It might be supply-and-demand for a white smile in the U.S. But I wouldn't pay a lot for it TBH.
You say you wouldn't pay a lot for your teeth now because you are still young, healthy and have no kid. Wait until you have kids and each them will need ortho treatments, you will see how expensive the ortho treatments will be. You will have no choice but to pay the orthodontist big $$$ so your kids can have a beautiful smile. When your teeth fall out in 20-30 years from now, you'll have no choice but to pay the perio/OS big $$$ for dental implants so you can enjoy eating the food you love again.
Most of my patients are low income Hispanic kids. The parents don't make much and they have to find ways (either borrow from the relatives or use credit cards) to pay for their kids' ortho tx because they don't want their kids to be teased at school for having ugly smiles. I've taken over a lot of cases that were treated in TJ, Mexico because the parents got tired of driving too far every month.
I'm always curious who goes to a American dentist unless you have good teeth and insured. Because I know basic dental insurance from regular jobs doesn't cover much other than cleaning.
People who want to have good teeth for the rest of their life. The reason people have good teeth is they see their "American" dentists every 6 months. Without regular cleanings and exams by their dentists every 6 months, they will lose their teeth in 5-10 years. Perio disease is a silent disease that causes no pain to patients....bone loss is an irreversible process. Regular dental visits easily prevent this. By the time you feel pain that is caused perio disease, it's too late. There are kids who get new cavity(ies) every 6 months.
But those with serious problems, where do they go to.
When I was a dental student, I did my oral surgery rotation at a government-run county hospital that offered free dental extractions for everyone who showed up. USC dental school has a mobile dental clinic program that provides low cost dental treatments to kids in underserved areas. People who don't have $$$ can go to these types of clinics. Of course, they won't get ideal care....only palliative care....mostly filings and extractions....no RCT, no crown, no implant.
To get good dental care, they have to work and have a job that offers them dental insurance so they can see a private dentist.