In 1977 a dental plan with a $1,000 annual maximum was considered comprehensive coverage. Today a $1,000 maximum is still common, and it buys about a tenth of the dentistry it bought then. That single fact explains a lot of what happens at your front desk: patients who stop treatment in October, ask for "the cheaper option" and split a quadrant across two years.
This is the first article in our Then and Now series. We went back to government statistics and historical records to see what dental care cost, who paid for it and how it changed since the 1950s.
Key Takeaways
- Since 1970, dental prices have risen 15.7 times, while prices in general rose 8.3 times.
- Dental and general prices moved together until the early 1980s; the gap opened after that.
- In 1960, patients paid 97% of US dental spending out of their own pockets. By 1988 it was 55%.
- To buy the same dental care as a $1,000 annual maximum in 1977, a plan would need about $10,100 today. A third of in-network plans still cap benefits at $1,000 to $1,500.
- In 1957 to 1958, 55% of Americans aged 65 to 74 had lost all their teeth. By 2009 to 2012 it was 14%.
Quick Answer
Why does dental care cost so much more than it used to? According to the Bureau of Labor Statistics, $100 of dental services in 1970 costs about $1,570 today, while $100 of everything else costs about $829. Dental prices tracked general inflation until the early 1980s and have outpaced it ever since. Insurance did not keep up: many plans still cap annual benefits near 1970s levels, so patients now pay a much larger share of real treatment costs than their plan design suggests.
How much dental prices have risen since 1970. Prices in general rose 8.3 times over the same period (BLS consumer price index, annual averages 1970 and 2025).
The 1950s and 1960s: Patients Paid for Almost Everything
Dental insurance barely existed in the 1950s. The first prepaid dental plan is usually dated to 1954, when the International Longshoremen's and Warehousemen's Union welfare fund worked with dentists in Washington State to create a prepaid plan for members' children. The organization it grew into became Delta Dental of Washington, and dental benefits became an industry.
Share of US dental spending paid out of pocket in 1960. By 1988 it had fallen to 55% (Health Care Financing Review, 1990).
When Medicare was created in 1965, the law excluded services for the care, treatment, filling, removal or replacement of teeth. That exclusion still shapes dental coverage for older Americans today.
The 1970s: Insurance Arrives, With a $1,000 Ceiling
Employer dental plans spread quickly in the 1970s. By 1977, 46% of people with group dental insurance had comprehensive coverage with an annual maximum of $1,000 or more. In 1977 that was a generous number.
What a plan would need to pay today to buy the same dental care as a $1,000 annual maximum in 1977, based on the BLS dental services price index. By general inflation alone, $1,000 in 1977 equals about $5,312 today.
Plans did not move with those numbers. According to the National Association of Dental Plans, 32.8% of in-network annual maximums today are between $1,000 and $1,500, and 48.2% are between $1,500 and $2,500. The ADA notes that many plans' annual maximums have not increased in 50 years. At the same time, an ADA Health Policy Institute analysis found that only 3.4% of patients actually reach the typical maximum, so the cap mostly bites on the patients who need major restorative work.
The 1980s to Today: Prices Pull Away
For most of the 1970s, dental fees rose in step with general inflation. A 1976 ADA analysis found fees up 61.9% from 1967 to 1975 against 61.2% for the overall consumer price index. The chart above shows when that changed: from the early 1980s on, the dental services index climbed faster than everything else and never came back. By 2025 the gap was almost two to one.
What drove it? The index measures prices, not causes, but the usual suspects are familiar to every practice owner: more complex care (implants, CAD/CAM and ceramics were rare in 1980), higher costs for staff, equipment, supplies and infection control, and a steady shift of costs onto patients as plan designs stood still.
Teeth Then and Now
Higher prices bought something real. Complete tooth loss among older Americans has fallen dramatically:
| Survey years | Adults aged 65 to 74 with no natural teeth |
|---|---|
| 1957 to 1958 | 55.4% |
| 1971 to 1975 | 46.1% |
| 1988 to 1994 | 28.6% |
| 1999 to 2002 | 22.6% |
| 2009 to 2012 | 13.7% |
What This Means at the Chair
- Expect price sensitivity. Patients compare today's fees with a benefit design from the 1970s. Explaining what the maximum covers, before treatment, avoids surprises.
- Phase big cases deliberately. When treatment is split across benefit years, plan the sequence and the provisionals from the start.
- Protect the investment. When patients pay more of the cost themselves, a remake or an early failure costs trust as well as chair time. Predictable materials and complete records matter more than ever.
Elegant Dental Laboratory
We make crowns, bridges, implant restorations and dentures for practices across the US from our facility in Brooklyn, with a 5 business day standard turnaround and up to a 7-year warranty on final restorations. See our services, send a case or call 877-335-5221. For how the lab side has changed, read our analysis US Dental Labs by the Numbers.
FAQ
How much have dental prices gone up since 1970?
According to the BLS consumer price index, dental services cost about 15.7 times as much in 2025 as in 1970, while prices overall rose about 8.3 times.
When did dental insurance start in the US?
The first prepaid dental plan is usually dated to 1954 in Washington State, created by a longshoremen's union welfare fund and local dentists. Employer dental plans spread widely in the 1970s.
Why is the dental insurance annual maximum still around $1,000 to $1,500?
Many plans set maximums decades ago and never indexed them to inflation. A $1,000 maximum from 1977 would need to be about $10,100 today to buy the same dental care.
Did Medicare ever cover dental care?
Traditional Medicare has excluded routine dental care since it was created in 1965. Many Medicare Advantage plans now add limited dental benefits with their own annual caps.
Are Americans keeping their teeth longer than before?
Yes. Complete tooth loss among adults aged 65 to 74 fell from 55.4% in 1957 to 1958 to 13.7% in 2009 to 2012.
Sources
- US Bureau of Labor Statistics. Consumer Price Index for All Urban Consumers: Dental services (CUUR0000SEMC02) and All items (CUUR0000SA0), annual averages 1970 to 2025. Calculations by Elegant Dental Laboratory.
- Delta Dental of Washington. Our history. deltadentalwa.com
- Office of National Cost Estimates. National health expenditures, 1988. Health Care Financing Review, Summer 1990. PMC4193116
- 42 U.S.C. 1395y(a)(12), Medicare exclusion of dental services.
- Commissioner v. Heininger, 320 U.S. 467 (1943). law.cornell.edu
- 18 U.S.C. 1821, repealed by Pub. L. 116-260 (2020). uscode.house.gov
- Carroll MS, Arnett RH. Private health insurance plans in 1977. Health Care Financing Review, Fall 1979. PMC4191074
- ADA News. Dear ADA: Annual maximums, December 19, 2025 (NADP data and ADA Health Policy Institute analysis). adanews.ada.org
- ADA Bureau of Economic Research and Statistics. Dentists' fees and inflation. J Am Dent Assoc. 1976;93(1):129-133. PubMed 1064654
- ADA Health Policy Institute. State of the U.S. Dental Economy, Q2 2026 Update. ada.org
- Slade GD, Akinkugbe AA, Sanders AE. Projections of U.S. edentulism prevalence following 5 decades of decline. J Dent Res. 2014. PMC4212322
- National Institute of Dental and Craniofacial Research. The story of fluoridation. nidcr.nih.gov
Then and Now series by Elegant Dental Laboratory, Brooklyn, New York. Reviewed by Gary Fingerman, founder and CEO. Last reviewed: September 27, 2026.
