Medicare does not cover most dental. Here is what a year of teeth actually costs me.

The first dental bill I got after I retired was for a cleaning and X-rays, and it was $212, and I called the office because I assumed they had forgotten to run my Medicare. The woman at the desk was kind about it. She had clearly had the call before. Medicare, she explained, does not pay for cleanings. Or fillings. Or crowns, or dentures, or most of the rest. I had carried mail for thirty-four years with a good federal dental plan and I had no idea.

This is the article I wish someone had handed me at that desk. The numbers are mine, from my folder, in Dayton, Ohio. Yours will be different. The shape of the problem will be the same.

What Original Medicare covers

Almost nothing, for teeth. The official Medicare page on dental services says it in one paragraph: Medicare does not cover most dental care, dental procedures or supplies, like cleanings, fillings, tooth extractions, dentures, dental plates or other dental devices. There are narrow exceptions when dental work is tied to a covered medical procedure, like an exam before a heart valve operation or a transplant, or jaw reconstruction after an injury. For an ordinary retiree with ordinary teeth, those exceptions will not come up.

I want to say clearly that this is not a mistake or a gap someone forgot. It has been this way since Medicare started in 1965. Teeth were left out on purpose and have stayed out.

What a Medicare Advantage plan may cover

Medicare Advantage plans are the private plans that bundle Medicare Parts A and B and usually add extras, and dental is the extra most people sign up for. I switched to one in my second year of retirement mostly for the dental.

Here is what mine covers, and I am describing my plan, not all plans: two cleanings and exams a year at no cost, one set of X-rays a year, and then a dollar allowance, $1,500 in 2026, toward other work like fillings, crowns and deep cleanings, after which I pay the rest. It also has a network, and Dr. Patel is in it, which I checked before I signed anything. Some plans pay a percentage instead of an allowance. Some have a much smaller allowance. Some have a waiting period for major work. Read the dental pages of the plan documents, not the brochure. The brochure says "dental included." The plan documents say what that means.

What I actually paid

From my folder, for 2025, the most expensive year I have had.

The deep cleaning and the crown used up the whole $1,500 allowance, so the last $500 of the crown was mine. The third cleaning, the varnish and the paste are not covered by my plan at all. Donna's year was $340 billed and $0 out of pocket, because she has a mouth that behaves. Mine does not, mostly because of the dry mouth from my blood pressure medication, which I wrote about in the first article.

Ways to pay less

A few things that have worked for me or for people I know at the senior center.

Dental school clinics. The University of Louisville and Ohio State both have dental schools with clinics where students do the work under a licensed dentist's supervision, at a fraction of private prices. The appointments are long and you may wait weeks to get one. A man at my center had a crown done at Ohio State for about a third of what I paid. If there is a dental school within driving distance, it is worth a call.

Asking the office for the cash price. Dental offices often have a lower rate for people paying without insurance, because they do not have to deal with the claim. When my allowance ran out mid-crown, I asked, and they knocked $120 off the balance.

Dental discount plans, which are not insurance but a membership that gets you a reduced fee schedule at participating dentists. I have not used one. Two people I know have and were satisfied. Read the fee schedule before you join, and make sure your dentist takes it.

Prevention, which is the boring one and the one that works. Every cavity I prevent is a filling I do not pay for, and every filling I prevent is a crown I do not pay for. My $120 a year on varnish and my $90 on fluoride paste are the best money in that table. The MedlinePlus dental health page covers the basics of prevention without trying to sell anything, and the WHO's oral health fact sheet is a reminder that fluoride and sugar control are what keep teeth in heads across whole countries, not fancy products.

What I spend on the mouth outside the dentist

Since someone will ask, and since I believe in showing the whole folder.

Extra-soft electric brush heads, about $30 a year. Floss, $12. Xylitol gum, about $70 a year. Dry mouth spray for the nightstand, $40. Distilled water for the humidifier, maybe $30 for the winter. And ProDentim at the three-bottle price, which is $177 for ninety days, so about $700 a year, which is the biggest line by far and the one I thought hardest about.

I take it for the morning breath that stayed after I had fixed the dryness, and it works for that, which I describe in the dry mouth article. Is $700 a year worth it? For me, yes, because Donna has to live with me and because I tried the cheaper things first and they did not get there. For someone whose breath is fine and whose gums are fine, no, and I would not pretend otherwise. If you try it, buy the three-pack, give it the full two months, and use the refund if it does nothing for you; the company gives you sixty days to ask. That is on the prodentim-buy.net page along with the price breakdown, and I would read it before ordering.

The advice, in large print

Find out what your plan actually covers before the year starts, in dollars, and plan the big work around the allowance. Ask about cash prices. Look into a dental school. Spend on fluoride and a soft brush, because they are cheap and they prevent the expensive things. And go to the cleanings, because the $212 I was so surprised by in year one is a good deal next to the $1,380 crown in year four.

My folder is open to anyone at the center who wants to see it. I figure the more of us who know the numbers, the fewer of us will be surprised at the desk.