photo: ToastyKen/ BY-NC-SA

By: Emily Beaver

If you've been skipping dentist visits to save some cash, you're not alone.

Recent surveys say that many Americans, even ones who have dental insurance, skipped dental care in 2009 to save money. And people who don't have dental insurance, which is usually sold separately from health insurance, are even more likely to skip dentist visits.

Young adults, in general, are less likely to have health insurance than older adults or children. Many aren't offered health or dental insurance benefits at work -- and even when they are offered dental insurance, some young people choose to skip the extra expense of dental insurance. The Affordable Health Care for America Act, the health care reform bill U.S. House of Representatives passed Saturday, requires everyone to have health insurance, but it doesn't require everyone to have dental insurance.

"People are more likely to spend money on health insurance and skip over dental insurance," says Keith Mendonsa, consumer expert at eHealthInsurance, a company that lets people search for and purchase individual health and dental insurance plans.

Keeping your mouth healthy is important, says Liz Rogers, director of communications and public affairs for Oral Health America. The organization works to improve public health by eliminating oral disease.

"People need to remember that oral health is very much connected to overall health," Rogers says. "Any bacteria or decay in your mouth can travel to other parts of your body."

For a 20-year-old man or woman in the San Francisco bay area, the average monthly premium for dental insurance is about $25, Mendonsa says.

But basic dental services like fluoride applications and sealants cost less than $50 each, so what's the advantage of spending about $300 a year on dental insurance?

The answer has to do with how dental insurance works. Unlike health insurance, dental insurance must be sold to everyone, regardless of whether they have pre-existing conditions, Mendonsa says. This standard is called guaranteed issue. The catch is that most dental insurance plans require that you have insurance for six months before your insurance pays for services other than preventive care -- such as a tooth extraction or a root canal, he says. So if wait until you think you need care to buy dental insurance, or if you have an emergency while you're uninsured, you may end up with a large bill.

If you don't get insurance through a parent or work, there are alternative ways to get care, Rogers says. Self-care, or daily brushing and flossing, is important and get any problems, like white lesions or wounds in your mouth, checked out by a professional, she says. Oral Health America recommends that people who don't have dental insurance visit dental school clinics, which provide low-cost, high-quality dental care. You can also visit a free or low-cost clinic that charges on a "sliding scale" based on your income, she says.

If you decide to buy an individual dental insurance plan, make sure your dentist is in your insurance plan's network, Mendonsa says. If you visit a dentist outside of your plan's network, your care may not be covered by your insurer. He also recommends looking for dental plans with a $1,000 annual maximum benefit. Your annual maximum benefit is how much your insurance company will spend for your care in a year. Choosing a lower maximum benefit, like $750, only saves you a few dollars off your monthly a premium, but you'll end up paying $250 more out of pocket if you need care that costs more than your maximum benefit.