For many, doling out the cash to get a toothache treated can hurt almost as much as the tooth itself. That’s because about 40 percent of Americans lack dental insurance, and most who have a dental plan lose that coverage once they retire.

But ignoring dental problems or skipping preventive care can harm you—for example, chronic gum infection is associated with an increased risk for heart attack, some studies suggest.

Our experts recommend these 10 steps to maintain oral health without wrecking your budget.

Savvy Strategies

  1. Get dental insurance through work if you can. Most employers who offer dental insurance pay half or more of the premium cost, and most plans fully cover exams, X-rays, and cleanings; 80 percent of basic procedures such as fillings; and 50 percent of bigger-ticket work such as crowns, says Evelyn Ireland, executive director of the National Association of Dental Plans. Expect an annual deductible of $50 to $100; the yearly maximum many insurers pay out is usually $1,000 to $1,500.
  2. Consider dental savings plans. No dental insurance through work? Participants in these buying-club-like programs pay an annual fee of $80 to $200 to access a large network of dentists (60 percent of those nationwide) who offer discounts of up 50 percent for members. Find dental plans here.  
  3. See whether a dental HMO may work. Dental health maintenance organizations, most often available in larger urban areas, charge $200 to $300 per person per year. Participants get twice-yearly cleanings and exams with no additional fee, and pay a few dollars to a few hundred for fillings, root canals, and crowns. About 20 percent of dentists nationwide participate. Search for dental plans here by checking the “DHMO” box and then your state.
  4. Consider ACA coverage. If you get health insurance through the Affordable Care Act, you can also purchase optional dental insurance. Currently, dental is available only when you enroll in a full health plan. But dental coverage will be available separately next year for Medicare recipients on the exchange in Kentucky, and more states are expected to follow suit.
  5. Check veteran’s benefits. If you have a service-connected disability, you’re eligible for free comprehensive dental care from the Department of Veterans Affairs. Other veterans can buy comprehensive dental insurance at a reduced rate.
  6. Bargain hunt. Look up local rates for dental procedures at Fair Health Consumer and Healthcare Bluebook, then ask your dentist for a discount. In our 2012 survey, Consumer Reports readers who asked for a break were often successful.
  7. Create an emergency dental fund, and put aside money every month. “Unpredictable things happen, and you have to have a way to pay for it,” says Julia Hallisy, D.D.S., president of the nonprofit Empowered Patient Coalition in San Francisco. “You could bite on a peach pit and crack a tooth.”
  8. Check community health centers. Some offer low-cost dental care but may have limited services and, possibly, waiting lists. Call the local health department or state dental association, or go to Tooth Wisdom to find those centers.
  9. Try university dental schools. Many charge 30 to 40 percent less than private dentists, and you’ll be treated by supervised students. “The quality of care is excellent,” says Judith Jones, D.D.S., professor of dentistry at Boston University and an American Dental Association spokeswoman. Find dental schools here.
  10. Help your teeth last longer. Brush for a full 2 minutes—most of us stop after 30 seconds—twice each day with a soft-bristle manual or electric toothbrush, and floss before bed. Drink tooth-friendly beverages, including plain water. (Soda and drinks with lemon and lime can erode enamel and weaken teeth.) Increase your production of saliva, which helps protect teeth, with sugar-free hard candy and gum. Avoid sugary food and drinks. See a dentist once each year—more often if you have periodontal disease or are still getting cavities.

Dental Insurance You Can't Rely On

  • Medicare. It covers little dental care (except for hospital services such as post-accident jaw reconstruction). Medigap (the supplemental private insurance) generally offers no dental insurance. Medicaid coverage is quite limited.

  • Dental insurance you buy on your own. Just 4 percent of Americans do that. “Insurance makes you feel protected, but there are often one-year waiting periods before you can qualify for work like root canals and crowns,” says Julia Hallisy, D.D.S. “Some plans exclude these altogether.” One typical plan, AARP’s PPO “Plan B” dental insurance, begins at $474 per year per person. It has a $100 deductible and an annual cap of $1,000, and you pay part of the cost for all services and procedures. So you’d spend at least $574 before reaping a benefit.