Caught in the Middle: The Current Dental Insurance Problems
Dental insurers were originally designed to offset the cost of care, but today many patients and providers feel that insurance is doing more gatekeeping than helping. Unlike medical insurance, most dental plans cap annual benefits at around $1,000 to $2,000—a figure that hasn’t changed much in decades despite inflation and rising treatment costs. In 1954, the first dental “insurance” plan emerged from Washington, Oregon, and California to provide benefits and access to dental care. These later formed what we know today as a Delta Dental. The purchasing power back then of $1000 in dental coverage afforded a vast amount of dental treatment. For example, a gold crown in 1951 cost a whopping $50. Compared to today, most offices charge $1500 for a crown. This means that $1000 of coverage in 1951 could have afforded you 20 crowns, but barely half a crown in 2025.
Indeed, the purchasing power for a patient even with dental insurance has dramatically changed and patients are left to foot the bill. When we account for inflation, the purchasing power of $1000 in the 1950s is equivalent to $25,386.74 in 2025. Between the 1970s and 1980s, dental insurance became more mainstream and somewhere along the line, the maximums were capped at approximately $1500. Fast forward to 2025, and you’d need $17,024.44 in dental insurance maximums for it to cover the same amount as $1500 in 1975. This leaves a very big problem that most patients foot the bill for dental treatment.
The Result. Patients often enter the dental chair expecting that insurance will cover the bulk of their treatment—only to discover that’s rarely the case. With high out-of-pocket costs, confusing billing through complex coding, and reduced reimbursements, many patients delay or avoid needed treatment altogether.
Dentists want to provide the best care possible, but insurance restrictions can get in the way. To get reimbursed, dentists must navigate a maze of coding rules, pre-approvals, and documentation—often with little guarantee of payment.
What emerges is a broken system in which patients feel underserved and misled,and dentists feel undervalued and overburdened, while insurance companies prioritize profit over preventive, long-term care. Heck, the CEO of a major dental insurance company made $15 million in 2024. That’s a lot for a nonprofit organization.
Dental insurance was meant to make oral health more accessible, but the current model often adds complexity and cost instead. Rebuilding trust between patients, dentists, and insurers means rethinking the system—so that everyone is working together, not against each other.
