A TikTok video showing a woman crying in her car over a large dental bill has once again drawn attention to one of the biggest problems in American health insurance: that dental coverage pays for only a tiny percentage of major procedures.
In the video, a woman whose name was not disclosed, except for Hali, talks about how she visited a dentist to find out how much it would cost her to fix her receding gums and get rid of that embarrassment. The plan will cover only $787, with her paying $14,000 out of pocket.
“What the actual f—,” Hali says, dabbing her tears. “$800 from my insurance — like, what the f— am I even paying for?” Then she adds that they expect her to pay $14,000 so that “my teeth don’t fall out of my head.”
@_haliry #dentalcare #insurance #healthinsurance
♬ original sound – Hali
From those numbers, we can see that the plan covers about 5% of the total amount ($14,800).
The procedure Hali is talking about sounds like gum grafting, a surgical procedure that involves transplanting tissue (often from the roof of the mouth) into areas where the gums have receded from the teeth. Depending on the procedure used, the cost can range from $600 to $1,500 per tooth, while connective tissue grafts are the cheapest option and donor-tissue allografts are the most expensive, ranging from $1,500 to $3,000 per tooth, according to Sacramento Periodontics. Other clinics list prices between $600 and $3,000 per tooth, according to Madison Avenue Periodontics. Extensive work done on many teeth can easily reach thousands.
It mostly depends on the necessity. If the grafting is performed due to root sensitivity and exposure, the procedure is considered medically necessary, and insurance covers 40% to 80% of the costs after deductibles. However, if the surgery is needed to look better, it is considered cosmetic. In that case, patients need to pay for everything themselves, with only prior authorization required, which can take several weeks and may still result in partial approval of the procedure for only some of the teeth, according to The Goodbye Company’s Treatment Cost Guide.
Even the approved claims have limitations, too. There is an annual maximum, or the maximum amount a dental plan will cover in a benefit year, which goes from $1,000 to $2,000, and then the rest is on the patient’s head, with Delta Dental.
According to the National Association of Dental Plans, most network and indemnity plans have maximum benefits from $1,000 to $1,500, according to Spirit Dental.
Such limits have remained pretty much unchanged for decades. Around 90% of private dental plans offered in the United States have maximum benefit limits. While $1,000 annual maximums were common in the 1960s and 1970s, the average maximum has not kept up with inflation since then, according to DentalInsurance.com.
Dental insurance is also different from medical insurance in that it doesn’t have the same cap on what the patient is supposed to pay in a year. Unlike medical plans, which have a yearly limit on patient liability, dental plans have none, and patients are responsible for covering the full remaining cost, according to DentalPlans.com.
However, this dissatisfaction with the current state of affairs is common. It is estimated that there are 72 million adults in the US, or 27% of the adult population, who have no dental insurance, which is nearly three times as many as people without health insurance, according to the CareQuest Institute for Oral Health. More than half of Americans say they have an oral health problem. Of these, more than half do not seek help due to cost, according to the institute’s State of Oral Health Equity in America survey.
Dental care is the most frequently skipped type of health care service due to financial constraints, with 21% of respondents skipping it in a Federal Reserve Board survey, according to a Statista analysis.
Some patients even go to other countries. About 4% of adults, which makes almost 9.6 million people, have had dental procedures done in another country, and more than half of them, or 58%, say that the treatment costs less overseas, according to a CareQuest report in June 2026. People who have exceeded their annual maximum in the last year travel abroad for treatment at 7.6%, compared with 2.7% for those who haven’t.
