Americans work an average of 14.2 hours, or about two full workdays, to pay for one person's annual dental care, with significant variation by state ranging from 10.8 hours in Rhode Island to 20.1 hours in South Dakota.
- U.S. average dental care cost equals 14.2 hours of work, or $619 per person annually.
- South Dakota has the highest burden at 20.1 hours; Rhode Island has the lowest at 10.8 hours.
- State income levels significantly impact affordability -- lower incomes mean the same dental costs require more work hours.
- Dentists can help bridge affordability gaps through membership plans, financing options, and cash discounts.
As a clinician, it happens daily: You examine a patient, share your findings with them, and propose a treatment plan, which is met with a concerned look and reasons why the patient cannot commit to treatment.
A recently published analysis validates your firsthand experience. The Dental Care Affordability Index released its findings examining state by state how many hours the average U.S. household works to pay for one person’s dental care.
South Dakota had the highest burden, clocking in at 20.1 hours -- or 2.5 average eight-hour workdays -- to pay for care. Rhode Island, by contrast, had the lowest burden at 10.8 hours -- still more than one full workday -- to pay for care. The U.S. average was 14.2 hours, or $619, to pay for one family member’s dental care, also surpassing two full workdays.
After South Dakota, other states with the highest burden were Wyoming, North Dakota, Alaska, and Louisiana. The states with the lowest burden after Rhode Island were Maryland, Hawaii, Texas, and New Jersey.
For some neighbor states, the contrast in affordability is stark. For example, Louisianans work 17.5 hours for one person’s dental care, while Texans work 11.5 hours. Louisiana spends $43 more per person, because, according to DentalReviewed.com, who created the index, lower incomes add further weight to each dollar.
DentalReviewed.com pointed out that a state could spend less per person on dental care but still rank high in terms of burden, owing to a low household income. For example, residents of Mississippi spend $311 less than people in Massachusetts on dental care, $489 versus $800, but they must work longer to pay for that care, 16.9 hours versus 13.5. Low spending, DentalReviewed.com said, can also signal that people are forgoing dental care.
The index ranked U.S. states by how much dental care figures into household finances, how much the average person spends on dental care annually, how long an average household would need to cover such care, and how the cost compares to local incomes. State dental spending data was culled from the U.S. Centers for Medicare and Medicaid Services health expenditure data, while household income figures were pulled from U.S. Census Bureau data.
No current economic bright spot
There may not be a light at the end of the tunnel anytime soon. Americans continue to grapple with high costs, including historically high diesel prices, that are outpacing wages.
Further adding to consumer wariness is healthcare. KFF reported in September 2026 that enrollment in Medicaid and the Children’s Health Insurance Program dropped by more than 6 million. KFF estimates that enrollment in health plans offered under the Affordable Care Act receded by nearly 5 million individuals, for a rough estimate of 11 million who lack health insurance.
Dentists are feeling the pinch too. According to the ADA’s Health Policy Institute’s fourth-quarter U.S. Dental Economy Report, reimbursements from private insurers and public insurance were not keeping up with inflation.
What dentists can do
Based on the index’s findings, what can a clinician do?
If you’re a dentist whose practice is in a high-burden state, some options to consider might be offering a membership plan in which patients pay a flat rate annually that covers preventive care for a certain number of visits and discounted treatment for other procedures. A second option might be offering financing to patients. A third option is discounting treatment when patients pay in cash or by check.
While these suggestions have their limitations, they can bridge the gaps between patients getting the care they need and what they can afford without ignoring the financial challenges dentists are grappling with.
