (10 years old), including cleaning||$70||$173||$253|
|Topical fluoride application for a child (10 years old)||$0||$34||$76|
|Sealant, per tooth, for a child (12 years old)||$36||$73||$128|
|Two-surface composite filling on an adult molar||$145||$291||$575|
|One-surface composite filling on an adult molar||$110||$228||$458|
|Simple single root canal on an adult premolar, excluding any restorative work||$450||$970||$1,470|
|New porcelain crown for an adult molar, including post and core, fused to high noble metal||$1,026||$1,569||$2,310|
You’ll find similarly large price differences among dental specialists. Our researchers, without revealing their affiliation with Checkbook, called a sample of dentists and obtained prices for several common procedures. For surgical placement of one endosteal implant body (including sedation and X-rays), our shoppers were quoted prices ranging from $1,343 to $5,695—not including fabrication and placement of the crown, which would add $1,026 to $2,310, depending on the dentist. Prices for a full set of characterized upper and lower dentures made with Lucitone acrylic base and IPN teeth ranged from $3,625 to $10,495. For periodontal scaling and root planing of upper gums, prices ranged from $488 to $2,112. Need a root canal? It can cost between $450 and $1,470, depending on the dentist.
For general dentists, we used the prices to calculate price comparison scores for each dentist, reported on our Ratings Tables. Our price comparison scores show how a dentist’s prices compare to the average prices at all surveyed dentists for the same mix of procedures. The price comparison scores are calculated so that a score of $100 is about average, a score of $110 means prices about 10 percent above average, and a score of $90 about 10 percent below average.
Keep in mind that even dentists whose average prices are lower than the Washington area average may not have good prices for the specific procedures you need; be sure to check prices with any dentist—especially for high-priced procedures.
Many dentists who received high patient ratings on all aspects of care and service also had below-average fees. In fact, we found little quality-price correlation among dentists.
Regardless of a dentist’s charges, the cost of dental care will be high if you are over-treated. Below we discuss other steps you can take to restrain dental costs.
Brush, brush, brush.
Good preventive care is by far the best way to save money. Regular brushing, flossing, and professional cleanings will help you avoid future expenses for treatment and restorations.
Ask dentists to describe alternative treatments for any condition.
Look also for signs of individually tailored treatment—for instance, scheduling different intervals between visits depending on the patient’s propensity for dental disease, and calling for a complete X-ray survey no more than every three years, unless special circumstances require more frequent examination.
When evaluating candidates, ask about fees for a few common procedures.
Many dentists readily provide such information to potential patients.
Request written treatment plans and estimates in advance.
Almost all dentists will provide estimates for free. Even a modest fee for a written estimate is worthwhile if it helps you avoid an unpleasant surprise after the work is done.
Get a second opinion.
Probably the most underused consumer tool in dentistry, obtaining a second opinion before agreeing to costly treatment can make sure you get appropriate, reasonably priced care. It can also be useful leverage if a dispute arises later. Consult a dentist who is independent of your own dentist, telling this dentist in advance that you will not be using him or her for the treatment or procedure. If opinions differ, weigh each dentist’s reasons—and possibly solicit still another opinion if the recommended work is extensive.
Getting a written treatment plan and a second opinion protects both your oral health and your wallet. Treatment plans and final bills should itemize costs. Dentists should not make it uncomfortable for you to discuss costs, and they should be willing to work out payment plans or alternative treatments if the costs exceed your means.
Consider asking for a warranty.
Only a few dentists offer written warranties; more should—at least on major restorative work such as bridges and crowns. Even if a dentist won’t provide a written warranty, discuss your expectations and get the dentist to agree verbally that he or she will replace work that fails much sooner than normal, assuming you care for your teeth properly. Regardless of what agreement you have in advance, don’t hesitate to ask for a free replacement if a restoration doesn’t last as long as it should.
If you switch dentists, have the new dentist obtain your records from your previous one.
Doing so may spare you the cost of some procedures. For example, unless your new dentist has a good reason to take new ones, full-mouth X-rays taken by a previous dentist are usually good for three to five years. Your former dentist is ethically bound to pass along X-rays and other records.
Ask about specials and discounts.
Some dentists offer periodic specials on certain procedures to encourage patients who have been putting off dental work to go ahead and get it done. Others advertise low-priced package deals, including examination, cleaning, and X-rays, to attract new patients. To save time and money in collecting unpaid bills, many dentists offer discounts for payment at the time of service. Some offer discounts to special groups, such as seniors, certain professionals, fire and police personnel, students, persons with limited incomes, etc.
Double-check your health insurance policy for dental benefits.
Determine what coverage you already receive for a reduced or subsidized premium through benefits offered by your employer, your spouse’s employer, or another source.
If you have kids, they could already have dental coverage under your family’s health insurance plan. The Affordable Care Act (“Obamacare”) requires all individual and small-group health plans to provide basic dental coverage for children under age 19; insurance plans offered by your state’s exchange can satisfy the pediatric dental benefit requirement by offering buyers standalone family dental policies.
Most health insurance plans don’t provide other dental benefits to adults, but it’s still worth checking. Some Medicare Advantage plans, for example, include basic dental coverage, and many “consumer-driven” and “high-deductible” health plans let you set aside money for dental expenses.
If you have dental insurance, or are thinking about buying it, make sure you understand the benefits and limitations.
Insurance benefits vary greatly from policy to policy. Most plans have groups of participating dentists who accept a specified fee schedule. You’ll probably save a lot by using one of these dentists—and not save much by using a non-participating one. Our section on dental insurance discusses in detail the many things to consider when buying it.
Fund your FSA.
Whether you have dental insurance or not, do a bit of planning to estimate your likely out-of-pocket medical and dental costs, and stash that money in a flexible spending account (FSA). By funding an FSA with pretax earnings, you effectively reduce eligible bills by your tax-bracket percentage.
Consider getting treatment at a dental clinic.
To provide hands-on experience for their students, dental schools operate clinics where students treat patients under the supervision of dental school faculty. Loma Linda University; the University of California, San Francisco; and the University of the Pacific operate such clinics. We’ve found prices at dental clinics to be significantly lower than average prices for dental practices. Keep in mind that if you need extensive treatment, it is likely to take longer at a dental school clinic than with a private dentist.