As a self-employed adult, if I want health insurance, I need to do the research and purchase an individual policy for myself. In recent years (Obamacare notwithstanding), what this has led to is purchase of a basic medical plan and paying out of pocket for dental care. This system was working just fine until this year, when two old fillings decided to crack and my TMJ flared up again (meaning I needed an expensive custom-molded night guard). Caught unawares at the time, I ended up paying several hundred dollars in cash to get my teeth fixed. But now I’m hot on the trail of an answer to this question: "Is purchasing a dental insurance policy worth paying for the cost of the policy?" Here’s what my research has yielded—if you’re an adult who is currently without dental insurance, I hope these tips can help you too!

Average cost of an individual dental policy 

The National Association of Dental Professionals (NADP) reports that as of 2011, between 40-50% of adult Americans carried dental insurance.

For policyholders, most policies are employer-sponsored (versus individual policies). Most dental policies cover 100% of routine care, 80% for routine problems (fillings, root canals), and half of more extensive care (crowns, bridges, implants).

  • Typical policy costs for an employer-sponsored plan range from $234 to $432, and average around $360.
  • Most plans cover up to $1,500 on covered care expenses in a calendar year, but no more.
  • Typical policy costs for an individual plan are around $50 per month or $600 annually.

What dental care costs

If you—like me—do not have dental insurance, here’s about what you can expect to pay for routine services in the following areas.

  • Cleaning and checkup: $75 – $200 (less for hygienist-only appointment)
  • Xrays: $100 – $300
  • Extraction: $100 – $200 per tooth (simple) / $200 – $400 per tooth (surgical)
  • Filling: $100 – $300 per tooth
  • Root canal: $600 – $1,500 per tooth (depending on tooth location)
  • Bridge: $2,000 – $3,000
  • Crown: $700 – $1,200 per tooth

Questions to ask before buying a policy

Even if you have access to an employer-sponsored plan, purchasing dental insurance is typically optional. When I worked for an employer that offered healthcare in the past, I typically would purchase a dental insurance rider. This was because I primarily worked for large blue chip companies that had tremendous negotiating power, and often my dental policy rider was just $10 or $20 per month.

Now, with options priced in the $40 and $50 range, I am still undecided. But at least I now know how to decide if buying a policy is the right choice for me.

Here are the best questions to ask to make the choice for yourself:

  • What options do I have for purchasing dental insurance? (An employer-sponsored plan? An individual plan? Both?)
  • What is my personal dental history? (Checkups only? Fillings every other year? Early periodontal disease?)
  • What is covered under the policy I am considering? (Preventative care? Fixing problems only? A bit of both?)
  • Do I have the disposable income to gamble on a policy purchase?
  • Could I afford a sudden out-of-pocket cash outlay of up to $2,000 for dental work?

Estimating annual dental costs 

After answering these questions, the final step is to calculate a few scenarios to see whether buying a dental policy is a win-win or a lose-lose.

Example 1: You have had no major dental issues for the past three years. You have paid for a cleaning and checkup and X-rays each year – total 3-year costs: $225 x 3 = $675.

  • Outcome: Unless you get a great (read: cheap) deal on a policy, you may want to opt for self-pay dental care, because you probably won't get much use out of your policy in exchange for tying up your available cash. 

Example 2: You had one filling last year, and the dentist mentioned the tooth next to it was likely to go next. You have also been feeling twinges in a wisdom tooth that was never removed.

  • Outcome: You are looking at a potential dental bill of $200 (filling) + $400 (wisdom tooth extraction) + $225 (cleaning and X-rays) = $825. Now your policy is beginning to show its value so a purchase might make sense.

Example 3: After a sports accident a few years ago, your dentist predicted you would need a bridge within the next three years. You've also named the three teeth in the back of your mouth that don't yet have root canals.

  • Outcome: Buy the policy! $2,000 (bridge) + $1,000 (another root canal) + $225 (cleaning and X-rays) = $3,225.
Dental Insurance: How to Decide if Paying for a Policy Is the Right Choice