Think you can’t afford to have healthy teeth? Even if you don’t have dental insurance, there are low-cost ways to get dental care.

When’s the last time you saw a dentist?

For nearly 40 percent of Americans, it’s been too long, according to a recent Gallup-Healthways Well-Being Index poll. For those living in states with high uninsured rates — states like Mississippi, Louisiana, and West Virginia — the situation is even graver: About half of them haven’t gone to the dentist in the last 12 months.

But these people are at risk for more than just cavities: Poor dental health has been linked to an increased risk of heart disease, stroke, respiratory infections, and other health problems.

There’s no debating the importance of dental care — but many Americans say it’s financially out of reach for them, even with dental insurance.

Who Lives Without Dental Insurance?

About 60 percent of low-income Americans don’t have dental insurance. For higher-income Americans, dental coverage can still be expensive, with limited coverage and high co-pays (which may explain why 36 percent of these higher-income adults also forgo dental coverage).

“Many Americans choose to go without dental care because they do not know how to find dental care they can afford,” says Alyson Hope Koslow, DDS, a clinical assistant professor of restorative dentistry at the University of Illinois Chicago.

Unsurprisingly, having dental insurance and getting dental checkups go hand in hand. About 35 percent of these higher-income adults and 67 percent of lower-income adults went without a checkup in the past year.

The problem spans across all age groups, too. AAccording to a recent study, nearly 50 percent of Americans age 65 and older did not visit their dentist in the past year, with high costs cited as the No. 1 reason. One problem for retired people is that Medicare doesn’t cover routine dental care or most dental procedures.

Decoding Your Dental Insurance Plan

“Your dental insurance options may depend on your age, your job, and where you live, as well as your income,” explains Dr. Koslow. These options may include:

  • Private insurance. Dental insurance may be offered by your workplace, but know that plans may not be as generous as the medical portion of your benefits. Private dental insurance plans tend to have high deductibles, limited coverage, and high co-pays.
  • Medicaid. Federal law does not require states to cover dental health under Medicaid, so even if your income qualifies you for Medicaid, how much dental care you have access to will depend on where you live. For instance, New York provides comprehensive dental care and Florida provides emergency care, whereas Texas provides no dental care. Check with your state Medicaid office.
  • Children’s Health Insurance Program (CHIP). Dental care for childrenis available under this federal program. Each state is required to provide the dental coverage necessary to promote and restore oral health for children younger than 19 who are without dental insurance. Services are different from state to state, so check with your state health department.

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