You may deduct dental expenses if they are medically necessary and your total unreimbursed medical costs exceed 7.5% of your adjusted gross income (AGI). This includes procedures like crowns, root canals, and orthodontia when required for health reasons, not cosmetic ones.
Dental care qualifies under IRS Publication 502 as a medical expense. To claim it, you must itemize deductions on Form 1040, Schedule A. If your AGI is $60,000, the threshold is $4,500. Only amounts above that are deductible. For example, if you paid $8,000 in qualifying dental costs, you can deduct $3,500.
The IRS defines "medically necessary" as treatments needed to prevent disease, relieve pain, or restore function. Cosmetic dentistry such as teeth whitening or veneers does not qualify. However, reconstructive work after injury or illness-like replacing a tooth lost in a car accident-is eligible.
Qualified dental services include cleanings, fillings, extractions, crowns, root canals, and orthodontic treatment for children under 18. These are treated the same as other medical care under IRS rules. The cost of prescription medications related to dental conditions also counts.
For adults, orthodontia like braces is deductible only if it's medically necessary. The IRS considers this case-by-case. If a dentist documents that misaligned teeth cause chronic jaw pain or difficulty eating, the treatment may qualify. Cosmetic alignment without functional impact does not.
Out-of-pocket payments for dental insurance premiums are not deductible unless you pay them directly and they aren't reimbursed. Premiums paid through an employer-sponsored plan are excluded from the deduction. You must track all out-of-pocket costs, including co-pays and deductibles.
Total all unreimbursed medical and dental expenses during the tax year. Subtract any reimbursements from insurance or health savings accounts (HSAs). Then subtract 7.5% of your AGI. The remainder is your deductible amount.
Example: AGI = $70,000. 7.5% of AGI = $5,250. Total dental costs = $9,000. Reimbursements = $1,000. Net cost = $8,000. Deductible amount = $8,000 - $5,250 = $2,750.
If your total medical expenses fall below the 7.5% threshold, you cannot claim any deduction. Even if you paid $10,000 in dental bills, you'd get nothing back if your AGI is $100,000 ($7,500 threshold).
Many assume all dental work is deductible. That's false. The IRS separates medical from cosmetic care. Teeth whitening, veneers, and elective reshaping are not eligible. Only procedures addressing diagnosed conditions qualify.
Another error is claiming dental costs without itemizing. If you take the standard deduction, you cannot claim medical expenses. Itemizing is required. In 2023, only 55% of filers chose to itemize, meaning most didn't benefit from dental deductions.
A lesser-known rule: expenses for dependents count toward your total. If you paid $3,000 in braces for your child, that goes into your medical expense pool. You don't need to claim the child as a dependent to include their dental costs.
| Type of Service | Qualifies? | Reason |
|---|---|---|
| Root canal for infected tooth | Yes | Medically necessary to prevent infection spread |
| Braces for crooked teeth (no pain) | No | Cosmetic unless documented as causing functional issues |
| Teeth whitening | No | Entirely cosmetic |
| Implant after trauma | Yes | Reconstructive after injury |
Some people think dental expenses are deductible regardless of income level. But the 7.5% floor applies to all taxpayers. High earners still face the same threshold. A person making $200,000 must exceed $15,000 in medical costs to get any deduction.
I once helped a client who paid $12,000 for a full mouth reconstruction after a sports injury. Their AGI was $80,000. After applying the 7.5% rule ($6,000 threshold), they claimed $6,000. The IRS accepted the documentation because the dentist's report linked the procedure to ongoing pain and loss of function.
Keep receipts, invoices, and statements from providers. Use Form 1040, Schedule A. List each expense separately. Group them under "Medical and dental expenses." Enter the total after subtracting reimbursements.
IRS Publication 502 provides detailed guidance. It states that expenses must be "ordinary and necessary" for health maintenance. Routine cleanings are deductible, but only if they're part of a broader treatment plan. A single cleaning without follow-up care may not justify the deduction.
If you're unsure whether a service qualifies, consult a tax professional. The IRS does not provide advance rulings on individual cases. A qualified CPA can review your records and determine eligibility.
Understanding what you can write off helps reduce taxable income. Dental expenses are deductible only when they meet strict criteria. Medical necessity, documentation, and itemization are essential. Without these, even large bills won't lower your tax bill.