Some people skip twice-yearly dentist appointments because they dread discomforts like poking, scraping, or drilling. However, a more common reason people never go to the dentist is cost. More than half of older Americans skip regular check-ups, and among working-age Americans, 13 percent cite cost as the reason for foregoing their dental care, according to a 2016 Health Affairs study.
So what do you do if you don’t have dental insurance or are underinsured? If you brush your teeth twice a day, floss, and don’t experience any signs of oral pain, you may think it’s fine (and less expensive) to skip seeing the dentist. However, seeing a dentist is important for your general health.
Going to the dentist goes beyond just taking care of your mouth and your teeth—it can also protect your heart, reduce your risk of type 2 diabetes, stroke, and pneumonia and may even prevent pregnancy problems, according to the American Dental Association (ADA). Good dental care may even lower the risk of developing dementia, according to a 2017 study in the British Dental Journal. (Check out the 11 reasons you really need to take care of your teeth.)
“Teeth are part of the body and their health is part of our overall health and well-being,” says Edmond Hewlett, DDS, ADA spokesperson and professor at the UCLA School of Dentistry in Los Angeles.
Here are some options if you are looking for affordable dental care.
Government insurance programs
There are three major federal insurance programs in the U.S. that eligible people can apply for to get dental care. The first is Medicare, which is for people 65 or older as well as younger people with disabilities or certain medical conditions. It provides only limited dental coverage and does not cover routine cleanings or check-ups, according to the Department of Health and Human Services.
Medicaid, which covers people below a certain income level, does offer some dental benefits for adults but the actual benefits vary from state-to-state, says Dr. Hewlett. Medicaid does cover most dental services for those under age 21 while the Children’s Health Insurance Program (CHIP) has options for kids 19 and under. (Here are some health insurance secrets that will shock you.)
Health insurance marketplace
People who don’t qualify for Medicaid, Medicare, or CHIP and who don’t have employer-sponsored health insurance can sometimes get health insurance—including dental—through the health insurance exchange also known as Obamacare. Types of coverage vary from state to state, says Dr. Hewlett. They also vary from plan to plan but plans are required to provide coverage for children, if not adults. You can get stand-alone dental care or dental as part of more comprehensive health coverage. High option dental plans have higher premiums but lower copays and deductibles while low option plans have lower premiums but you’ll end up with a higher deductible and more copays, according to the ADA.
Public health clinics
So if you aren’t eligible for federal programs and can’t afford dental insurance as part of your health plan, what are your options? Well there are Federally Qualified Health Centers (FQHCs) that provide dental services, along with other types of healthcare. These are called Community Health Centers, Migrant Health Centers, Health Care for the Homeless, or Health Centers for Residents of Public Housing, and they receive federal funds in the form of grants to provide care.
“We’re there to bridge the gap if someone is between jobs or even with Medicaid it’s difficult at times to get into private providers,” says Don Phillips, chief operating officer of Riggs Community Health Center in Lafayette, Indiana, which operates four clinics providing dental care to people who are uninsured or underinsured, as well as people who have insurance. “We bridge that gap for whoever whenever.”
At Riggs, fees for preventive dental care at Riggs start at $40 (excluding X-rays). The center also offers payment plans and does not send unpaid bills to collection agencies. You can use this site to find a community health center near you.
If a public health center doesn’t work for you, dental schools are also a great way to get high-quality, reduced-rate dental care. You’ll be treated by third- and four-year dental students who are supervised by experienced and licensed dentists.
“They typically will offer care at a substantially lower cost than is available at a private dentist,” says Dr. Hewlett. Student care at the University of California, San Francisco Dental Center, for instance, costs about half what you would pay elsewhere.
You can search for dental schools at the Commission on Dental Accreditation and for dental hygiene schools at the American Dental Hygienists’ Association. Many general practice residency programs are based in hospitals so you may want to contact your local hospital to see if they have a dental program as well, says Michael Conte, DMD, senior associate dean in the Office for Clinical Affairs at Rutgers School of Dental Medicine in Newark, New Jersey.
Community dental health coordinators
The ADA developed the Community Dental Health Coordinator (CDHC) program in 2006 to increase access to healthcare, especially in underserved rural, urban, and Native American communities.
“This is a program to train to train individuals in communities as a resource to guide patients to low-cost options,” says Dr. Hewlett. The CDHCs, usually from the same local community, not only connect residents with dentists, but also help navigate other obstacles to dental care, such as transportation and child care. The goal is to empower people to start taking care of their (or their children’s) oral health needs. The program is now in 45 states and has plans to reach all 50.
Programs for kids
The Give Kids A Smile (GKAS) program, initiated by the ADA in 2003, provides dental care to underserved kids. Thousands of dentists and other volunteers donate their services to provide screenings, treatment and health education to kids who are not getting dental care. The clinics start on the first Friday in February and continue throughout the year. Reduced-cost dental clinics, as well as dentists who participate in State Children’s Health Insurance Programs (SCHIP) and Medicaid, can also help. And an organization called Smiles Changing Lives has discounted braces for kids who need them. Orthodontic clinics at dental schools, like the University of Maryland, also sometimes offer affordable braces for kids and adults.
Many non-profit organizations provide free or low-cost dental clinics around the country:
- Mission of Mercy, for instance, has 14 free clinics in Arizona, Maryland, Pennsylvania and Texas
- Mission of Mercy is part of America’s Dentists Care Foundation, which offers care in other parts of the country as well, including Connecticut, Washington State and North Carolina
- United Way offers affordable dental care. A local United Way chapter should be able to steer you in the right direction
- Seniors aged 65 and over can contact Dental Lifeline Network. In addition to seniors, the organization provides help for people with permanent disabilities or who are “medically fragile”
- NeedyMeds has a database of more than 4,000 clinics that offer low-cost or free dental care to people who need help paying
Local and state resources
State dental associations are a font of information when it comes to free or low-cost dental care. In fact, says Dr. Hewlett, this may be the best place to check. “Every state in the union has a dental association as a component part of the ADA and many of these associations will have one or two free dental-care events every year for individuals who can’t afford dentistry under traditional delivery systems,” he says. State dental associations will also be aware of philanthropic programs near your home. Finally, check out state and local health departments for more resources. (Learn about secrets dentists won’t tell you.)
wutwhanfoto/Getty ImagesTalk to your dentist
According to the ADA’s Health Policy Institute (HPI), private dental practitioners provided free or discounted dental care totaling $2.4 billion in 2018. Many of these volunteers help out with established programs, but many also give back to their community with free days of care, sliding scales, or dental membership plans. A fixed fee paid to the membership plan every year entitles you to get cleanings and exams. You also get discounts if more serious work is needed.
“We know from data that a great many dentists in the country each take it upon themselves individually to provide free or reduced-cost care on a situation-by-situation basis, so it absolutely doesn’t hurt to ask,” says Dr. Hewlett.
Dentists are also ethically obliged to give you alternatives to dental care (if there are alternatives available), along with the relative risks and benefits, Dr. Hewlett adds.
The ADA website can help you find a dentist nearby.
If you’re enrolled in a clinical trial—research that is investigating new tests, procedures, or drugs—you may get dental work, even major dental work, for free or at a low cost. The downside of clinical trials is that finding the right one is a lot like looking for a needle in a haystack. “Clinical trials are very specific and very narrowly limited,” says Dr. Hewlett. It would be great if there was a lower molar implant trial going on at exactly the time you needed this type of implant, but chances are slim that you’ll encounter such a coincidence. The National Institutes of Dental and Cranofacial Research sometimes does trials for dental, oral, and craniofacial conditions. (Here’s how to find out if you should join a clinical trial.)
Traveling to other countries
In this day of soaring dental costs, it’s not unheard of for people to go outside the U.S. to Mexico or other countries to find lower-cost dental care. Usually, it’s for fairly major, expensive, work.
“The ADA recognizes that a lot of our communities have people who are seeking and will access treatment across the borders, particularly in the Southwest where it’s easier to cross the border,” says Dr. Hewlett.
While there are many excellent dentists in other countries, you do have to understand what you’re looking for. “You’re looking for competent, well-trained people,” says Dr. Hewlett. A good place to start is referrals from family and friends.
But bear in mind that the regulatory environment is likely quite different from the U.S. where you have recourses (like dental licensing boards) if something goes wrong. “If you go across the border, it’s important to investigate how much of that will be replicated there,” says Dr. Hewlett. And most people travel for complex, expensive work which usually requires follow-up visits. It’s not likely you can travel to another country for an afternoon and go home again. You want to have a relationship with your dentist, wherever he or she is located.
Take care of your teeth
The best thing you can do if you don’t have dental insurance or can’t afford regular dental care is take care of your teeth, says Dr. Conte. (Although this is something you should do even if you have dental insurance.) It’s not complicated: Brush twice a day with fluoride toothpaste and floss once a day so you reach the places the brush cannot. That means brushing thoroughly with a soft-bristle brush, he adds.
“The idea is to remove plaque—the biofilm of living bacteria which is living by eating the sugar-fermentable carbohydrates,” Dr. Conte says. The process produces acid which starts eroding your enamel. That can eventually lead to tooth decay and lead to other problems across the board. (Check out these mistakes to avoid when brushing.)