dental care and costs in all 50 states

By Emma Yasinski


Which state would you guess provides its residents the best dental care? The worst?

The Badger State, Wisconsin, stands atop all 50 states and the District of Columbia for the quality of the oral health services it provides its citizens.

Once commonly referred to as the “Toothpick State,” and since 1995 going by the official nickname of the “Natural State,” Arkansas rests dead last in the oral health rankings.

Both rankings are according to the third annual state-by-state assessment of dental health, published by, a consumer-oriented personal finance website.

The WalletHub report, States with the Best & Worst Dental Health, was released in late January 2019 and is chock full of data relevant to consumers and doctors alike, including state-by-state comparisons on a variety of metrics.


For example:

  • The highest percentage of adults who visited a dentist in the past year live in Connecticut, followed by the District of Columbia, Rhode Island, and Minnesota. The lowest percentage live in Louisiana, with Mississippi, Arkansas, and Oklahoma rounding out the bottom.
  • The most affordable states for dental care are Alabama, Kentucky, Mississippi, Tennessee, and Texas, all tied at #1 least expensive; the most expensive states, tied at #46, are Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont.
  • Patients needing a dentist will find the highest number of providers per capita in Hawaii, then Massachusetts. Residents of Louisiana have the smallest pool of dentists per capita, followed by Idaho.
  • Asked whether they experienced oral pain in the past year, respondents in Connecticut and Illinois reported the least discomfort. Residents of California felt the most oral pain, with those in Montana and West Virginia tied at the #2 spot.
Graphic from
Graphic from

“We tried, through this report, to make [people] aware of the fact that prevention is much cheaper than treatment. For example, while a check-up is around $100 on average (nationally), a filling can go for as much as $300,” WalletHub analyst Jill Gonzalez told Incisor.  “All in all, the lack of dental health has a big impact on our social lives, as well as our wallets.”

WalletHub considered 26 metrics for each state, applied rankings and weighted each one to determine the state’s ranking in two primary categories: dental habits & care, and oral health. Then they used these to assign the states an overall ranking.

WalletHub's Jill Gonzalez
WalletHub's Jill Gonzalez

The team looked at a broad range of factors that might affect the quality of a person’s dental health and care in each state, including: The number of dentists per capita, how much of the state’s water is fluoridated, consumption of sugar-sweetened beverages, cost of care, percentage of the state’s elderly population that still has natural teeth, and percentage of adults who visited a dentist within the previous year.

There was a seven-fold difference between the states with the lowest percentage of adults reporting low life satisfaction due to their oral condition (North Dakota, District of Columbia, and Hawaii) and those that had the highest percentage (Texas, Louisiana, and West Virginia).

WalletHub’s Gonzalez said not much has changed in three years that her company has conducted the report, but in 2019’s edition, there were some surprises.

For example, “the fact that only about two-thirds of adolescents in Florida visited a dentist in the past year, and only a little over half of Louisiana's adults went to get their teeth checked. The latter could be connected to the fact that Louisiana has the fewest dentists per capita,” said Gonzalez.

In addition to the rankings, the report included commentary from six experts:

  • Jane Grover, DDS, MPH, director of the Council on Advocacy for Access and Prevention with the American Dental Association
  • Joan Pellegrini, PhD, RDH, an associate professor at Virginia Commonwealth University School of Dentistry
  • Pamela Rettig, RDH, MS, an associate clinical professor of dental hygiene at Indiana University School of Dentistry
  • Meg Atwood, RDH, MPS, a professor in the Department of Dental Hygiene at Orange County Community College
  • Amy Funk, chair of the Department of Dental Hygiene at West Virginia University
  • Marji Harmer-Beem, RDH, MS, director of dental hygiene at the University of New England

Each expert answered questions about how to keep dental care affordable, sealant programs in schools, fluoridation, and whether dental care should be part of health insurance.

“Our analysis encompasses things like the number of dentists and dental professionals, the share of the population living in dental health professional shortage areas, and the dentist supply-demand ratio projected by 2025. Those metrics together with stats on sugar-sweetened beverage consumption, or the share of people who receive fluoridated water, can prove useful to dentists,” said Gonzalez.


Author: Contributing writer Emma Yasinski received her Master of Science (MS) in science and medical journalism from Boston University. Her articles have also appeared at, Kaiser Health News, NPR Shots, and Genetic Engineering and Biotechnology News.

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