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Understanding Dental Costs

By Commonwealth DentistryNovember 19, 2020Dental Learning Center
Midlothian exam room

Ouch! What is worse, the pain from the tooth itself or the cost of the dental procedure? Dental costs sometimes catch patients off guard. While these costs may seem overwhelming, our hope is by breaking down the variables within costs our patients will gain a better understanding of the factors that impact cost and why they exist. 

General Dental Costs:

Perhaps you are experiencing dental pain or you’ve had non-symptomatic issues identified at a routine cleaning:  The next step is to create a treatment plan and estimate the cost to rectify the issue.  There are several factors that affect almost any dental procedure.

1. Your Location: 

Costs are often higher in cities vs. rural areas. This chart illustrates fluctuations based on zip codes.  The geographic fluctuations in cost follow a similar trend to the cost of living differences we are accustomed to seeing. 

2. The Necessities:

 Examinations and X-rays are almost always a must to diagnose any dental issue. Any time you haven’t seen your dentist in 10 months or longer or you have an emergency issue, X-rays and a thorough exam are necessary to properly diagnose a problem or provide ongoing preventative care.

3. Lab Fees:

Items like crowns, implants, dentures, night guards are sent to a dental lab that custom makes each item thus a fee is associated.

4. The Extent of Work:

Sometimes estimates fluctuate based on a variety of factors due to the condition of the teeth, bone structure, gums, etc.  

5. Delaying Dental Procedures:

Here’s the thing, tooth decay never gets less expensive or more simple to address with time. If you wait on addressing issues, you may require more extensive treatment when you’re ready to fix the problem. The more serious the issue, the higher the price tag for the dental repair due to the complexity of the work. In short, the sooner you address the issue the better.

6. In and Out of Network:

If you have dental insurance, going to an in-network provider will result in lower costs.  Out of Network providers may still be able to file claims with your dental insurance company, although some policies will only cover care with their ‘network providers’.

7. Cosmetic Procedures:

 Cosmetic procedures,  defined as services that solely improve the appearance of the teeth and mouth, are not generally covered by insurance and will incur higher costs. This includes teeth whitening, tooth shaping, veneers, and gum contouring.

8. Preventative, Basic & Major Procedures:

These are the three classifications insurance companies define procedures by resulting in different coverage for each.

Type  What it Includes Insurance Coverage*
Preventive Care Semi-annual cleanings, x-rays, and sealants Insurance covers around 90-100%
Basic Care Fillings and extractions Insurance covers around 80%
Major Care Dentures, bridges, inlays, and crowns Insurance covers around 50%

*these are generalizations, your  insurance may vary, always check your plan for exact details

Quality of Care

One key component of dental care is the quality of care received.  Sure there are providers that offer a quick turn around with lower-cost options on some dental procedures, but cheap price tags are almost always at the expense of something else.

For example, have you ever seen advertisements for low-cost, same-day dentures?  The old adage ‘you get what you pay for’ can apply to these scenarios as these cheaper alternatives often lack personalized care, quality, and long-term viability. The customer is almost always getting the short end of the stick to save a few dollars. If you want quality, long-lasting dental care, the work must be completed by a highly trained and experienced dentist that oversees the process from start to finish.

On the other end of the spectrum, you may also see increases in the cost of care for ‘extras’ that don’t necessarily correlate to the quality of your dental care i.e. ‘spa dentistry‘ with equipment like massage chairs.

Average Baseline for Care

Your teeth-just like you- are unique. Therefore, every estimate provided is unique to you and your individual needs. Depending on the complexity of the issue,  your price may fluctuate; however, consulting the table below can help you formulate a baseline. Oftentimes the estimate is given based on visible clues the dentist identifies during their exam and what the x-rays show. However, the estimates can vary based on underlying conditions and numerous other factors which we detail below. 

Price Range for Top 7 Dental Procedures

Procedure Average National Cost Before Insurance*
Cleanings $70- $200
Periodontal Maintenance  $140-$300
Crowns $500 – $3,000
Root Canal Therapy $300 – $2,000
Extractions  $75-$650
Dentures $300- $8,000
Dental Implants $3,000- $4,500 per tooth

*price ranges reflect National Averages and are not indicative of Commonwealth Dentistry prices

Xray of teethFirst things First- Initial Exams:

If you are a new patient or it has been longer than 10 months since you’ve had a cleaning, a comprehensive exam is the first step in allowing your provider to gather baseline information about your dental health.  This exam will include x-rays, a periodontal (gum and bone) evaluation, an oral exam, and should include an oral cancer screening. 

After your comprehensive exam, you may receive a treatment plan with the recommended work.  An ideal treatment plan should prioritize necessary work based on a joint understanding of the most pressing issues noted by your dentist and hygienist.

Factors that Cause Fluctuations in Pricing:

Whether it’s a routine cleaning or a root canal, each specific procedure performed during your visit has an associated fee that varies based on several factors such as the supplies and equipment utilized and the complexity of the work performed.

X-Ray Recommendations Frequency Details
Full Mouth 3-5 years Includes every tooth that is present, shows the root of the tooth to make sure there is no infection, shows bone health/levels 
Bite Wings 1-2 years Help diagnose gum disease and cavities between teeth
Panorex 3-5 years Shows a global view of the teeth, jaws, sinus spaces, Temporomandibular joint (TMJ)


Regular mouth maintenance is a must, price fluctuations largely occur because of improper maintenance. If you are not getting regular cleanings (every 3-6 months depending on the presence or absence of gum disease) or maintaining ideal oral hygiene at home to prevent plaque build-up, a more in-depth cleaning may be necessary. 

Mouth care musts

Think about cleaning your baseboards at home.  If you only cleaned them once a year, it would take much longer to get all the dust and dirt off.  If you wiped them down more frequently – it’s a quicker process.  The same principles apply – if you’re past due on your cleaning, your hygienist may need to take more time and care to get your gum and bone health on track. 

The more time and attention your cleaning requires, the higher your cost on the range quoted above.  This is an incredibly important step in the process of safeguarding your dental and overall health. Good oral hygiene on your behalf is always the foundation of good dental care. Skipping recommended cleanings can lead to much more invasive and more expensive procedures down the road (i.e. extractions, implants, etc.)

Basic vs. Deep Cleanings

Would you buy or build a home on a foundation that wasn’t solid? Beautiful teeth in unhealthy bone have a foundation problem. The way your hygienist diagnoses the need for a basic vs. deep cleaning will be through measuring the gum pocket around each tooth and looking at the height of your bone around your teeth on your x-rays. 

dental examIf you have not received regular cleanings, have inadequate home care, or have genetic predispositions to gum and bone disease, your gum tissue may become inflamed as the bacteria nestles underneath your gum line. These issues will require deep cleaning rather than just basic care.

From here it’s a self-propelling process.  Your gum is inflamed, bacteria is trapped under the irritated gum line, and your toothbrush can’t get to it so it calcifies (hardens) and irritates your gum more. This process can result in damage to the bone around your tooth.

As this happens your gum pockets become deeper because the bottom of the pocket gets deeper as the bone is lost.  In conjunction, the ‘top’ of the pocket rises up more because your gums become more swollen and inflamed.  This phenomenon is a chronic infection that puts you at risk for things like heart issues, lung problems (like pneumonia), diabetic complications, etc. 

Periodontal Maintenance

If periodontal disease is diagnosed, your dentist may recommend deeper cleanings as an initial step in getting your gum and bone health back on track.  After the deep cleanings, think about the baseboards analogy – you’ll likely need more frequent cleanings called ‘periodontal maintenance’ (every 3-4 months) to maintain that health.

woman with jaw painPeriodontal maintenance is more expensive than a standard prophylaxis cleaning because it goes a little deeper below the gum line because people with periodontal disease are more susceptible to plaque and tartar buildup. If you carry dental insurance, most basic cleaning and exam fees are generally covered, but the cost of periodontal maintenance can be an out of pocket cost.


Dental crowns are used to restore the look and functionality of a damaged tooth. The type of material used is based on the strength of the patient’s bite, aesthetic demands, and placement of the tooth; however, there is less price variation among the materials used compared with the underlying reason the tooth needs a crown.  The main fluctuation in price for crowns is due to the reason behind needing the crown. 

Three Reasons You Need Crowns:
  1. Fracture- The tooth has become cracked or broken. The tooth still has a good foundation but is in need of something to protect it.  Teeth often need diligent monitoring after a crack or break as these situations can cause nerve or bone issues long term.  The sooner you crown a tooth after a fracture or break is diagnosed, the more predictable the outcome.
  2. Extensive Decay or filling material – 50% or more of the tooth’s structure is filling material or decayed.  If decayed, a ‘core build-up‘ may also be necessary to make the tooth an appropriate shape and size to place the crown on top of.  The need for a core build-up is an additional fee that often goes hand and hand with crowns.
  3. A root canal has been performed- A tooth had a cavity that reached the tooth’s nerve space or an abscess or injury occurred requiring root canal therapy (a nerve ablation of your tooth).  To do a root canal a significant amount of tooth structure has to be removed which leaves the tooth vulnerable to breaking.  A crown helps protect the tooth from breaking.

It is important to note, the root canal, core build-up, and crown are three different procedures and incur three different prices. 

Root Canals vs Extractions

Root Canal Therapy is needed when the inside of the tooth (the pulp chamber) becomes infected, inflamed, or dies. Common conditions leading up to this procedure include deep decay, a crack in a tooth, an existing deep filling, or injury. 


If decay is significant enough to involve the nerve of your tooth, the tooth will require root canal therapy or you will need to extract the tooth.  While an extraction is sometimes viewed by patients as a simple, more affordable option, this is not necessarily the case.

The upfront costs of root canal therapy are higher but the additional procedural costs associated with extraction can accumulate quickly. This is because an extraction ideally requires a replacement tooth to maintain your mouth’s long-term functionality (i.e. bridges, implants, dentures).  These subsequent procedures to replace a tooth can easily exceed the investment of saving your tooth with a root canal.  Extractions are more invasive procedures and surgical in nature. 

Root Canals

If a tooth can be saved, a root canal is a predictable, less invasive option. During a root canal, the dentist cleans and shapes the infected area before finally filling and sealing the root. After the procedure, the tooth may be capped with a crown. 

The biggest fluctuation in price for a root canal depends on where in the mouth the tooth needing the root canal is located.  The variation occurs because of the amounts of roots and procedural difficulty associated with each tooth.  Dental coding puts root canal therapy in three buckets:

Teeth Location Avg. National Costs*
Anterior Teeth Front Teeth $300 – $1,500
Premolars Middle Teeth $400 – $1,800
Molars Back teeth $500 – $2,000

*price ranges reflect National Averages and are not indicative of Commonwealth Dentistry prices


dental moldPricing for dentures varies greatly because dentures are a personal decision that needs to be discussed in detail with your doctor.  Many see dentures as a relatively quick or easy process, but the truth is, there are multiple steps to get the appropriate fit. 

Factors that Affect Dentures

There are a variety of factors that affect dentures. If a patient has no existing teeth and a good bone structure – making dentures can be a straightforward process.  Some offices offer dentures that can be ready in one visit, however, depending on the methodology of the doctor, sometimes multiple fitting appointments are needed.  If the patient has poor bone structure implants may need to be placed in order to support the dentures.

Another scenario would be that a patient has existing teeth that need to be removed. This situation is more complicated and has additional costs. First, the patient would incur fees for extracting the teeth. Next, the patient must make a decision about what to do in order for the mouth to heal. 

An immediate denture is made so that the patient does not have to go without teeth.  As your gum and bone heal, the shape of your bone will change and your denture will need to be adjusted and refitted several times.  After healing (6-12 months), the denture will need a permanent refit done by a dental lab or a new denture may be necessary if the healing was dramatic.

Cost of Dentures

The entire denture process is an investment in time and money. Personalized dentures that fit properly make a world of difference in the long run.  Dentures are not a place you want to take shortcuts because it will result in more problems down the road.  Poorly fitting dentures will be an aggravation and may be difficult to wear.

Dental Implants

Dental Implants can be straightforward as long as you follow the advice from your doctor.  A dental implant is a great option for patients missing teeth because it replaces both the tooth and the root. Dental implants are built to last (failure rate of less than 5%), so while the process of getting an implant exactly right is lengthy, the implant itself is a permanent fixture and with proper care will last for decades to come. 

What is included in a typical Dental Implant?

Part Description Fee
Dental Implant Titanium post that replaces a tooth root $1,000-$3,000
Implant Abutment Connection between the Dental Implant and Crown $500-$3,000
Crown Replacement ‘Tooth’ that is connected to the Implant Abutment $1,500-$13,000+

The average cost estimated for implant, abutment, and crowns is around $4,263.


dental moldThe first step in receiving an implant is a consultation with your doctor.  Here the doctor will determine if you are a candidate for an implant.  You will receive X-rays and map out a personalized plan. 

If a tooth needs to be removed, a bone graft and protective covering (a membrane) may be recommended to prepare the bone for a future implant. A 3-4 month healing process is generally necessary for this process. The cost of the grafting is not included in the implant price range quoted above.

Dental Implant

Next, the dental implant can be placed.  This is a precise process that replaces the root of the tooth. Depending on how dense the bone around the implant is on the day of placement, a 3-6 month healing period is given for the implant to integrate and attach to your bone.  During this time, the tooth will still visually be missing and the implant will be healing below the gum-line. 


Once the implant has adequate healing time, an impression of the implant is taken.  This allows the lab to make an abutment (connection from implant to crown) and a crown to place on top of the implant. There will be several appointments to make sure that everything fits exactly as it should. This is necessary to ensure the optimal fit and comfort of the tooth. 

When it comes to pricing, it is important to remember that the abutment (connector) and crown are a separate fee from the implant.  To summarize the fees that may be incurred during implant therapy: The extraction of a tooth, the grafting of the extraction socket, the dental implant, the implant abutment, and the implant crown. 

Other procedures sometimes needed as part of Dental Implant Therapy

Part Description Fee
Tooth Extraction Removal of a tooth  $75-$650
Bone graft Cadaver, animal or synthetic bone that is used to add bone where a tooth has been removed $300-$800
Sinus Lift or ‘Bump’ Placing or moving bone to the floor of the sinus to help hold an implant for someone’s upper back teeth/tooth. $3000-$6000

What We Promise:


A Pre-procedure Quote:

Our patients are provided with a thoughtful treatment plan.  We discuss the “worst-case scenario” cost-wise to avoid any surprises. We do our best to explain all the ins and outs of a procedure. If at any point you have questions about recommended treatment, please reach out to our team.

Try Our In-House Dental Plan- The Commonwealth Care Membership:

commonwealth care membership

We know that dental costs can be overwhelming especially for those without insurance. Did you know we offer our own Dental Membership Plan? Commonwealth Care Membership is a discounted annual dental membership plan for those who are uninsured and in need of quality dental care. With our membership plan, you and your family have access to easy and affordable dental services. 

A Variety of Payment Options:

We offer a variety of payment options including payment plans and Care Credit. We will always listen to any concerns you have regarding payment and do our best to formulate a plan that works for you.

Various Sedation Methods:

Please know that if you feel overwhelmed or nervous about any procedure, we offer a variety of sedation techniques to put patients at ease.

dentist and patient

Open and Honest Conversations:

At Commonwealth Dentistry we consider everyone an extension of our family and deliver an experience that exceeds expectations. If you have any concerns, we encourage open dialogue to address any issues. If you are interested in learning more reach out to one of our offices that best serves you.

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