Dental work is one of the most expensive out-of-pocket medical costs Americans face — and a lot of it is deductible. Fillings, crowns, root canals, braces, dentures, and even some cosmetic procedures qualify under IRS Publication 502. The catch is the same as all medical deductions: you need to clear the 7.5% of AGI threshold and itemize.
What Dental Expenses Are Deductible?
The IRS allows deductions for dental treatment that prevents or alleviates dental disease. That covers a wide range of common procedures:
- Preventive care: exams, X-rays, cleanings
- Restorative work: fillings, crowns, bridges, root canals
- Oral surgery: extractions, wisdom tooth removal, jaw surgery
- Periodontal treatment: gum disease therapy, deep cleanings
- Orthodontics: braces and aligners (Invisalign included) — for both adults and children
- Dentures and implants: full dentures, partial dentures, dental implants
- Dental anesthesia administered during a qualifying dental procedure
What About Cosmetic Dentistry?
This is where people get tripped up. The IRS distinguishes between procedures that treat disease and procedures that are purely cosmetic. Teeth whitening, veneers for aesthetic reasons, and cosmetic reshaping are not deductible — they don’t treat a dental condition.
However, the line isn’t always clean. A crown placed to save a structurally compromised tooth is deductible. The same crown placed purely for appearance on a healthy tooth probably isn’t. When a procedure has both functional and cosmetic elements, the portion attributable to the medical necessity may be deductible. If your dentist documents the medical necessity, you have a stronger case.
Are Braces and Orthodontics Deductible?
Yes — orthodontic treatment is listed as a deductible medical expense in IRS Publication 502. This applies to traditional braces, Invisalign, and other aligner systems, for both adults and children. The full cost of the treatment counts, including down payments and monthly installment payments made during the tax year.
If you’re on a multi-year payment plan for braces, you deduct the amounts you actually paid in each tax year — not the total treatment cost up front.
Dental Insurance Premiums
Dental insurance premiums paid with after-tax dollars are deductible as medical expenses. If your premiums come out of your paycheck pre-tax through your employer’s cafeteria plan, they’re already excluded from your taxable income and cannot be deducted again.
The 7.5% AGI Floor: When It Matters Most for Dental Costs
Dental expenses count toward the overall medical expense deduction — the same pool as doctor visits, prescriptions, vision care, and medical travel. You don’t get a separate dental deduction. All qualifying medical and dental costs are added together, then only the amount exceeding 7.5% of your AGI is deductible.
A single crown or root canal costing $1,500–$3,000 often isn’t enough on its own to clear the threshold. But add it to a year with significant other medical spending — prescription costs, therapy, glasses, or a hospitalization — and you can get over the line.
This is why high-cost dental years (major oral surgery, full dentures, implants, or extensive orthodontic work) are the ones most worth tracking carefully. Use the free medical expense calculator to see whether your total qualifying expenses clear the threshold.
HSA and FSA: Already Pre-Tax
If you paid dental bills with funds from a Health Savings Account (HSA) or Flexible Spending Account (FSA), those expenses cannot be deducted on Schedule A. The tax benefit was already received when the money went into the account tax-free. Only out-of-pocket costs paid with after-tax dollars count toward the Schedule A deduction.
Keeping Records for Dental Deductions
Keep your Explanation of Benefits (EOB) from your dental insurer for every claim — it shows the date of service, procedure, total charge, insurance payment, and your out-of-pocket cost. For procedures paid in cash or through a payment plan, keep receipts from the dental office showing dates and amounts paid.
For orthodontic payment plans, print or save your payment history from the orthodontist’s patient portal at year-end. You need to show what you actually paid during the calendar year, not the total treatment contract amount.
For the full picture of deductible healthcare costs — including vision, prescriptions, therapy, and medical travel — see the medical deductions guide.