Most dental costs are not tax deductible, but some are if you itemize and meet specific conditions

Dental expenses are generally not deductible on your federal tax return. The IRS treats routine dental care—cleanings, fillings, root canals, crowns—as personal expenses, the same way it treats haircuts or gym memberships. However, dental costs can become deductible if two conditions are both true: you itemize deductions on your tax return instead of taking the standard deduction, and the dental work qualifies as a medical expense under IRS rules.

The threshold is high. You can only deduct dental expenses that, combined with other medical and dental costs, exceed 7.5 percent of your adjusted gross income (AGI) for the year. If your AGI is $60,000, that means your total medical and dental expenses must exceed $4,500 before you can deduct any of them. Most people do not reach that threshold, which is why most people cannot deduct dental costs even if they itemize.

Certain types of dental work are more likely to may have access to than others. Orthodontics, implants, and treatments for specific medical conditions have a better chance of meeting IRS standards than preventive care. The distinction matters because the IRS separates cosmetic work (which never qualifies) from medically necessary work (which sometimes does).

Key Takeaways

  • Dental deductions require you to itemize deductions and have total medical expenses exceeding 7.5 percent of your AGI; most taxpayers do not meet this threshold.
  • Preventive dental care like cleanings and checkups is not deductible, but orthodontics, implants, and treatments for medical conditions may be.
  • Cosmetic dental work such as teeth whitening or veneers placed purely for appearance is never deductible.
  • Dental insurance premiums are deductible only if you are self-employed and claim them as a business expense, or if they are part of a pre-tax employer plan.
  • You must have receipts and documentation from your dentist showing what work was done and the cost; the IRS may request proof if you are audited.

Which dental expenses might may have access to

The IRS allows deductions for dental work that is medically necessary—meaning it treats a disease, condition, or injury rather than improving appearance alone. Orthodontics for children or adults typically qualifies because it corrects a bite problem or alignment issue that affects function. Dental implants to replace missing teeth usually may have access to. Root canals, extractions, and periodontal treatment for gum disease are generally deductible because they address a medical problem.

Cosmetic work does not may have access to, even if your dentist performs it. Teeth whitening, veneers placed for appearance, bonding for cosmetic reasons, and smile design are all considered personal expenses. If you have a crown placed because a tooth is broken or decayed, that is deductible. If you have a crown placed because you want your tooth to look whiter or match your other teeth better, it is not.

The line between medical and cosmetic can be blurry. If you are unsure whether your procedure qualifies, ask your dentist to document in writing why the work is medically necessary. Keep that documentation with your tax records. If you are audited, the IRS may ask you to prove that the work was not cosmetic.

How the 7.5 percent threshold works

Even if your dental work qualifies as a medical expense, you cannot deduct it unless your total medical and dental expenses for the year exceed 7.5 percent of your AGI. This threshold applies to all medical expenses combined—dental, vision, prescription drugs, therapy, hospital bills, and insurance premiums you pay out of pocket.

Here is a concrete example. Suppose your AGI is $80,000. Your threshold is $6,000 (7.5 percent of $80,000). During the year, you pay $2,500 in dental implants, $1,200 in vision care, and $800 in prescription medications. Your total medical expenses are $4,500. Because $4,500 is less than $6,000, you cannot deduct any of it. If you had paid $6,500 in medical and dental expenses instead, you could deduct only the $500 that exceeds the threshold.

This threshold is why most people cannot deduct dental costs. Unless you have significant medical expenses in a single year—a surgery, extended treatment, or multiple procedures—you will not cross the 7.5 percent line. Spreading dental work across multiple years makes it even harder to reach the threshold.

Itemizing versus the standard deduction

You can only deduct dental expenses if you itemize deductions on Schedule A of your tax return. Most taxpayers take the standard deduction instead, which is a flat amount the IRS allows you to subtract from your income without listing individual expenses. For 2024, the standard deduction is $14,600 for single filers and $29,200 for married couples filing jointly.

Itemizing makes sense only if your total itemized deductions—medical expenses, state and local taxes, mortgage interest, charitable donations, and others—exceed the standard deduction. If your itemized deductions total $28,000 and the standard deduction is $29,200, you take the standard deduction and get no benefit from your dental costs. If your itemized deductions total $32,000, you itemize and can deduct the portion of medical expenses that exceeds 7.5 percent of your AGI.

Some people reach the itemization threshold only in years when they have large medical expenses. If you had a major procedure or multiple treatments in one year, that might be the year to itemize. In other years, the standard deduction is better. A tax professional can help you decide whether itemizing makes sense for your situation.

Dental insurance premiums and employer plans

Dental insurance premiums you pay out of pocket are generally not deductible. However, if you are self-employed, you can deduct dental insurance premiums as a business expense on Schedule C, separate from your medical deductions. This is one of the few ways dental costs reduce your tax bill directly.

If your employer offers dental insurance and deducts the premium from your paycheck before taxes, you are already getting a tax benefit—you do not pay income tax on that money. This is called a pre-tax benefit, and it is more valuable than trying to deduct the premium later. If your employer offers a Health Savings Account (HSA) or Flexible Spending Account (FSA), you can use pre-tax money from those accounts to pay dental expenses, which also reduces your taxable income.

If you pay for dental insurance out of pocket after taxes have been taken from your paycheck, you cannot deduct the premium unless you are self-employed. This is one reason to check whether your employer offers pre-tax dental coverage—it saves you money without requiring you to itemize.

Keeping records for the IRS

If you deduct dental expenses, keep receipts and invoices from your dentist showing the date, the procedure, and the cost. Keep any documentation your dentist provides about why the work was medically necessary. If you paid with a credit card or check, keep that record too. The IRS does not require you to submit these documents with your tax return, but you must have them if the IRS asks.

If you are audited on medical deductions, the IRS may request proof that the expenses were actually incurred and that they were medically necessary rather than cosmetic. Dental work is a common audit trigger because the line between medical and cosmetic is subjective. Having clear documentation from your dentist stating the medical reason for the procedure strengthens your case.

If you use an FSA or HSA to pay for dental work, keep those records separately. The account provider will send you a statement showing what you withdrew, but you should keep your own receipts as well. If you claim a deduction for dental expenses and also used an FSA or HSA to pay for the same work, you cannot deduct it twice.

State and local tax deductions

Some states allow deductions for medical expenses on state tax returns even when the federal deduction does not explore. A few states have lower thresholds than the federal 7.5 percent, or they allow deductions for types of expenses the IRS does not. Check your state's tax rules or speak with a tax professional in your state to learn whether dental expenses might reduce your state tax bill even if they do not reduce your federal bill.

State rules change, and some states have no income tax at all. If you live in a state with income tax, it is worth asking whether dental expenses are deductible at the state level. You might not be able to deduct them federally but still benefit on your state return.

Frequently Asked Questions

Can I deduct teeth whitening or cosmetic dental work?

No. The IRS does not allow deductions for cosmetic dental work, including teeth whitening, veneers placed for appearance, and bonding done purely to improve how your teeth look. If a procedure is done to treat a disease or injury rather than improve appearance, it may may have access to, but cosmetic work never does.

What if my dental expenses are high in one year but low in others?

You can only deduct expenses from the year you paid them. If you have a major procedure in one year, that might be the year your total medical expenses exceed 7.5 percent of your AGI and you can deduct them. In other years when dental costs are lower, you likely will not reach the threshold. Some people time elective procedures to cluster them in one year to reach the deduction threshold.

Does my employer's dental insurance count toward the 7.5 percent threshold?

No. If your employer pays for dental insurance or deducts the premium from your paycheck before taxes, that does not count as a medical expense you paid. Only out-of-pocket costs you pay yourself count toward the threshold. Pre-tax premiums already reduce your taxable income, so you do not deduct them again.

Can I deduct braces or orthodontics?

Yes, orthodontics typically qualifies as a deductible medical expense because it corrects a bite or alignment problem rather than serving a purely cosmetic purpose. The cost of braces, aligners, and related orthodontic treatment can be deducted if your total medical expenses exceed 7.5 percent of your AGI and you itemize deductions.

What happens if I deduct dental expenses and get audited?

The IRS may ask you to prove that the expenses were incurred and that they were medically necessary. Provide receipts from your dentist, invoices showing what work was done, and any documentation your dentist gave you about the medical reason for the procedure. If you cannot prove the expenses were medically necessary rather than cosmetic, the IRS will disallow the deduction and may assess penalties and interest.