Many people dislike visiting their dentist, especially if they haven’t kept up with their brushing and flossing. Some even have dental anxiety and phobia. But there are other people who wish they could go yet can’t afford it. According to the CDC, 36% of adults have gone over a year without seeing a dentist. The costs of frequent dental checks are absolutely worth it, though. Prevention is cheaper than treatment.
Brushing, flossing and getting an annual checkup aren’t the only things that impact dental health. Where you live can have an effect, too. For example, certain areas of the U.S. have a higher density of dental professionals. And one of the biggest locational factors is the presence of fluoridated water, which can help prevent tooth decay. Some states provide fluoridated water to nearly all of their residents, while others lag far behind.
In order to determine where people have the healthiest teeth and gums in the U.S., WalletHub compared the 50 states and the District of Columbia across 25 key indicators of dental wellness. Our data set ranges from the share of adolescents who visited a dentist in the past year to dental treatment costs to dentists per capita.
Cassandra Happe, WalletHub Analyst
Main Findings
States with the Best & Worst Dental Health
Overall Rank | State | Total Score | Dental Habits & Care Rank | Oral Health Rank |
---|---|---|---|---|
1 | Illinois | 72.61 | 7 | 1 |
2 | Wisconsin | 71.82 | 3 | 7 |
3 | Idaho | 70.53 | 1 | 11 |
4 | Minnesota | 70.39 | 11 | 4 |
5 | Michigan | 70.09 | 2 | 12 |
6 | Connecticut | 69.92 | 12 | 2 |
7 | District of Columbia | 69.74 | 6 | 6 |
8 | North Dakota | 68.54 | 8 | 8 |
9 | Massachusetts | 67.47 | 5 | 13 |
10 | Ohio | 65.21 | 19 | 9 |
11 | New Jersey | 62.89 | 44 | 3 |
12 | Iowa | 62.10 | 9 | 15 |
13 | Nebraska | 62.09 | 4 | 23 |
14 | South Dakota | 60.42 | 17 | 14 |
15 | Washington | 60.16 | 45 | 10 |
16 | Rhode Island | 59.41 | 15 | 18 |
17 | Delaware | 58.15 | 20 | 19 |
18 | Kansas | 58.04 | 22 | 21 |
19 | Hawaii | 57.73 | 50 | 5 |
20 | Oregon | 57.44 | 25 | 20 |
21 | Indiana | 56.62 | 28 | 16 |
22 | Georgia | 56.33 | 29 | 17 |
23 | Arizona | 55.99 | 27 | 22 |
24 | Virginia | 55.77 | 16 | 27 |
25 | New Hampshire | 54.56 | 14 | 32 |
26 | Vermont | 54.18 | 10 | 35 |
27 | Pennsylvania | 54.09 | 31 | 24 |
28 | Missouri | 53.57 | 36 | 25 |
29 | Maryland | 53.46 | 35 | 26 |
30 | New York | 52.86 | 23 | 29 |
31 | Colorado | 52.60 | 13 | 38 |
32 | Utah | 51.36 | 18 | 39 |
33 | North Carolina | 50.41 | 33 | 30 |
34 | Maine | 50.33 | 24 | 34 |
35 | New Mexico | 49.68 | 30 | 33 |
36 | Nevada | 49.35 | 45 | 28 |
37 | Oklahoma | 48.68 | 47 | 31 |
38 | South Carolina | 48.11 | 26 | 40 |
39 | Tennessee | 47.36 | 38 | 36 |
40 | Wyoming | 47.09 | 39 | 37 |
41 | California | 45.84 | 21 | 44 |
42 | Florida | 43.63 | 40 | 42 |
43 | Kentucky | 42.83 | 48 | 41 |
44 | Alabama | 39.91 | 41 | 45 |
45 | Alaska | 39.90 | 32 | 46 |
46 | Texas | 38.60 | 37 | 47 |
47 | Montana | 37.51 | 43 | 48 |
48 | Louisiana | 35.76 | 51 | 43 |
49 | West Virginia | 33.67 | 34 | 51 |
50 | Mississippi | 33.52 | 49 | 49 |
51 | Arkansas | 33.31 | 42 | 50 |
Note: With the exception of “Total Score,” all of the columns in the table above depict the relative rank of that state, where a rank of 1 represents the best conditions for that metric category.
- Highest
- 1. Utah
- 2. Idaho
- 3. West Virginia
- 4. Michigan
- 5. New Hampshire
- Lowest
- 40. Ohio
- 41. Arkansas
- 42. Louisiana
- 43. Texas
- 44. Florida
- Highest
- 1. Rhode Island
- 2. Hawaii
- 3. Utah
- 4. Massachusetts
- 5. Connecticut
- Lowest
- 47. Mississippi
- 48. West Virginia
- 49. Kentucky
- 50. Texas
- 51. Arkansas
- Lowest
- T-1. Alabama
- T-1. Kentucky
- T-1. Mississippi
- T-1. Tennessee
- T-1. Texas
- Highest
- T-46. Connecticut
- T-46. Maine
- T-46. Massachusetts
- T-46. New Hampshire
- T-46. Rhode Island
- T-46. Vermont
- Most
- 1. District of Columbia
- 2. Virginia
- 3. Nebraska
- 4. New Mexico
- 5. Maryland
- Fewest
- 47. North Dakota
- 48. Mississippi
- 49. Alabama
- 50. Louisiana
- 51. Tennessee
- Lowest
- 1. Massachusetts
- 2. New Hampshire
- 3. New Jersey
- 4. Idaho
- 5. Hawaii
- Highest
- 40. Tennessee
- 41. Arkansas
- 42. Mississippi
- 43. Kentucky
- 44. West Virginia
- Lowest
- 1. Utah
- 2. Maryland
- 3. California
- T-4. Connecticut
- T-4. Washington
- Highest
- T-45. Kentucky
- T-45. Missouri
- T-45. Ohio
- 48. Mississippi
- 49. Tennessee
- 50. Arkansas
- 51. West Virginia
- Lowest
- T-1. Minnesota
- T-1. Hawaii
- T-1. Illinois
- 4. Wyoming
- 5. New Jersey
- Highest
- T-43. Oregon
- T-43. South Carolina
- 48. Mississippi
- T-49. Arkansas
- T-49. Florida
- 51. Montana
- Lowest
- 1. Hawaii
- 2. Minnesota
- 3. California
- 4. Maryland
- 5. Connecticut
- Highest
- 47. Tennessee
- 48. Mississippi
- 49. Arkansas
- 50. West Virginia
- 51. Kentucky
- Lowest
- T-1. Connecticut
- T-1. Illinois
- T-3. District of Columbia
- T-3. Iowa
- T-3. North Dakota
- Highest
- 47. Kentucky
- 48. Alaska
- T-49. Montana
- T-49. West Virginia
- 51. California
- Lowest
- 1. North Dakota
- T-2. District of Columbia
- T-2. Hawaii
- 4. Wisconsin
- T-5. Idaho
- T-5. Kansas
- Highest
- T-45. Mississippi
- T-45. Montana
- T-45. Utah
- T-49. Louisiana
- T-49. West Virginia
- 51. Texas
In-Depth Look at the States With the Best Dental Health
Illinois
Illinois is the best state for dental health, in part because it has the lowest percentage of people who have frequently experienced pain or problems sleeping in the past year due to the condition of their mouth and teeth. In addition, it has the lowest share of people whose mouth and teeth are in “poor” or “fair” condition overall.
Other factors that boost Illinois to the number-one ranking include the fact that almost all of its residents have access to fluoridated water, there is a school-based dental sealant program, and there are extensive dental benefits for nonelderly adults through Medicaid.
Wisconsin
The second-best state for dental health is Wisconsin, which has the lowest percentage of people who have taken days off in the past year due to the condition of their mouth and teeth. It also has the lowest share of people who have reduced their social life due to their oral state.
Wisconsin has a high percentage of adults who have visited a dentist in the past year, at over 71%, and the state uses the AAPD recommended Dental Periodicity Schedule. That means when the state provides Medicaid dental benefits, it provides them at the intervals recommended by the American Academy of Pediatric Dentistry.
Idaho
Idaho is the state with the third-best dental health, in part because they have the second-highest share of adolescents who visited a dentist in the past year. The state also has one of the lowest costs for tooth extractions, on average.
Idaho also provides a lot of options for dental professionals, with one of the highest numbers of dental hygienists and dental assistants per capita in the country.
Young people in Idaho also show responsible behaviors when it comes to their teeth – for example, only around 10% of students in grades 9-12 drink soda at least once per day, the fourth-lowest rate in the country.
Ask the Experts
To help you brush up on the importance and benefits of good dental care, we asked a panel of experts in health and family studies to weigh in. Click on the panelists’ profiles below to read their bios and thoughts on the following key questions:
- What tips do you have for a person who wants to maintain dental health without breaking the bank?
- Should cities add fluoride to drinking water to improve dental health? What are the pros and cons?
- Should school sealant programs be expanded more aggressively, especially in low-income areas, in order to better prevent tooth decay in the school-aged population?
- How can dental health care become more affordable?
- Should dental coverage be included with standard health insurance or covered by Medicaid?
Ask the Experts
Methodology
In order to determine where people have the best dental health in the U.S., WalletHub compared the 50 states and the District of Columbia across two key dimensions, Dental Habits & Health and Oral Health.
We examined those dimensions using 25 relevant metrics, which are listed below with their corresponding weights. Each metric was graded on a 100-point scale, with a score of 100 representing the most favorable conditions for dental health.
We then determined each state and the District’s weighted average across all metrics to calculate its overall score and used the resulting scores to rank-order the states.
Dental Habits & Care – Total Points: 50
- Share of Adolescents Who Visited a Dentist in the Past Year: Full Weight (~2.78 Points)
- Share of Adults Who Visited a Dentist in the Past Year: Full Weight (~2.78 Points)
- Dental Treatment Costs: Double Weight (~5.56 Points)
Note: “Dental Treatment” includes cleaning, crowns, root canals and tooth extraction. - Reduced Dentist Visits Due to Costs: Full Weight (~2.78 Points)
Note: This metric measures the share of the population who didn’t visit the dentist more frequently due to costs (among those without a visit in the past 12 months). - Dentists per Capita: Full Weight (~2.78 Points)
- Dental Professionals per Capita: Full Weight (~2.78 Points)
Note: This metric measures the number of dental hygienists, laboratory technicians and assistants per capita. - Free or Low-Cost Dental Clinics per Capita: Full Weight (~2.78 Points)
- Share of Population Living in Dental HPSAs (Health Professional Shortage Areas): Full Weight (~2.78 Points)
- Sugar-Sweetened Beverage Consumption Among Adolescents: Full Weight (~2.78 Points)
- Share of Adult Smokers: Full Weight (~2.78 Points)
- Share of People Who Receive Fluoridated Water Through PWSs (Public Water Systems): Full Weight (~2.78 Points)
- Presence of State Oral Health Plan: Full Weight (~2.78 Points)
Note: This is a binary metric that considers the presence or absence of state oral health plans. According to the Centers for Disease Control and Prevention, “A state oral health plan is a roadmap for accomplishing the goals and objectives that have been developed in collaboration with partners and stakeholders, including the state oral health coalition, and members from the public health, dental and medical communities. A comprehensive state oral health plan should be used to direct skilled personnel and funding decisions to reduce the prevalence of oral disease.” - Presence of School-Based Dental Sealant Programs: Full Weight (~2.78 Points)
Note: This is a binary metric that considers the presence or absence of school-based dental sealant programs. According to the Centers for Disease Control and Prevention, “School-based sealant programs provide pit and fissure sealants to children in a school setting. These programs generally target vulnerable populations that may be at greater risk for developing decay and less likely to receive preventive care.” - Medicaid Dental Benefits for Nonelderly Adults: Full Weight (~2.78 Points)
Note: This metric measures the number of benefits, if any, provided to adults in the state through Medicaid. According to the Centers for Medicare & Medicaid Services, “States have flexibility to determine what dental benefits are provided to adult Medicaid enrollees. While most states provide at least emergency dental services for adults, less than half of the states currently provide comprehensive dental care. There are no minimum requirements for adult dental coverage.” - Presence of State Dental Periodicity Schedule: Full Weight (~2.78 Points)
Note: This is a binary metric that considers the presence or absence of state dental periodicity schedules. According to the Centers for Medicare & Medicaid Services, “Early and periodic screening, diagnostic and treatment (EPSDT) services are required services under the Medicaid program for most individuals under age 21. EPSDT … includes periodic screening, vision, dental, and hearing services and other necessary health services. Schedules specifying the content and periodicity of these services are to be established by each state after consultation with recognized medical organizations involved in child health care (in the case of screening, vision and hearing services) and dental organizations (in the case of dental services).” - Status of Older Adult Basic Screening Survey: Full Weight (~2.78 Points)
Note: This metric measures the status of a state’s Older Adult Basic Screening Survey (BSS) administration — more specifically, whether the state has completed (and how long ago) or is planning an Older Adult BSS. According to Oral Health America, a BSS “a surveillance of the oral health conditions of seniors in community and long-term-care settings of older adults.” - Oral Health Knowledge Index: Full Weight (~2.78 Points)
Oral Health – Total Points: 50
- Poor or Fair Oral Condition: Double Weight (~10.00 Points)
Note: This metric measures the share of adults whose mouths and teeth are in poor or fair condition. - Share of Elderly Population with No Natural Teeth: Full Weight (~5.00 Points)
Note: “Elderly Population” includes the population aged 65 and older. - Pain Due to Oral Condition: Double Weight (~10.00 Points)
Note: This metric measures the share of adults who have experienced pain very often in the past year due to the condition of their mouths and teeth. - Dry Mouth Due to Oral Condition: Full Weight (~5.00 Points)
Note: This metric measures the share of adults who have experienced dry mouths very often in the past year due to the condition of their mouths and teeth. - Sleeping Problems Due to Oral Condition: Full Weight (~5.00 Points)
Note: This metric measures the share of adults who have experienced problems sleeping very often in the past year due to the condition of their mouths and teeth. - Reduced Life Satisfaction Due to Oral Condition: Full Weight (~5.00 Points)
Note: This metric measures the share of adults whose lives in general are less satisfying due to the condition of their mouths and teeth. - Reduced Social Participation Due to Oral Condition: Full Weight (~5.00 Points)
Note: This metric measures the share of the population who have experienced reduced social participation very often in the past year due to the condition of their mouths and teeth. - Work Absence Due to Oral Condition: Full Weight (~5.00 Points)
Note: This metric measures the share of the population who have taken days off from work very often in the past year due to the condition of their mouths and teeth.
Sources: Data used to create this ranking were collected as of January 10, 2024 from U.S. Census Bureau, Bureau of Labor Statistics, Centers for Disease Control and Prevention, Healthy Grid, American Dental Association, Health Resources & Services Administration, United Health Foundation, Free Dental Care, American Academy of Pediatric Dentistry, Centers for Medicare & Medicaid Services and Association of State & Territorial Dental Directors.
WalletHub experts are widely quoted. Contact our media team to schedule an interview.