The US Braces Affordability Index: Where Braces Take the Biggest Bite Out of Earnings

The cost of getting braces can vary considerably across the United States. But treatment prices alone do not tell the whole story: the same dental expense can represent a very different share of earnings depending on where someone lives.

The estimated cost of metal braces runs from $4,767 in Indiana to $8,350 in Nevada, according to the state-level figures used here. A higher treatment price does not automatically mean a greater relative burden, because earnings differ from state to state too.

The US Braces Affordability Index, developed by Ignite Orthodontics, compares average metal braces costs with median salary across all 50 US states to identify where treatment costs represent a larger or smaller proportion of typical earnings.

Key findings

• Louisiana ranks first in relative cost. Average metal braces cost $7,509, equivalent to approximately 12.3% of the state's median salary of $60,986.
• Mississippi ranks second, where braces cost $6,362, or approximately 10.8% of median salary.
• Oklahoma ranks third. The estimated $6,940 cost of braces represents approximately 10.5% of median salary.
• Nevada ranks fourth. Its $8,350 estimated braces cost represents approximately 10.3% of median salary.
• Kansas rounds out the top five, where braces cost $7,735, equivalent to approximately 10.2% of median salary.
• Utah has the lowest cost-to-salary ratio. Its estimated $5,853 braces cost represents approximately 6.1% of median salary.
• California and Maryland also rank among the states with the lowest ratios, at approximately 6.1% each.

These rankings show that the states with the highest braces prices are not necessarily the states where braces account for the largest share of earnings. The relationship between treatment costs and salary changes the picture.

The 10 states where braces cost the largest share of median salary

The following states have the highest ratio of average metal braces cost to median salary in the dataset.

Calculation: average metal braces cost ÷ median salary × 100. Percentages are rounded to two decimal places.

Louisiana leads the ranking, with the estimated cost of metal braces equivalent to approximately 12.3% of median salary. Mississippi and Oklahoma follow, at approximately 10.8% and 10.5% respectively.

Nevada has the highest average braces cost in the top 10, at $8,350. However, its relative cost is lower than Louisiana's because the median salary figure used in the analysis is also higher.

Michigan and Ohio also feature in the top 10, with estimated braces costs equivalent to approximately 9.9% of median salary in each state.

The 10 states where braces cost the smallest share of median salary

At the other end of the index, these states have the lowest ratios between average metal braces cost and median salary.

States are ordered by the calculated cost-to-salary ratio before rounding.

Utah has the lowest ratio in the analysis, with the estimated cost of metal braces equivalent to approximately 6.1% of median salary. California and Maryland follow closely: both have estimated braces costs above $6,000, but their median salary figures are also relatively high.

Indiana illustrates a different pattern. It has the lowest average braces cost in the dataset, at $4,767, helping it achieve one of the lowest cost-to-salary ratios despite a lower median salary than several other states on this list.

What the rankings tell us about braces costs

The comparison highlights why treatment prices should be considered alongside earnings when examining the cost of orthodontic care.

In Louisiana, the estimated cost of braces represents approximately 12.31% of median salary. In Utah, it represents approximately 6.06%. That is a difference of approximately 6.25 percentage points, and Louisiana's ratio is just over twice Utah's.

The results also show that a state's position depends on both sides of the comparison. Massachusetts has one of the highest braces cost estimates among the lower-ratio states, at $7,007, but a median salary of $104,828 means treatment represents approximately 6.7% of earnings. Indiana has the lowest estimated braces cost in the dataset, at $4,767, and a similar ratio of approximately 6.6%.

This does not mean every resident in Louisiana will find braces less affordable than every resident in Utah. Individual circumstances, household income, insurance coverage, financing and treatment needs all affect what a patient can afford. Instead, the index provides a state-level comparison of the relationship between estimated treatment costs and median salary.

What this means for families planning treatment

For families, braces are a significant expense to plan for. The final amount a patient pays can vary depending on the complexity of treatment, the provider, the length of treatment, insurance benefits and the services included in the treatment plan.

State-level averages can help families understand the broader cost landscape, but they cannot predict an individual's bill or determine whether a particular family can afford treatment.

Before starting treatment, ask providers for a written estimate, check your dental insurance benefits and discuss payment schedules or financing options. Comparing the total treatment price and the terms of any payment plan can also help families understand the commitment involved.

How we calculated the index

The study uses two measures for each state: the state-level average metal braces cost, attributed to CareCredit, and the state-level median salary figure from the salary dataset used for this analysis.

We calculated the cost-to-salary ratio by dividing average metal braces cost by median salary and multiplying the result by 100. For example, Louisiana's calculation is $7,509 ÷ $60,986 × 100 = approximately 12.31%.

A higher percentage means the estimated braces cost represents a larger share of the median salary figure. A lower percentage means it represents a smaller share.

The index does not directly measure disposable income, household affordability or the proportion of residents who need or cannot afford orthodontic treatment. It also does not account for insurance benefits, taxes, living expenses, financing or differences in individual treatment plans.

What to consider before getting braces

For people considering orthodontic treatment, state-level averages can provide context, but they are not a substitute for an individual quote.

The final cost of treatment can depend on the type and complexity of the case, treatment duration, provider fees, insurance benefits and the services included in a treatment plan.

Ask an orthodontic provider for a written estimate, check whether your dental insurance includes orthodontic benefits, and discuss payment schedules or financing options before starting treatment.

About the study

The US Braces Affordability Index was developed by Ignite Orthodontics to compare estimated metal braces costs with median salary across the 50 US states. The findings represent a comparison of state-level estimates, not the actual cost experienced by every patient. The index should not be interpreted as a measure of the number of residents who need braces or who cannot afford treatment.

Sources

• CareCredit, “How Much Do Dental Braces Cost? Pricing and Insurance Guide” (carecredit.com), for the state-level braces cost estimates.
• A state-level median salary dataset, supplied for this analysis.