Dental expenses are deductible only if you itemize deductions and they exceed 7.5% of your adjusted gross income

Most people cannot deduct dental costs because the standard deduction is larger than their itemized deductions would be. But if you do itemize, dental expenses count as medical expenses on Schedule A of Form 1040. The catch: you can only deduct the amount that exceeds 7.5% of your adjusted gross income (AGI) for the year.

For example, if your AGI is $80,000, you can only deduct dental expenses above $6,000. If your dental costs were $5,500, you get no deduction. If they were $7,200, you deduct $1,200.

This threshold makes dental deductions rare for most households. You would need either very high dental costs in a single year, a low income, or both.

Key Takeaways

  • Dental expenses are only deductible if you itemize deductions on Schedule A, and only the amount exceeding 7.5% of your AGI counts.
  • Preventive care (cleanings, exams, X-rays) and treatment (fillings, root canals, crowns, orthodontia) both count, but cosmetic work does not.
  • Dental insurance premiums you pay yourself are deductible medical expenses, but premiums paid by your employer are not (they reduce your taxable income differently).
  • If you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), you can pay dental costs with pre-tax dollars, which is usually more valuable than itemizing.
  • Bunching dental work into a single year — scheduling multiple procedures you were planning anyway — can push you over the 7.5% threshold and create a deduction.

What dental costs count as deductible medical expenses

The IRS treats dental care as a medical expense if it treats or prevents disease of the teeth, gums, or jaw. This includes routine cleanings, exams, X-rays, fillings, root canals, crowns, bridges, dentures, and orthodontia (braces or aligners). Extractions, gum surgery, and implants also count.

Cosmetic dentistry does not count. Teeth whitening, veneers for appearance only, and bonding purely for cosmetic reasons are not deductible. But if a crown or bridge is necessary to restore function after decay or injury, it counts even if it also improves appearance.

Dental insurance premiums you pay out of pocket are deductible. If you are self-employed and pay your own dental insurance, you can deduct it as a business expense on Schedule C, which is often better than itemizing. If you are an employee and pay premiums through payroll deduction, those premiums are usually already pre-tax, so you cannot deduct them again.

When itemizing makes sense versus using an HSA or FSA

Before you assume itemizing is your best route, compare it to a Health Savings Account or Flexible Spending Account. Both let you pay dental costs with pre-tax dollars, which reduces your taxable income directly.

An HSA is available if you have a high-deductible health plan. You contribute up to $4,150 per person per year (2024; the limit changes annually), and the money rolls over if unused. You can withdraw it tax-free for any medical or dental expense, including preventive care. An FSA is offered by some employers and lets you set aside up to $3,300 per year (2024) for medical expenses, but unused money is forfeited at year-end.

Both are usually better than itemizing because they reduce your AGI directly, not just the amount above 7.5%. If you have access to either, fund it first before considering itemized deductions.

How to calculate whether you will have a deduction

Start with your adjusted gross income (AGI) from your tax return. Multiply it by 0.075. This is your threshold.

Add up all your medical and dental expenses for the year: insurance premiums you paid, out-of-pocket costs for procedures, mileage to dental appointments (at the IRS rate for medical travel), and lodging if you traveled for treatment. Keep receipts and invoices.

Subtract the threshold from your total expenses. If the result is positive, that is your deductible amount. You enter it on Schedule A, line 1, under Medical and Dental Expenses.

Then compare your total itemized deductions (medical plus charitable, mortgage interest, state and local taxes, and other deductible items) to the standard deduction for your filing status. If itemized deductions are larger, you itemize. If not, you take the standard deduction and get no benefit from the dental expenses.

Bunching dental work into one year to exceed the threshold

If you are close to the 7.5% threshold, you can time major dental work to fall in the same tax year. This is called bunching. If your dentist has recommended a crown, implant, or orthodontia that you have been delaying, scheduling it in a year when you also have other medical expenses might push you over the threshold.

Talk to your dentist about timing. Some procedures can be done in December rather than January, or vice versa. If you know you will have a high-income year or a year with other medical costs, that is the year to bunch dental work.

This strategy only works if your total itemized deductions will exceed the standard deduction. If they will not, bunching does not help.

Self-employed and business owner considerations

If you are self-employed, you have two routes for dental expenses: the medical expense deduction on Schedule A (subject to the 7.5% threshold) or the self-employed health insurance deduction on Form 1040.

The self-employed health insurance deduction is usually better. If you pay your own dental insurance premiums, you can deduct up to 100% of them as a business expense, with no 7.5% threshold. This deduction reduces your AGI directly, which also lowers your self-employment tax.

Out-of-pocket dental costs (procedures not covered by insurance) still go on Schedule A as medical expenses and are subject to the 7.5% threshold. But your insurance premiums themselves bypass that threshold entirely.

Record-keeping and documentation

Keep all invoices, receipts, and explanation of benefits (EOB) statements from your dental provider and insurance company. The IRS does not require you to attach them to your return, but you must have them if you are audited.

For each expense, note the date, the provider's name, the type of service, and the amount you paid out of pocket. If you paid for travel to a dental appointment, keep a log of mileage or receipts for lodging and meals.

If you use tax software, it will walk you through entering medical expenses on Schedule A. If you work with a tax professional, give them a summary of all dental costs and insurance premiums paid during the year, organized by category.

Frequently Asked Questions

Can I deduct dental work my insurance did not cover?

Yes. Any dental expense you paid out of pocket counts toward the medical expense deduction, whether or not your insurance covered part of it. The amount you paid (your copay, coinsurance, or full cost if uninsured) is what you deduct, not the full bill.

What if I paid for my child's dental work?

Dental expenses for your spouse and dependents count toward your deduction if you paid for them. You do not have to claim them as a dependent to include their dental costs; you just have to have paid the bill.

Does orthodontia for my teenager count?

Yes. Braces and aligners are deductible medical expenses, even though they are often considered cosmetic. The IRS treats orthodontia as treatment for a medical condition, not purely cosmetic work.

Can I deduct dental expenses if I take the standard deduction?

No. The standard deduction is a flat amount you take instead of itemizing. You cannot use both. If your itemized deductions (including medical expenses) do not exceed the standard deduction, you get no tax benefit from dental costs.

What if I paid for dental work in 2024 but the bill arrived in 2025?

You deduct the expense in the year you paid it, not the year you received the bill. If you paid in December 2024, it goes on your 2024 return. If the bill arrived in 2025 but you did not pay until then, it goes on your 2025 return.