En español | Like many older Americans, 79-year-old Phyllis Tabbi of Stoughton, Mass., lacked dental insurance. So she found herself putting off visits to the dentist. "I was on a fixed income, so I let some things slide," she says. For example, a crown might be pushed back a few months until she had the $1,000 to pay for it.

— Masterfile

Tabbi's plight was far from unusual, especially since Medicare does not cover most dental services.

According to a recent study by Boston-based discount dental service provider Universal Dental Plan, nearly half of Americans age 65 and older did not visit a dentist in the previous year, the number one reason being cost.

The consequences of that decision can be dangerous. Poor oral health increases one's risk of heart disease by 180 percent, risk of stroke by 300 percent and risk of respiratory infection by 500 percent, the study found. Then there's the obvious: gum disease.

Dental insurance often isn't a viable route for older adults. Those on fixed incomes often can't spare the $30 a month that, according to the Dallas-based National Association of Dental Plans, is a typical premium. Plus there are other costs such as deductibles and copayments.

Some seniors opt to pay out of pocket, like 67-year-old Barbara Perry of Bowie, Md., who is uninsured. "Unless I was having major procedures done every year, I would have paid three or four times in premiums what I spent on the work I needed."

When using a dental plan makes sense, and when it doesn't >>