Are Dental Expenses Tax-Deductible? + FAQs

Yes – dental expenses can be tax deductible, but only under specific conditions.

You must itemize deductions on your tax return and meet certain IRS rules for dental costs to reduce your taxable income.

According to a 2023 analysis of IRS data by AARP, the number of taxpayers claiming medical and dental deductions plummeted from 10.1 million in 2017 to about 4 million in 2022.

This dramatic drop – driven by more people taking the higher standard deduction – means millions of Americans may be leaving potential tax savings on the table by not deducting eligible dental bills. With dental care expenditures exceeding $165 billion nationwide in 2022, understanding how to deduct dental expenses can translate into significant tax relief for those who qualify.

What You’ll Learn:

• 🦷 Dental Deduction Basics: Exactly how federal tax law treats dental expenses – and why you must itemize on Schedule A of your Form 1040 to claim them.

• 📊 Federal vs. State Rules: A 50-state overview revealing which states follow the IRS rules, which have their own thresholds, and where no deduction is allowed.

• 💼 Impacts for Everyone: Insights tailored to self-employed individuals, W-2 employees, retirees, and business owners – including special tools like HSA and FSA accounts.

• ❌ Expenses That Don’t Qualify: Why cosmetic procedures (like teeth whitening) and other costs won’t get you a tax break, and how to avoid IRS red flags.

• ⚠️ Mistakes to Avoid: The most common errors (e.g. double-dipping pre-tax plans or missing the 7.5% threshold) and how to sidestep costly misunderstandings when deducting dental bills.

Yes, But There’s a Catch: Federal Tax Law on Dental Expense Deductions

The IRS does allow dental expenses to be tax deductible as part of the medical expenses deduction – but only if you itemize your deductions on your federal income tax return. In other words, you cannot deduct a penny of dental bills if you claim the standard deduction. Here’s how it works:

• Schedule A & the 7.5% Rule: Dental costs fall under the “Medical and Dental Expenses” category on Schedule A (the itemized deductions form attached to Form 1040). You can deduct unreimbursed dental and medical expenses above 7.5% of your adjusted gross income (AGI). This means you first calculate 7.5% of your AGI, and any qualifying dental/medical expenses beyond that amount are deductible. For example, if your AGI is $60,000, the first $4,500 (7.5% of $60k) of your combined medical and dental expenses is not deductible – you only deduct the portion exceeding $4,500.

• Itemizing vs. Standard Deduction: You should only itemize (filing Schedule A) if your total deductions – including dental, other medical, mortgage interest, state taxes, charity, etc. – exceed your standard deduction. After tax reforms, only ~10% of taxpayers itemize. If your itemized deductions don’t beat the standard deduction (which for 2025 is around $13,850 for singles or $27,700 for joint filers, subject to inflation adjustments), you won’t benefit from claiming dental expenses. This is why many Americans, despite having some dental costs, get no tax benefit – their standard deduction provides a bigger write-off.

• “Unreimbursed” Expenses Only: Only out-of-pocket dental expenses qualify. If your dental insurance or an employer FSA (Flexible Spending Account) reimbursed you for part of a procedure, you can’t deduct that reimbursed portion. Similarly, you cannot deduct costs paid with pre-tax dollars (like via an HSA or cafeteria plan) since those were never taxed in the first place.

• Common Qualified Dental Expenses: The IRS treats most necessary dental care as deductible medical expenses. This includes routine care (cleanings, exams, x-rays), fillings and root canals, tooth extractions, dentures, crowns, dental implants, braces and orthodontics, periodontal (gum) treatments, and other procedures to treat dental disease or improve oral health.

  • Dental insurance premiums you pay out-of-pocket (with after-tax dollars) also count. Even dental-related travel costs – mileage to and from the dentist or specialized treatment centers, and lodging if required for out-of-town dental care (up to $50/night) – are deductible medical expenses.

• What’s Not Deductible: Cosmetic dental work is never deductible. Costs for purely cosmetic procedures like teeth whitening, bleaching, or veneer treatments done solely to improve appearance are explicitly disallowed. The tax code (IRC §213) and IRS regulations make clear that expenses aimed at “improving one’s appearance” don’t qualify.

  • So while fixing a cavity or getting a medically necessary crown counts, getting your teeth whitened for a brighter smile does not. Additionally, non-prescription hygiene products (toothpaste, floss, over-the-counter mouthwash) can’t be written off as they are personal care, not medical treatment.

How the Dental Deduction Works (Example)

To illustrate, suppose you had $5,000 of qualifying dental and other medical expenses this year:

• If your AGI is $50,000: 7.5% of that is $3,750. You could deduct expenses above $3,750 – in this case, you’d get to deduct $1,250 of your $5,000 dental bills on Schedule A.

• If your AGI is $200,000: 7.5% of that is $15,000. If you still had the same $5,000 of dental expenses, none of it would be deductible (because $5,000 does not exceed $15,000).

• The higher your income, the higher the threshold you must clear; conversely, if you have a lower income or extremely high dental costs, you’re more likely to benefit. Some taxpayers with very large dental bills (for example, major oral surgery or multiple implants in one year) and moderate incomes can get a significant deduction.

Keep in mind this deduction is available for you, your spouse, and any dependents you claim on your return, as long as you paid the expense. For instance, if you’re a parent who paid for your child’s braces, you can include that cost even if the child doesn’t file their own return. If you have a family, all those dental and medical costs go into the same pot toward the 7.5% threshold.

What Dental Expenses Qualify and Which Don’t

Not every dollar you spend at the dentist is treatable the same way at tax time. It’s crucial to distinguish qualifying medical/dental expenses from those that the IRS will reject. Here’s a breakdown:

✅ Eligible Dental Expenses (Deductible):

• Preventive and Routine Care: Exams, dental cleanings, X-rays, fluoride treatments, and sealants.

• Basic and Major Treatments: Fillings, extractions (tooth removal), root canal therapy, gum disease treatment, crowns, bridges, dentures and prosthetic teeth, and dental implants (when medically needed to replace teeth).

• Orthodontics: Braces, clear aligners (e.g. Invisalign), retainers and related orthodontic care to correct dental irregularities.

• Restorative Surgery: Oral surgeries such as wisdom tooth removal, corrective jaw surgery, or treatment of temporomandibular joint (TMJ) disorders.

• Medically Required Cosmetic Reconstruction: Procedures that might improve appearance but are medically necessary – for example, reconstructive dental surgery or veneers needed to correct deformities from birth defects, accident injuries, or disease. (These are exceptions to the cosmetic rule – documentation may be needed to show the medical necessity.)

• Dental Appliances and Supplies: Mouthguards or splints prescribed for a medical condition (such as to prevent teeth grinding), medically prescribed orthodontic devices, and even special medical-grade toothpaste or rinse if specifically prescribed by a dentist to treat a dental illness (rare, but for conditions like serious gum disease, some items could qualify).

• Insurance Premiums: Dental insurance premiums you pay out-of-pocket (not through pre-tax payroll deductions). If you’re self-employed, you likely deduct these premiums separately (more on that later), but if not and you paid after-tax for a private dental policy or COBRA coverage, you can add those premiums to your medical expenses on Schedule A.

• Travel and Lodging for Dental Care: As noted, you can include the cost of traveling to receive dental treatment. This can be mileage (at the IRS-approved medical mileage rate, which is 22 cents per mile for 2023), tolls, parking fees, or public transit fares to get to your appointments. If you need to travel out of town and stay overnight for a specialized dental procedure, lodging costs up to $50 per night (for the patient and one companion) can be counted.

🚫 Non-Deductible Dental Expenses:

• Cosmetic Procedures: As emphasized, things like teeth whitening, purely cosmetic veneers, tooth bonding done for appearance, or cosmetic contouring are not deductible. The IRS draws a hard line: if it’s not necessary for dental health, it’s personal and not a medical expense.

• General Personal Care Items: Money spent on everyday toothpaste, toothbrushes, dental floss, mouthwash, or whitening strips from the drugstore can’t be deducted. These are considered personal hygiene costs, not medical treatment, even if your dentist recommends a certain product.

• Elective Products and Services: For example, professional at-home whitening kits, cosmetic tooth jewel application, or elective orthodontic work done purely for aesthetic reasons (with no functional or health justification).

• Missed Appointment Fees or Membership Plans: If a dentist charges you for missing an appointment or you pay for an optional “dental discount plan” or concierge service that isn’t actual medical care, those costs aren’t medical expenses for tax purposes.

• Expenses Covered by Others: Any portion of a dental expense that your insurance paid, that was reimbursed by an employer plan, or paid via a tax-free account cannot be deducted. For instance, if you paid $2,000 for a procedure but later got a $1,500 reimbursement from your dental insurance, only the $500 difference is potentially deductible (subject to the AGI threshold).

• Over-the-Counter Drugs and Supplements: Generally, OTC medications or supplements aren’t deductible even if recommended for oral health (unless prescribed by a doctor). For example, if your dentist suggests a specific fluoride rinse or calcium supplement for your teeth, unless you obtain it via prescription, it won’t count as a deductible expense.

• Illegal or Unapproved Treatments: It’s rare in dentistry, but any expense for unapproved treatments or illicit services is not deductible. (And if something is illegal, it’s definitely not deductible by law.) Stick to licensed dental practitioners and medically accepted treatments if you plan to claim a deduction.

Understanding these distinctions will save you from trying to deduct something impermissible. When in doubt, consult IRS Publication 502, which lists many eligible and ineligible expenses in detail.

State-by-State Nuances: How States Handle Dental Deductions

Federal law is just one side of the coin. State income tax laws can differ significantly in whether they allow you to deduct dental and medical expenses. After you navigate the federal rules, you’ll want to know: Can I also deduct dental costs on my state tax return? The answer varies by state:

• No State Income Tax (No Deduction Needed): Firstly, if you live in a state with no income tax, state deductions are a non-issue. States like Florida, Texas, Washington, Nevada, South Dakota, Alaska, Wyoming, Tennessee, and New Hampshire do not tax ordinary income, so there’s no state tax return line for dental expenses. (New Hampshire and Tennessee tax only certain investment income and not wages, so for dental expenses there’s nothing to deduct at state level.)

• States Following the Federal 7.5% Rule: A majority of states that allow itemized deductions piggyback on the federal definition for medical expenses. In states such as California, Georgia, Delaware, Hawaii, Idaho, Iowa, Maine, Massachusetts, Montana, New York, North Carolina, Oklahoma, Oregon, and Washington D.C., you can deduct unreimbursed dental/medical costs that exceed 7.5% of your AGI, just like on your federal return.

  • These states generally require you to itemize at the state level (and in many cases you must have itemized federally as well) to claim the deduction. (Note: Some of these states tied their law to an older version of the federal code – for instance, New York historically used a 10% threshold for a period when federal was 10%. As of the latest updates, many states have moved to 7.5%, but always check your state’s current rule.)

• States with a Higher 10% Threshold: A few states still impose a stricter threshold. For example, Virginia, South Carolina, and Arkansas currently allow a medical/dental deduction but only for expenses above 10% of AGI. This means it’s a bit harder to get a state deduction there compared to federal. New York, which we mentioned, also had a 10% floor in recent years – meaning New Yorkers could deduct on the NY state return only the portion of expenses above 10% of their AGI (a tougher hurdle than the federal 7.5%).

• More Generous States (Lower Floors): On the flip side, a couple of states make it easier to deduct. Alabama and Nebraska use a only a 4% of AGI floor for medical and dental expenses – so residents can deduct amounts above just 4% of income (much lower threshold than 7.5%).

  • Meanwhile, Arizona stands out by allowing all qualified medical and dental expenses with no income floor at all – every dollar of unreimbursed dental expense in AZ can potentially reduce your state taxable income if you itemize. And New Jersey doesn’t allow broad itemized deductions, but it offers a special deduction for medical and dental expenses exceeding 2% of New Jersey gross income – making it one of the lowest thresholds in the country for state tax.

• States That Don’t Allow Medical/Dental Deductions: Several states either have no itemized deductions or explicitly disallow the medical expense deduction. For instance, Pennsylvania and Illinois tax systems do not permit itemized deductions at all (so no break for dental costs on those state returns). Michigan and Indiana also do not offer an itemized deduction for medical expenses.

  • In Kentucky, itemizing is allowed on state taxes, but Kentucky law specifically does not allow any deduction for medical and dental expenses – they’re carved out. Other states that effectively disallow medical deductions include Connecticut, North Dakota, West Virginia, Louisiana, Missouri, and Maryland (each of these has either no applicable deduction or has decoupled from the federal medical expense provision). Rhode Island, Vermont, and Colorado do not permit itemized deductions on the state return at all – meaning you get no separate state benefit for your dental costs.

  • And Utah and Wisconsin take a unique approach: instead of a deduction, they provide a tax credit related to itemized deductions or medical expenses. (Wisconsin, for example, offers a credit for certain medical expenses over a small monthly threshold, effectively requiring at least $35 per month in expenses.)

• Special State Nuances: A few states have one-of-a-kind rules. New Mexico allows a supplementary medical deduction or credit subject to specific conditions (often aimed at low-income or senior taxpayers with high medical costs).

  • Kansas allows only 75% of the federally deductible medical expenses to be claimed on the state return (essentially a partial allowance). And Louisiana lets you deduct medical expenses on the state form only to the extent your total itemized deductions exceed the amount of the federal standard deduction – a quirky rule that can limit the usefulness of medical deductions.

As you can see, the landscape is patchwork. Here’s a quick reference table summarizing the state-level treatment of dental/medical deductions:

(Tax laws change – always check your state’s latest tax instructions. Some states have adjusted thresholds or rules in recent years.)

In practice, remember that to benefit on your state taxes, you usually need to itemize there as well. Many states require that if you took the standard deduction federally, you must take the state standard deduction (thus forfeiting any medical deduction). A handful allow itemizing on state even if you didn’t on federal – in those cases you’d compute itemized just for the state.

For example, Massachusetts and New Jersey don’t have general itemized deductions, but they specifically let you deduct certain medical expenses separately – so check your state’s forms for a line for medical or dental expenses.

The key takeaway: federal law is uniform, but state tax treatment of dental expenses ranges from generous to non-existent. Always review your state’s tax guidelines or consult a tax professional for state-specific rules, especially if you had significant dental costs.

Different Situations: Self-Employed, Employed, Retirees, and Businesses

Tax deductions for dental expenses can play out differently depending on your employment status or whether it’s a personal vs. business expense. Let’s break down special considerations for various scenarios:

Self-Employed Individuals (Freelancers, Business Owners)

If you’re self-employed, you have an additional avenue to get tax relief for dental costs: the self-employed health insurance deduction. As a self-employed person (with net profit from Schedule C, or partner in a partnership, or >2% S-corp shareholder), you can deduct medical and dental insurance premiums for yourself, your spouse, and dependents above the line on your Form 1040 (meaning it reduces your AGI, without itemizing). This is a big advantage – you can claim your dental insurance premiums as an adjustment to income, avoiding the 7.5% threshold entirely. A few notes:

• This above-the-line deduction covers insurance premiums (health, dental, vision insurance). It does not cover out-of-pocket dental care costs – those still fall under itemized deductions if you want to deduct them.

• You can’t claim more in premiums than your business income. For example, if your Schedule C profit is $5,000 and you paid $6,000 in health/dental premiums, you can only deduct $5,000 of those premiums above the line. (Any excess could then be treated as an itemized medical expense on Schedule A if you itemize.)

• Aside from premiums, your actual dental treatment bills are treated the same as any individual’s: you must itemize to deduct them and clear the 7.5% AGI floor. The self-employed don’t get a special pass on personal out-of-pocket expenses. However, being self-employed might give you flexibility to bunch expenses in one year (for instance, planning major dental work in a high-income year or a year you know you’ll itemize) to maximize the deduction.

• Health Savings Accounts (HSAs): If you have a high-deductible health plan, you might contribute to an HSA. Money you put in an HSA is tax-deductible, and withdrawals used for eligible medical/dental expenses are tax-free.

  • Essentially, using an HSA to pay for dental bills gives you a tax break without needing to itemize or worry about thresholds. For the self-employed, this is a powerful tool: you deduct contributions to the HSA (above the line), then pay your dentist with those pre-tax dollars. Just remember, if you use HSA funds for a dental bill, you cannot also count that bill toward an itemized deduction. It’s one or the other – but the HSA usually provides the better benefit if you have access to it (because it’s a dollar-for-dollar tax deduction up to annual limits, regardless of your medical expense total).

W-2 Employees (Regular Job Holders)

For employees, dental expenses are primarily handled through itemizing or via employer benefit plans:

• Itemizing: As a W-2 earner, your out-of-pocket dental costs are deductible on Schedule A just like for anyone else, subject to the 7.5% rule and itemizing requirement. There’s no special provision for employees beyond that – in fact, tax law has eliminated miscellaneous itemized deductions for unreimbursed job expenses, but medical expenses like dental remain deductible if you qualify.

• Flexible Spending Accounts (FSAs): Many employers offer an FSA or similar cafeteria plan. If you set aside part of your paycheck into a health FSA, that money is pre-tax and can be used to reimburse qualifying medical and dental expenses. For example, you might contribute $2,000 to your FSA and later use it for a dental crown or braces payment. In doing so, you effectively get a tax deduction on those dental dollars via your paycheck (avoiding income and payroll taxes).

  • However – you cannot also claim those FSA-paid expenses on Schedule A. No double-dipping. FSAs have a “use it or lose it” rule, but they’re a great way for employees to get an immediate tax benefit for predictable dental costs (like orthodontic payment plans). Often, it’s better to use an FSA for known expenses (e.g. $1,500 of dental work) rather than hoping to deduct them, especially if you’re unlikely to itemize otherwise.

• Health Savings Accounts (HSAs): If you have an HSA through your employer’s insurance, similar logic applies. You’re using pre-tax money for dental bills, which is usually more beneficial than trying to deduct them after the fact. Again, expenses paid with HSA funds can’t go on Schedule A.

• Dental Insurance via Employer: If your employer provides dental insurance and you pay part of the premium, those premiums are often taken out pre-tax. In that case, you’re already getting a tax break and can’t deduct the premiums again. If for some reason your dental premiums are paid with after-tax money (uncommon), you could include them in your itemized deductions. But typically, employer-sponsored insurance premiums are handled pre-tax or are paid by the employer.

• Example – Employee Scenario: Suppose you are an employee with $80,000 salary, and you had $3,000 of dental work not covered by insurance this year. If you take the standard deduction (around $13,850 if single), you get no specific tax benefit from the dental work.

  • If you had other deductions and itemized, your $3,000 faces a $6,000 threshold (7.5% of $80k) – so none would be deductible anyway. In contrast, if you knew ahead and put $3,000 into your FSA, you would have saved income tax on that $3,000 immediately.

  • Moral: use employer health plans and FSAs/HSAs if available to cover dental costs tax-free, because itemizing medical expenses often yields nothing unless your expenses are very high.

Retirees and Seniors

Retirees often face significant dental expenses (for example, dentures, implants, or simply more frequent dental work) while on fixed incomes. The medical expense deduction can be particularly valuable for seniors:

• Lower AGI, Lower Threshold: Many retirees have less income, which means the 7.5% threshold is lower in absolute terms. For instance, 7.5% of a $40,000 AGI is $3,000. If a retired couple spends $10,000 on dental and other medical expenses (quite possible between dental, hearing aids, vision care, etc.), they could deduct about $7,000 on Schedule A – which often, combined with other deductions, makes itemizing beneficial.

• Retirement Income and Itemizing: Retirees who own homes may or may not have mortgage interest (many have paid off their mortgage), but they might have property taxes and charitable contributions. The addition of large medical bills can push a retiree’s itemized deductions over the standard deduction, especially since there’s an extra standard deduction amount for age 65+ (for 2025, about $1,850 extra per person if over 65).

  • So, a retired married couple both over 65 has a standard deduction roughly $30,700. If they have, say, $20k in medical (including dental), $5k in property tax, and $5k in charity, their itemized total hits $30k – just about that mark. A slightly higher medical outlay would make itemizing pay off.

• Medicare and Dental: Traditional Medicare (Parts A & B) generally does not cover routine dental care. Many seniors pay dental costs out-of-pocket or purchase separate dental insurance or Medicare Advantage plans that include dental benefits.

  • Premiums for Medicare itself (Part B, Part D, Medicare Advantage) are deductible as medical insurance if you itemize; likewise, if they buy a private dental insurance plan, that premium is deductible if paid after-tax. (Medicare premiums taken out of Social Security are considered paid by you with after-tax money, so those count.)

• Using HSAs in Retirement: If you had an HSA from when you were working, you can continue to use those HSA funds tax-free for dental expenses in retirement. You just can’t contribute new money to an HSA once you’re on Medicare. But any accumulated HSA balance can pay for dental work (or other medical needs) and doesn’t require you to itemize or worry about thresholds.

• Planning Medical Expenses: Some retirees strategically plan elective medical or dental procedures in the same year to maximize deductions. For example, getting needed dental implants and an elective surgery in one calendar year could produce a large combined medical deduction that wouldn’t happen if those were split across years. Retirees on fixed incomes but with large medical needs can often benefit from this bunching strategy.

• One Caution: If an elderly person has extremely high medical expenses, they might not owe much tax to begin with (especially if income is low), so sometimes the deduction doesn’t produce a huge benefit – it merely reduces taxable income that may already be modest. However, it can help reduce taxes on retirement account withdrawals or other income. It’s still worth tracking expenses, since even a partial deduction could save some money.

Businesses and Employers (Dental Benefits)

From the perspective of a business offering dental benefits:

• Employer-Provided Dental Insurance: If you run a business (whether a C-corp, S-corp, partnership, etc.) and you provide dental insurance to employees, the premiums your business pays are generally 100% deductible to the business as a compensation expense, and the benefit is not taxable to your employees.

  • This is the best-case scenario: the employer gets a deduction, and employees get dental coverage tax-free. Even if you’re a small business owner with just a couple of employees, you can usually deduct the cost of their dental insurance or reimbursements.

• Health Reimbursement Arrangements (HRAs): Some small businesses set up an HRA to reimburse employees for medical/dental expenses. These reimbursements are deductible to the business and tax-free to the employee (within plan rules).

  • For example, a qualified small employer HRA (QSEHRA) might allow reimbursing an employee up to a certain amount each year for dental bills they paid, instead of offering a formal insurance plan. If you’re self-employed with no employees, an HRA isn’t applicable (you can’t reimburse yourself pre-tax unless you have a formal C-corp and you’re an employee of it, or via a spouse’s coverage).

• Owners vs. Employees: If you’re a sole proprietor or single-member LLC, you cannot deduct your personal dental work as a business expense on Schedule C – it remains a personal medical expense. Instead, you use the self-employed health insurance deduction for premiums or Schedule A for out-of-pocket costs.

  • However, if you operate through a corporation and draw a salary, the corporation can offer you (and other employees) health and dental benefits. In that case, the corporation deducts the premiums and you (as an employee) don’t pay tax on that benefit (S-corp >2% shareholders have to include it in wages but then take the personal deduction – a technicality, but the outcome is similar).

• No Personal Dental on Business Tab: It should be clear that you cannot charge your company for your personal dental procedure and call it a business expense. Even if having a nice smile might help your business interactions, the IRS will consider that a personal expense. The only way to get a business deduction for dental costs is through a bona fide employee benefit plan that covers employees generally, not a one-off payment for the owner’s personal procedure.

• Tax Credits: While beyond the scope of most individuals, note that there is a small business health care tax credit for very small employers who provide health insurance to employees. Dental insurance can sometimes be included if it’s part of the overall health plan offering. This credit is complex and limited, but it’s worth mentioning that supporting employees’ health (including dental) can have tax incentives beyond just deductions.

Key Tax Forms and Concepts You Should Know

To successfully claim dental expenses and avoid issues, familiarize yourself with these key tax entities and terms and how they relate to each other:

• IRS (Internal Revenue Service): The U.S. tax authority that defines what’s deductible and enforces the rules. The IRS provides guidance (like Publication 502) on medical and dental deductions and may require you to substantiate (prove) your deduction if audited. Essentially, the IRS sets the 7.5% rule and the definitions of qualified expenses.

• Form 1040: The main individual income tax return. This is where you choose between taking the standard deduction or itemizing. If you claim dental expenses, it will be via an itemized deduction on Schedule A, which then reduces your taxable income on Form 1040.

• Schedule A (Itemized Deductions): A crucial attachment to Form 1040 for itemizers. Medical and Dental Expenses are the very first section on Schedule A. You list your total out-of-pocket medical/dental expenses, then the form has you compute 7.5% of AGI and subtract it, leaving the deductible portion. Schedule A is also where you tally other itemized deductions (state taxes, mortgage interest, charitable contributions, etc.). Only if the sum of all itemized deductions exceeds your standard deduction does itemizing actually save you money.

• Adjusted Gross Income (AGI): This is your gross income minus certain above-the-line adjustments (like IRA contributions, student loan interest, the self-employed health insurance deduction, etc.). AGI is found on line 11 of Form 1040. The 7.5% threshold for medical/dental is based on your AGI. Strategies that lower your AGI (like contributing to retirement plans or HSAs) can indirectly make it easier to deduct medical expenses by lowering that threshold.

• Dental Insurance: Insurance affects your deductions in two ways. First, premiums you pay (with after-tax money) are part of your medical expenses. Second, any amounts insurance pays for your care are not deductible. It’s important to only deduct what you paid. If your employer pays your premium or it’s handled pre-tax, you can’t deduct those premiums. And if you get reimbursed for a dental expense after you’ve deducted it, you may need to adjust your return (or include the reimbursement as income) to avoid a double benefit.

• Flexible Spending Account (FSA): An employer-sponsored plan that lets you set aside pre-tax dollars for medical and dental expenses. If you use an FSA to pay for a dental expense, you cannot deduct that expense on Schedule A because it was paid with pre-tax money (it’s already tax-free). For example, paying your orthodontist through your FSA means you’ve effectively gotten a tax deduction upfront, so you can’t get another by itemizing. FSAs typically have annual contribution limits (around $3,050 in 2024) and a use-it-or-lose-it rule.

• Health Savings Account (HSA): A savings account for medical expenses available if you have a qualifying high-deductible health plan. Contributions to an HSA are tax-deductible (or pre-tax via payroll), and withdrawals used for medical/dental expenses are tax-free.

  • Using HSA funds for dental bills is often the most tax-efficient method: you get a deduction for the contribution, and you pay no tax on the distribution for the expense. But again, no double-dipping – you can’t also count that expense toward itemized deductions. HSAs have contribution limits (e.g. $3,850 single / $7,750 family in 2025, plus $1k catch-up if over 55). Notably, you can save receipts and choose to reimburse yourself later; some people save HSA money for retirement but keep the option to reimburse past medical expenses tax-free.

• Health Reimbursement Arrangement (HRA): An employer-funded arrangement (not an account you own) that reimburses employees for medical expenses. If you have an HRA at work and it pays for your dental work, you can’t deduct those expenses because, from your perspective, they weren’t paid out-of-pocket (your employer bore the cost). HRAs are less common at large scale, but small employers may use them to help with costs without a formal insurance plan.

• Tax Court Rulings: Over the years, tax courts have clarified what’s allowed as a medical deduction. They consistently disallow purely personal or cosmetic expenses and uphold the IRS’s definition of medical necessity. For example, courts have denied deductions for cosmetic surgeries (like elective cosmetic dental veneers) unless tied to a deformity or disease.

  • On the other hand, if you had unique dental-related costs (say, a guide dog trained to assist after an oral surgery complication affecting mobility, hypothetically), the courts and IRS have allowed unconventional deductions if they squarely meet the criteria of treating or mitigating a medical condition. While you don’t need to cite court cases on your return, being aware of these boundaries helps – when in doubt, ask your dentist or doctor for a letter stating why a procedure is medically required to support your case.

Documentation Tip: Always keep good records of your dental expenses. Save receipts, invoices, mileage logs for travel, credit card statements showing payments, and insurance Explanation of Benefits (EOBs). If you claim a large deduction, the IRS could ask for proof. Having a paper trail will make it easy to substantiate your deduction.

Avoid These Common Mistakes When Deducting Dental Expenses

Even savvy taxpayers can trip up on the medical expense deduction. Here are some frequent mistakes to steer clear of when dealing with dental deductions:

• ⚠️ Mistake 1: Not Itemizing When Required – Some assume they can deduct dental bills in addition to taking the standard deduction – unfortunately, you must itemize to claim any dental or medical expenses. There’s no “above-the-line” deduction for personal out-of-pocket dental costs (except for the special self-employed insurance premium deduction). Don’t list dental expenses on your return without filing Schedule A; the IRS will disallow them.

• ⚠️ Mistake 2: Misunderstanding the 7.5% Threshold – Taxpayers often think all their dental bills are deductible. In reality, you only get a deduction for the portion over 7.5% of AGI. For example, if you have $2,000 of expenses and $50,000 AGI, none of that $2,000 actually becomes a deduction because it doesn’t exceed $3,750. Failing to calculate this floor can lead to overestimating your deductions or a surprise when your tax software limits the write-off.

• ⚠️ Mistake 3: Trying to Deduct Cosmetic or Ineligible Costs – As discussed, cosmetic dentistry is not deductible. Some taxpayers still attempt to include things like teeth whitening or purely aesthetic veneers, or they might lump in vitamins, health club dues, or other wellness expenses. The IRS routinely denies these if noticed. Stick to medically necessary dental costs – if it’s cosmetic or general personal care, leave it out.

• ⚠️ Mistake 4: Double Dipping with HSAs/FSAs or Insurance – This is a big one. Say you paid a $1,000 dental bill using your HSA debit card – you already got a tax break by using pre-tax HSA money. You cannot also claim that $1,000 on Schedule A. Or if your employer’s FSA reimbursed you for an orthodontics payment, you can’t deduct that expense either. Similarly, if insurance covered part of a procedure and you deduct the full amount, you’re overstating your deduction. Always subtract any reimbursements or pre-tax payments when tallying what you personally paid.

• ⚠️ Mistake 5: Lack of Documentation – Medical deductions can be a red flag in audits because people occasionally inflate or misclassify them. If you claim a large amount, be prepared to show receipts, canceled checks, or statements, and even a letter from the dentist if a procedure could be seen as cosmetic. A common mistake is not having proof of payment or proof that an expense was medically required. Keep a file of all your dental bills, mileage records (date and purpose of each trip), and insurance statements. If you’re ever asked, you can quickly validate your deduction.

• ⚠️ Mistake 6: Overlooking Timing and Bunching – The IRS only lets you deduct expenses in the year you paid them. A mistake is spreading out payments in a way that never clears the threshold in any single year. Savvy taxpayers will bunch medical and dental expenses when possible – for example, scheduling multiple procedures or paying outstanding medical bills in one calendar year – to maximize the chance of exceeding the 7.5% floor that year. If you spread $5,000 of dental work over two years ($2,500 each year) and your threshold is $3,000 each year, you get zero deduction in either year. But if you do $5,000 all in one year, you’d get a $2,000 deduction (if the threshold is $3k). Failing to plan this way is a missed opportunity.

• ⚠️ Mistake 7: Ignoring State Tax Differences – Don’t assume that if you got a federal deduction, you’ll automatically get a state one (or vice versa). Another error is not considering state rules: some people itemize federally but then mistakenly try to deduct medical expenses on a state return that doesn’t allow them. Or they fail to claim a state medical deduction they could take because they didn’t itemize federally. Always check your state’s tax instructions. You might have a state-only deduction (like NJ’s 2% threshold rule) or, conversely, your state might not allow any deduction even though you got one federally.

By steering clear of these mistakes, you can safely navigate the rules and make the most of any dental deductions available to you.

Weighing the Pros and Cons of Dental Expense Deductions

Not sure if claiming dental expenses is worth the hassle? Consider these pros and cons:

Frequently Asked Questions (FAQ) on Dental Expense Deductions

Q: Are dental expenses tax deductible for 2025?
A: Yes. Dental expenses are tax deductible in 2025 if they are unreimbursed, medically necessary costs and you itemize deductions on your tax return. Only amounts exceeding 7.5% of your AGI can be deducted.

Q: Can I deduct dental expenses without itemizing?
A: No. You must itemize deductions on Schedule A to claim any dental or medical expense deduction. If you take the standard deduction, you cannot deduct out-of-pocket dental bills.

Q: Are braces and orthodontic costs tax deductible?
A: Yes. Braces and other orthodontic treatment are deductible medical expenses if they are unreimbursed costs for you, your spouse, or dependents. You must itemize and meet the 7.5% of AGI threshold.

Q: Is cosmetic dental work like teeth whitening deductible?
A: No. Purely cosmetic dental procedures (teeth whitening, bonding done for appearance, etc.) are not tax deductible. Only procedures needed to treat disease, fix a defect, or restore function qualify.

Q: Can I claim my dental bills on my taxes if I have an HSA or FSA?
A: No. If you use tax-free HSA or FSA funds for a dental bill, you cannot also deduct that expense on your return. No double-dipping is allowed.

Q: Are dental insurance premiums tax deductible?
A: Yes, if paid with after-tax money. Self-employed people deduct dental insurance premiums above-the-line. Other taxpayers can include after-tax premium payments as itemized medical expenses. Pre-tax employer premiums aren’t deductible.

Q: Do I need receipts for dental expenses I deduct?
A: Yes. Keep all receipts and proof of payment for your dental expenses. You don’t submit them with your return, but you may need them if the IRS asks for verification.

Q: Are dental expenses for dependents or a spouse deductible?
A: Yes. You can deduct qualifying dental expenses you paid for your spouse and anyone you claim as a dependent on your tax return, subject to the same 7.5% rule and itemizing requirement.

Q: Can a business deduct the cost of an employee’s dental work?
A: No. A company can deduct offering dental insurance or a medical plan, but an employee’s personal dental procedure is not a business expense. Only the employee can claim it as a medical deduction.

Q: Are travel expenses to my dentist deductible?
A: Yes. You can deduct travel costs to get dental care, including mileage (~22¢/mile), parking, tolls, and transit. If you must stay overnight for treatment, lodging up to $50/night is allowed.

Q: If I didn’t deduct a large dental expense last year, can I amend my return?
A: Yes, if you qualified that year. You can file an amended return (Form 1040-X) within three years to claim a missed dental deduction, provided you itemized and exceeded the 7.5% AGI threshold for that year.

Q: Do all states allow a dental expense deduction?
A: No. Some states allow a medical/dental deduction (often with their own thresholds), but many do not. State laws vary, so check your state’s tax rules to see if dental expenses can be deducted.