Getting braces completely free is possible for children and teens in low-income families, primarily through Medicaid, CHIP, or nonprofit orthodontic programs. Adults have fewer options, but dental schools and flexible spending accounts can cut costs significantly. The path you take depends on your age, income, and the severity of your orthodontic issue.
Medicaid and CHIP for Children Under 21
Medicaid is the most common route to free braces for kids. Under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, states must provide comprehensive dental coverage for children and adolescents under 21, and that includes orthodontics when there’s a documented medical need. The Children’s Health Insurance Program (CHIP) works similarly in states that run it as a Medicaid expansion, though benefits vary in states that operate standalone CHIP programs.
The catch is that Medicaid doesn’t cover braces for cosmetic reasons. Your child’s case needs to meet medical necessity criteria, which typically means a malocclusion severe enough to cause pain, difficulty chewing, speech problems, or ongoing dental damage. The American Association of Orthodontists defines auto-qualifying thresholds: an overjet (upper teeth protruding forward) of 9 millimeters or more, a reverse overjet of 3.5 millimeters or more, or a crossbite affecting three or more teeth per arch. Many states use scoring systems like the Salzmann Index to rate severity, and each state sets its own cutoff for approval.
To start the process, your child needs a referral from a dentist to an orthodontist who accepts Medicaid. The orthodontist submits diagnostic records, including X-rays and impressions, to the state for a medical necessity determination. If you’re denied, you can appeal. In Florida, for example, families whose Medicaid claims were denied on medical necessity grounds can apply for orthodontic grants through programs like Sunshine Health’s My Healthy Child Reinvestment Fund, which requires a copy of the denial letter, a Medicaid ID number, and a cost estimate from a participating orthodontist.
Medicaid Coverage for Adults
Adults over 21 face a much harder road. States are not required to offer any dental benefits to adult Medicaid enrollees, and most that do provide dental coverage limit it to emergency or basic preventive care. A handful of states cover orthodontics for adults when there’s a documented medical necessity, such as jaw misalignment severe enough to impair eating or breathing, but this is rare. If you’re an adult on Medicaid, call your state’s Medicaid office directly to ask whether orthodontic services are covered under any circumstances.
The AAO Gifted Smiles Program
The American Association of Orthodontists runs Gifted Smiles, a program that connects low-income families with orthodontists who donate their services. Your child must be 18 or younger, currently receiving regular dental care with good oral hygiene, and not already in orthodontic treatment or between phases of a previous treatment plan.
Income eligibility follows 200% of the federal poverty level. For 2026, that means a family of four in the continental U.S. qualifies with a household income of $62,400 or less. A family of three qualifies at $51,640 or less. The thresholds are higher in Alaska and Hawaii: a family of four qualifies at $78,000 in Alaska and $71,760 in Hawaii. Applications are submitted through local participating orthodontists, so availability depends on whether a provider near you is part of the program.
Smile for a Lifetime Foundation
Smile for a Lifetime is a nonprofit that provides free braces to children and teens ages 8 to 18. Like Gifted Smiles, it’s income-based, though exact thresholds are listed on their website and may differ from federal poverty guidelines. Applicants must be enrolled in school with a C average or above. The foundation operates through local chapters, each run by a sponsoring orthodontist, so whether you can apply depends on your location. Check their website for a chapter near you and apply directly through that chapter’s orthodontist.
Dental Schools and University Clinics
Orthodontic residency programs at dental schools need patients for their residents to treat under faculty supervision. Fees at these clinics can be nearly half what a private practice charges, according to orthodontic faculty at Case Western Reserve University. Some university programs occasionally take cases at no cost, particularly if a patient’s case offers a strong learning opportunity for residents.
Treatment at a dental school takes longer than at a private practice because appointments are scheduled around the academic calendar and each step is reviewed by supervising faculty. But the quality of care is high since every decision is overseen by experienced orthodontists. Search for accredited orthodontic residency programs through the Commission on Dental Accreditation (CODA) or simply call dental schools in your area and ask about their orthodontic clinic fees and waitlist.
Clinical Trials
Universities and research institutions sometimes run clinical trials that provide orthodontic treatment at no cost in exchange for participation. These studies might test new bracket designs, aligner materials, or treatment protocols. The National Institute of Dental and Craniofacial Research (NIDCR) maintains a searchable database of recruiting trials on its website, and ClinicalTrials.gov lists additional studies. Eligibility is narrow since researchers need participants whose cases match specific criteria, but it’s worth searching if your situation aligns with an active study.
Give Kids A Smile and Local Events
The ADA Foundation’s Give Kids A Smile program mobilizes roughly 6,500 dentists and 20,000 dental team members each year to provide free care to about 300,000 underserved children. These events primarily offer screenings, cleanings, and basic restorative work rather than full orthodontic treatment. However, attending a GKAS event can get your child a professional assessment and referral to an orthodontic program. Many communities also host standalone free dental clinics through churches, community health centers, or local dental societies that can serve as a starting point.
Reducing Costs With Pre-Tax Dollars
If you don’t qualify for free braces but need to make them more affordable, a Health Savings Account (HSA) or Flexible Spending Account (FSA) lets you pay for orthodontic expenses with pre-tax money, effectively saving you 20% to 35% depending on your tax bracket. Qualifying expenses include the initial evaluation, diagnostic records, down payments, and monthly treatment fees. You can set up recurring reimbursements through your FSA to match your monthly payment plan with your orthodontist.
This won’t make braces free, but for a family paying $5,000 out of pocket, the tax savings could amount to $1,000 to $1,750. If your employer offers an FSA, you need to enroll during open enrollment and estimate your orthodontic costs for the coming year, since most FSA funds expire if unused.
How to Strengthen Your Application
Whether you’re applying through Medicaid, Gifted Smiles, or a nonprofit, a few things make approval more likely. First, get a full orthodontic evaluation before you apply. Programs want documentation showing specific measurements of the malocclusion, not just a general statement that braces are needed. Second, make sure your child’s general dental health is in good shape. Most programs require evidence of regular dental visits and good oral hygiene, and some will deny applicants with untreated cavities or gum disease. Third, gather your financial documents early. You’ll typically need proof of income (pay stubs, tax returns, or benefit statements), proof of insurance status, and your child’s dental records.
Apply to multiple programs simultaneously. Waitlists can be long, and not every program has a chapter or participating provider in your area. Starting with your state’s Medicaid office, then layering in nonprofit applications and a dental school inquiry, gives you the best chance of finding coverage before your child’s orthodontic window closes.