Key takeaways:
Flexible spending accounts (FSAs) and health savings accounts (HSAs) are tax-advantaged accounts that you can use to pay for qualified medical expenses, including dental care.
HSA- and FSA-eligible dental expenses typically include medically necessary treatments such as braces, crowns, extractions, and fillings. Some dental expenses that don’t normally qualify may be eligible if your dentist provides a letter of medical necessity explaining the reason for the procedure or item.
It’s important to keep itemized receipts and supporting documents that include the procedure name, date of service, and amount paid. If you use your HSA to pay for a nonqualified expense, you may have to pay taxes or penalties.
Dental care can be expensive, and it’s not always covered by insurance. If you have access to a flexible savings account (FSA) or health savings account (HSA), you can use it to save on certain out-of-pocket costs that are not reimbursed by insurance or any other source. These tax-advantaged accounts allow you to set aside pretax dollars to pay for qualified medical and dental expenses — from routine cleanings to braces.
Below, we take a look at what dental expenses qualify and how you can use your HSA or FSA to pay for them.
What dental expenses are covered by an FSA or HSA?
You can use an FSA or HSA to pay for qualified dental expenses for yourself, your spouse, and any dependents. Dependents in this case could be children, siblings, or parents. The IRS requires that the expenditures be primarily for the purpose of preventing or treating a specific condition — and not for cosmetic purposes.
Many costly dental treatments, from braces to oral surgery, qualify as HSA and FSA eligible, which can save you thousands of dollars. For example, you could use your account to pay for a dental implant, which can cost $3,000 to $7,000. Common dental expenses covered by an FSA or HSA include:
Dental sealants
Extractions
Fillings
Gum cleaning
Full-mouth dental reconstruction
Full-mouth periodontal surgery
Inlays and outlays
Models or molds
Orthodontia
Root canals
Teeth cleaning
Tooth contouring
Wisdom-teeth removal
X-rays
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You can even use an FSA or HSA for travel expenses related to a qualified medical procedure at a dentist office. These travel expenses might include fees for a ride-share service, gasoline, tolls, or parking.
Some expenses that are normally considered cosmetic may qualify if your dentist provides a letter of medical necessity. This letter must explain the specific dental condition being treated and why the procedure you’re having is medically required.
For example, dental veneers are usually not eligible for reimbursement if they are done solely for cosmetic reasons, such as whitening or closing small gaps. However, they may qualify with a letter of medical necessity if they are used to repair a chipped or broken tooth, restore function after decay or injury, or protect teeth from severe enamel erosion. In these cases, the procedure is considered restorative rather than cosmetic.
How to use your HSA for dental expenses
If your dentist accepts HSA debit cards, you can swipe your HSA card at checkout. If you pay out of pocket, keep your itemized receipt and reimburse yourself from your HSA. You can reimburse yourself immediately or later. There is no deadline to reimburse yourself as long as the expense was incurred after your HSA was opened.
When you use your HSA to pay for an expense, it’s important to keep proper documentation from your dentist that shows the following:
Procedure name
Date of service
Amount paid
Looking for ways to save on dental care? From buying a dental savings plan to visiting a dental school, here are some ways to make dental care more affordable.
Can you deduct dental expenses on your tax return? Yes, if you meet these requirements.
Health savings accounts (HSAs) vs. flexible spending accounts (FSAs): Learn how these accounts work so you can determine if an HSA or FSA is right for you.
That way, if the IRS asks for proof that the expense was HSA eligible, you will have the appropriate documentation on hand.
Also, remember that HSAs have annual contribution limits, so planning ahead can help you budget for major dental expenses. For 2025, the contribution limit is $4,300 for individuals and $8,550 for families.
What dental expenses are not covered by an FSA or HSA?
Not every dental expense qualifies for HSA or FSA reimbursement. And it’s not always clear what counts as an eligible expense, so it’s a good idea to check with your HSA or FSA administrator before spending your funds.
In general, you cannot use an FSA or HSA for the following:
Reimbursed expenses — meaning, costs that have already been paid by insurance or another source
General health items not tied to a specific medical need
Cosmetic-only procedures that don’t treat or prevent a dental disease
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Below are some examples of dental expenses that are typically not HSA or FSA eligible:
Toothbrushes and electric toothbrushes
Toothpaste
Floss
Mouthwash
Teeth whitening
What happens if you use HSA funds to pay for nonqualified dental expenses?
Unlike an FSA, you manage your own HSA. That means you can typically reimburse yourself from your HSA account without submitting receipts to an administrator. However, you’re still responsible for following the rules. Using your HSA for expenses that don’t qualify for tax benefits can be costly. If you’re not sure whether a dental procedure or item is eligible, check IRS guidelines or ask your HSA administrator before paying.
If you use HSA funds for a nonqualified expense, the amount will be subject to regular income tax. And if you’re under age 65, you may also face a 20% penalty, unless an exception applies. These costs can add up quickly, so it’s worth confirming eligibility in advance.
Is toothpaste or floss FSA or HSA eligible?
No, as mentioned above, toothpaste and floss are not qualified expenses for HSA or FSA reimbursement. Like mouthwash, they are considered general health items. This is typically the case even if the toothpaste is specialized or medicated.
Is a Waterpik FSA or HSA eligible?
A Waterpik is typically considered a general dental hygiene tool and is not eligible for reimbursement with an HSA or FSA. However, if your dentist recommends it to treat a specific condition and you have a letter or medical necessity, it may qualify for reimbursement.
A Waterpik is a type of brand-name water flosser. Like other devices, it uses a stream of pulsating water to remove food particles and plaque between teeth and along the gumline. According to the manufacturer’s website, scientific studies show that the device is easier to use and more effective than floss and interdental brushes.
Are electric toothbrushes FSA or HSA eligible?
Electric toothbrushes are typically classified as personal care items and not considered FSA or HSA eligible. However, if your dentist recommends an electric toothbrush to treat a specific dental condition and you have a letter of medical necessity, you may be eligible for reimbursement. It’s a good idea to contact your HSA or FSA administrator to learn more about eligibility and what specific documentation would be needed to qualify.
Are braces FSA or HSA eligible?
Yes, you can use your HSA or FSA to pay for braces, including both traditional and lingual types. Traditional braces typically cost $3,000 to $7,000, while lingual braces can range from $8,000 to $10,000. A dental insurance plan may cover part of the cost, but you can use your HSA or FSA to pay for any out-of-pocket expenses.
Can you use your FSA or HSA for a dental implant or crown?
Yes, as long as a dental implant is not purely for cosmetic purposes, it’s an eligible expense. Implants can improve your ability to eat, reduce the risk of losing other teeth, and help prevent jawbone deterioration. Crowns are also eligible because they protect your teeth and help prevent dental disease.
Is Invisalign FSA or HSA eligible?
Even though Invisalign aligners are clear and can improve your smile’s appearance, they are primarily used for orthodontic treatment. That means your out-of-pocket costs can be paid for or reimbursed with an HSA or FSA.
The cost of Invisalign depends on the complexity of your orthodontic issues, the length of treatment, your location, and your healthcare professional’s experience and fees. Adults typically pay between $1,800 and $9,500, while treatment for teens averages around $3,000. Many insurance plans cover part of the cost of Invisalign, but rarely the full amount.
Frequently asked questions
You can open an HSA through a bank, credit union, online financial institution, or HSA administrator. To qualify, you must be enrolled in an HSA-eligible health insurance plan. After you open an account, you may get a debit card to pay for eligible expenses directly. If not, you can usually reimburse yourself through your administrator’s online portal.
If you want to contribute the maximum amount to your HSA, you can make regular deposits throughout the year or make a lump-sum deposit. Contributions can come from you, your employer, or both of you combined.
Pay attention to annual contribution limits so you don’t exceed them. Also, keep in mind that you can make contributions for the prior year until the tax filing deadline, which typically falls on April 15.
In most cases, you can change your HSA contribution amount at any time during the year if you have an HSA through your employer. If you have an HSA outside of work, you can make contributions directly to the account whenever you want. You can also make prior-year contributions (up to the annual limit) until the tax filing deadline, which is usually April 15. For example, you have until April 15, 2026 to make HSA contributions for 2025.
You can open an HSA through a bank, credit union, online financial institution, or HSA administrator. To qualify, you must be enrolled in an HSA-eligible health insurance plan. After you open an account, you may get a debit card to pay for eligible expenses directly. If not, you can usually reimburse yourself through your administrator’s online portal.
If you want to contribute the maximum amount to your HSA, you can make regular deposits throughout the year or make a lump-sum deposit. Contributions can come from you, your employer, or both of you combined.
Pay attention to annual contribution limits so you don’t exceed them. Also, keep in mind that you can make contributions for the prior year until the tax filing deadline, which typically falls on April 15.
In most cases, you can change your HSA contribution amount at any time during the year if you have an HSA through your employer. If you have an HSA outside of work, you can make contributions directly to the account whenever you want. You can also make prior-year contributions (up to the annual limit) until the tax filing deadline, which is usually April 15. For example, you have until April 15, 2026 to make HSA contributions for 2025.
The bottom line
You should not overlook dental expenses when thinking about how to use your FSA or HSA. The tax benefits can help lower your overall costs for common dental procedures and items. But you need to be careful to use the funds on eligible expenses. If you use your FSA or HSA to pay for nonqualified dental expenses, you may be subject to taxes and penalties. So make sure to ask your FSA or HSA administrator about eligibility and documentation requirements before making a purchase.
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References
Internal Revenue Service. (2025). Instructions for form 8889 (2024).
Internal Revenue Service. (2024). Publication 502 (2024).
Waterpik. (n.d.). Clinical research - An evidence based product.
