Whether it’s fear of pain or bankruptcy, many of us avoid going to the dentist as long as possible. While the discomfort of dental procedures is no laughing matter, and there may even be procedures you feel are unnecessary, it’s indisputable that proper dental care is essential for your physical and cognitive health as you age. For some good basic advice and resources about dental care as you get older, open wide and click here, here and here.

If you can’t remember the last time you were at the dentist, you’re in good company, though perhaps for bad reasons. A recent analysis by the Kaiser Family Foundation found that ½ of seniors have not been to the dentist in over a year and that 15% of retirees have lost all of their natural teeth. That’s not shocking given that 2 out of 3 people over 65 have no dental insurance and that out-of-pocket dental expenses can be substantial, especially for those on a fixed or limited income. But the consequences of this lack of dental care can also be enormous.

It’s clear from recent research that older adults value oral health care and, in fact, one recent market survey found that good dental health was more important to people than their weight, exercise or mental health. And we have evidence that poor dental hygiene can not only lead to tooth loss, and trouble eating, but can also exacerbate conditions such as diabetes and cardiovascular disease. And now there’s research associating gum bacteria and toxins from poor oral hygiene to Alzheimer’s. As one researcher stated, “People with genetic risk factors that make them susceptible to rheumatoid arthritis or Alzheimer’s should be extremely concerned with preventing gum disease.” We also have research that associates poor cognitive function in older adults with poor oral hygiene and tooth loss in later life, a good reminder to caregivers not to forget about the oral health of impaired seniors.

Paying for dental care is complicated. Some Medicare Advantage Plans provide coverage, as do some Medicaid programs, but the reality of excessive costs remains as grim as a root canal for the moment. There’s one bright spot on the horizon: The advent of dental therapists, who can provide simple preventive and restorative care such as cleanings and fillings, under the supervision of licensed dentists but at much lower cost. Eight states have now passed legislation regarding the education and scope of practice for such dental assistants, and at least a dozen more are taking a look at this model. It’s not a complete solution but it should give those in need of help something to smile about.