Fifty-one percent of adults age 50 to 64 don’t know how they’ll get dental insurance once they reach age 65, according to a new survey conducted by the University of Michigan.

The survey asked a nationally representative group of 1,066 middle-aged adults about their teeth and how they care for them as part of the AARP-sponsored National Poll on Healthy Aging.

The researchers also found that only 41 percent of people surveyed felt they had very good or excellent oral health, and that more than a quarter of people had delayed or skipped needed dental care in the last two years. Of those, 69 percent said the cost of dental care was a major barrier to getting treatment.

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These findings are concerning, says Erica Solway, Ph.D., associate director of the National Poll on Healthy Aging with the University of Michigan. “People may not have good oral health going into their older years,” she says. “The likelihood that they’ll have serious problems in the future is much higher if they’re not getting the preventive care that they need.”

Solway says many people don’t realize that Medicare does not cover routine dental care. So for some, retirement may mean the end of being able to pay for a dentist.

Yet the older people get, the more susceptible they become to periodontal disease, or gum disease, says Jay W. Friedman, D.D.S., M.P.H., an expert on dental public health and an adviser to Consumer Reports.

Poor oral health can also take an emotional toll. The survey found that a third of people 50 to 64 feel embarrassed by how their teeth look.

But if Medicare doesn't pay, how can you get dental care? Here are a few tips for keeping your teeth healthy as you age.

Practice Good Oral Hygiene

Practicing good oral hygiene habits doesn't eliminate the need to go to the dentist, but it can help prevent serious problems such as tooth decay and gum disease. Here’s how to keep your mouth healthy, according to Friedman:

  • Brush your teeth twice a day with a fluoridated toothpaste, and rinse your mouth out thoroughly after brushing.

  • Floss regularly to remove food particles between teeth, which can become more common with age.

  • Avoid sugary foods and drinks, because they can promote tooth decay. Drinking plain water is best.

  • Dry mouth can increase your risk for tooth decay because saliva helps protect your teeth against bacteria. If you struggle with dry mouth, try increasing your production of saliva using sugar-free chewing gum or hard candy with xylitol. Or talk with your doctor about the medications you're taking; many can cause dry mouth.

And if you don’t already get your teeth checked once a year, do so. Routine care can help prevent significant issues down the road. “If people do end up having dental problems, some of them can be very expensive to treat,” Solway says.

Coverage and Discount Options

Many employers offer dental insurance, so if you’re working, see whether you can get coverage through your job. Your employer may also offer a retirement health plan that includes dental care. Some health plans through the Affordable Care Act (ACA) marketplace also include dental coverage. And U.S. veterans can buy dental insurance at a reduced cost.

If you don’t have dental coverage through your employer, the ACA, or the Department of Veterans Affairs, other options include dental savings plans and dental health maintenance organizations (DHMOs).

Dental savings plans allow you to pay an annual fee in exchange for discounts of up to 50 percent for many dentists across the country. In a DHMO, you also pay an annual fee in exchange for regular checkups and cleanings from participating dentists, plus discounts on more complicated procedures.

Go here to search for dental savings plans and here for DHMOs (check the box for DHMO and your state).

You’ll probably want to skip buying private dental insurance plans, our experts say, because these are often very expensive and may not cover procedures such as root canals or crowns.

Hunt for Low-Cost Care

Try asking your regular dentist for a discount. You can look up rates of many dental procedures in your local area using tools such as Fair Health Consumer or Healthcare Bluebook and ask your dentist for a comparable price.

Your local public-health department or community health centers may offer low-cost care. Tooth Wisdom can help you find these services, or you can call your local health department.

And if there’s a dental school in your area, you may be able to get discounted care from dental students. Find local dental schools here.