Yes, the “exam” costs…not sure how much but that’s a cost. It always takes 3 minutes, they mention a few depth #s and that’s it 
But they are doctors - so they deserve to make a bit. I guess having insurance changes things - a pure teeth cleaning shouldn’t be that much.
Makes me wonder how people stay in these high cost areas. I get why…but how??
Admittedly, I got lucky - my company made me move.
Why? I don’t really have an answer, but the lower COL areas are not drawing me, so I remain.
How? Save on other expenses elsewhere, I guess!
Maybe it’s a regional thing, but my basic, never tries to upsell me, dentist is around $250 per cleaning. Less if there are no X-rays. I get a 10% discount for paying cash. In the PNW like BunsenBurner. And I’ve called around, it’s pretty normal around here. When I looked at dental insurance last year, it was going to be over $50 per month, with max payout of $1000-1500 depending on plans. Not worth it to us.
COL area is usually primarily determined by cost of housing. I live in a VHCOL area where basic homes cost $2M+. The high cost of housing also leads to high cost of renting housing/apartment.
While higher cost of housing also leads to businesses needing to make up for their high rent expense and needing to pay employees higher salaries, impact on cost of other goods and services is usually far less notable, and not always in a positive direction. For example, I bought an 8th generation Camry a few months ago. When comparing prices, I found that in-region prices of the used Camry models that interested me were among the lowest in US. The only area of US that was significantly lower priced was a limited region within Florida.
There are also a minority of goods that are among highest cost in US, but I expect this usually has more to do with CA state policies than generally being a VHCOL area. For example, insurance prices are among highest in US for comparable home, which relates to CA prop 103 causing the larger insurers to leave the state, reducing competition. Wildfires also contribute. Automotive gas prices are also among highest in US, which relates to a combination of needed to use special gas for state environmental regulations + high state taxes on gas. Electricity prices in my region are also among highest in US, which relates to electric company losing money on solar customers under CA NEM 2.0 (I pay $0 for electricity because I have solar, in spite of using electric company grid like battery), which they need to make up for on non-solar customers; state environmental regulations requiring high portion renewable energy; CA public utilities price regulation; wild fire mitigation; …
I’ve found my personal cost of living is quite manageable, given that I own my home without a mortgage. If I wanted to comfortably and pleasantly live on $20k/year + property tax, I could do so without impacting my lifestyle significantly. However, if I was a new grad who did not own a home, the area would not be affordable without a decent salary or external help. I know several persons in their 20s and 30s who have given up on home ownership and instead choose to live with their parents. In some cases, they are married with children, with the full group living in one of their parents’ homes.
Knowing what dental insurance covers and how much helps one make an informed decision about getting said insurance or not after employment ends. No one in this thread has ever considered dental insurance or lack thereof as a deciding factor in whether to retire and when. Just saying.
We didn’t consider ‘helping’ DD1 and DD2 with home ownership as a consideration of what age we were going to retire - DH retired 8 months before he turned 65 and 11 months before I turned 65. DH was comfortable with what we had in our retirement nest egg and his jerk boss was stressing him out needlessly. I stuck to the plan and retired at 65 (he was to continue working until we both would retire together when I turned 65) - but I knew he needed to exit his job for his emotional health. It turns out that 6 weeks after retiring, his father got ill and passed at age 92, and 3 1/2 months later his mom passed at age 92. He spent a lot of time OOS with them.
Instead of transferring/converting more money from 401k to Roth IRA, we are transferring some money in our low tax years prior to RMD into our personal stock account. I am feeling the gains FA has with our Roth IRA is not that great, and we would like more of a financial cushion with buying a home in a new area and other expenses – and having more personal money available to potentially assist DDs with some funds for down payment. As in the past, if we do for one DD we do for the other. We start RMDs in 2029. In the next few years we will see what tweaking we will do on this aspect of our personal financials.
YMMV, but fluoride treatments were the only thing that helped me after years of tooth sensitivity. We were lucky enough to briefly have Dental Insurance that covered it for all ages (it also covered orthodontia for all ages) - that plan, I did COBRA on at 135/month for our family of five, but eventually it ran out.
I’m not saying lasers and light shows are worth it 
just fluoride…
I got so tired of all the upsells and uncovered things our dentist was doing. For 4 people, we really couldn’t afford it, and they weren’t very transparent about it. This had happened with a couple of dentists, the last of which retired at age 42(!).
So we started going to the community health clinic instead. You know, the one where all the medicaid patients go and they charge on a sliding scale. Getting an appointment isn’t quite as easy. But the dentists are great, it helps the clinic to have higher income patients, and they never upsell. Their care is excellent and the prices are dirt cheap. We’ve been happy there for years, and never intend to switch.
This is timely since I’m going to the dentist today. We didn’t have insurance for years. We got it maybe 15 years ago, but we pay 100% of the premiums. At the time, I figured we would break even if all 4 of us went 2x year. We would make money if we had problems. We only got $1000 per kid for braces, but we didn’t have it for kid #1. We have a $1000 per year cap for things like crowns/root canals.
I just looked at a recent bill. I never look anymore since the EOBs are digital and 100% covered, so I never see a bill. It cost $111 for a regular cleaning. However, I did look at how much we pay per year for just me and H and it’s $840/year. So the insurance company is definitely making $$$ off of us.
But, I would not go if I didn’t have insurance. I don’t always make 2xyear now. But before I had insurance I would go once every several years, sometimes 5 years in between. I loathe the dentist. So, it makes me go and now that I’m older, it’s more important. Our dentist doesn’t try to upsell us anything - not like our old one when we didn’t have insurance.
Wow, I just checked and our clinic charges $130 for the full exam, cleaning, and x-rays. They gave me ultrasonic cleaning last time I was in. Fluoride for the minors is another $20. The typical amount we’re charged after insurance is $15. Yet another reason to love our awesome community health clinic. We’re at the top of the sliding scale, so it is even less for most of their patients.
There is a very high fluoride content toothpaste which is by prescription only. That thing works. The little tray that you get to dip your teeth into for $40-50 oop - not so much. Our dentist stopped offering these treatments.
Speaking of lasers, those things do work to get rid of bacteria lodged below the gum line. Not to be confused with laser teeth whitening which is a gimmick.
Well my decision on whether or not to keep my current dental insurance through COBRA has probably be made for me. I chipped a front tooth. The repair is not major but the root cause is. Apparently the alignment of my teeth is causing me to wear down the enamel and chip my teeth so I need Invisalign which would be partially covered if I take COBRA. Had I known I had that problem I would have dealt with it prior to retiring.
So they stopped with the trays a while ago at my dentist also, though I preferred that experience (I know it doesn’t actually work as well). They do a drying/cleaning process and then paint something on as a sort of “varnish”. I’m on a routine of cleaning plus F- varnish every four months, and it has done wonders for my sensitivity.
I also have a prescription for the high-F- toothpaste but I never actually filled it; maybe I should. I’m sure that lasers have their place.
Re Invisalign, that helped with my alignment/grinding and I was very glad to have insurance at the time that covered it.
I would be paying for your dental insurance in your situation, and it breaks down to $80/month. For me, that is worth it even for two people, especially if you are in a higher cost area. My teeth are good, but I have had some major fillings that who knows if I will need a crown. DH just got a new crown due to a problem area. At the time our DDs had braces, it was Delta Dental and they paid $1500 - which at the time was about half. A lot more expensive now. DD1 had a family dental plan, and she has some choices of dental plans (her employer is the VA Hospital) - she is paying out-of-pocket for Invisalign because after her initial braces, she had a retainer for upper and the lower had a metal ‘brace’ bar adhered to the center lower teeth. But evidently her jaw/lower teeth are shifting, so she has needed braces to have her teeth back to better alignment and avoid jaw issues (she is 31). DD2 at 29 has no problem with the lower bar on her teeth and continues to use her retainer. SIL should have had braces, and he actually has quite severe teeth alignment issues that will become more health issues. Since he is in the Army, he is actually having periodontal work (covered/free under his Army care) because his gums are not in good shape with his terrible teeth alignment. SIL has a small oral cavity, which also affects breathing/sleep apnea - has machine. One of the grandsons is already seeing a ENT for evaluation, and the parents are going to have his dental care be proactive with having his teeth be properly tended to. Too soon to tell on the other grandson. DD1 evaluated dental plans - she said only one plan had for adult orthodontia; they figured out the best plan for them (lucky to have choices!).
Our initial dentist retired due to health issues years ago (heart attacks and serious heart issues) and sold his practice to our current dentists - husband and wife, but the husband has been the primary dentist. I took one fluoride treatment one time from the old dentist (he recommended and I said OK) and then the next time I refused - and he got mad. The fluoride upset my stomach, and I didn’t believe it was necessary. Really happy with the new owners, and they have been our dentists now for a very long time (decades).
Our dentists do a great job running their office. The wife is from an extended family of dentists, and it is clear they are happy with their work. Having the retiree patients continue with best cost option for dental care - and their in-office plan ($375/year cost for each of us) gives us a fixed cost of our regular cleanings and care. If/when we move to new city/state in 2026, we will have to carefully try to find as good medical and dental care. Get to know the way to get everything set up so after a year or so we have a routine with providers there.
Important to have good dental care and keep your teeth. Since many in our generation did have good dental care and semi-annual cleaning/exam, it is possible that one never needs to get to implants, a partial, or dentures. With upper dentures, one has a bit of loss of the taste of food. We already have to eat a lot less to keep weight off, so who wants to give up even more with food not having as good of taste.
Some interesting numbers in this article:
Today, many Americans are millionaires in net worth just from the value of their home. Houses they bought decades ago for very little are now worth over 1 million.
Sure. But many younger folks still have a mortgage.
The original report is here:
A couple of screenshots from the above:
Me too…and it made me not hate the hygienist visits anymore!
Some people in our generation might be doing well enough to assist their kids and grandkids - be it with obtaining a home (helping kids with down payment) or with some educational costs (grandkids). Probably retiring with a bit more than prior generation or two, but it depends – some have owned businesses that have done well, while others have done well professionally.
Areas with high cost of living can dampen some ownership due to trouble obtaining an affordable property - and the current mortgage interest rates also affects what is affordable.
The older generations that may have a home that has appreciated may also be dealing with growing property taxes and costs to maintain the home.
One has to weigh out what is important when determining when to retire and how big a nest egg to have. Some may choose to have a little no-stress part-time job to have some incoming cash, especially if one spouse continues to work.
A friend was downsized with a substantial severance (he was working remote). His wife retired from her job to relocate here where their two grandsons are. He just got an adjunct math teaching job at Community College, and it will keep his wife at bay (she wanted him to pursue high-end work in his field – he has master’s in ChE, but it was high stress work, and he wants to be retired).
Some retired people moving to our area (with kids and grandkids here) and moving into an apartment - there are a number of buildings in entertainment areas which is something some are trying out.
I like owning a property. We shall see what happens in 2026, and if it lines up for us to relocate.
