You’ve got your 401k, your Social Security start date, and your budget lined up. But there’s something you may have overlooked in your retirement planning — dental expenses. 

Medicare doesn’t cover dental treatment. Adam S. Harwood, an endodontist based in New York City, says, “This news often comes as a shock to retirees when they need to have some expensive work done.”

“The more dentistry you have had in your life, the more dentistry will be needed in the future.”
–Paul Amato

Many of us in the 50-plus crowd needed a filling or two after every childhood checkup. That adds up to a lot of potential problems.

“The more dentistry you have had in your life, the more dentistry will be needed in the future,” says Paul Amato of LeCuyer and Amato Dentistry in Seattle, Wash. “The oral environment is harsh, wet, acidic, and constantly being used, so the dentistry in your mouth will wear out over time.”

It might make sense to tackle high-cost treatments while you still have dental insurance. Ideally, you want to put your dental-care plan in place five to eight years before you retire, Amato says. 

That may seem early, but many dental insurance plans only cover $1,000 to $1,500 per year, says Emily Letran, a dentist based in Monrovia, Calif. Just one root canal, crown, or dental implant could easily hit that limit.

Here’s what you can do to keep your mouth — and your wallet — healthy before you retire.

Stay on top of your oral health

About 95 to 99% of expensive dental problems are preventable, says Sally Cram, a periodontist based in Washington, DC, and a spokesperson for the American Dental Association. “Catching things when they’re small, before they become big problems, is the most cost-effective thing to do,” she says. 

Share your thoughts and challenges with your dentist

Explain that as you’re getting older you want to prevent big problems in the future. And if you find that arthritis or other conditions make it hard to brush and floss well, mention it. It might make sense for you to use an electric toothbrush or a fluoride rinse, or to schedule cleanings more frequently. 

Have your fillings evaluated

Many people age 50 and up have old fillings, which can chip or break and need replacements, crowns or root canals for repair. Your dentist might see some fillings that should last another 10 to 20 years, while others might need replacement.

Watch for signs of periodontal disease

“Periodontal disease is an infection in the gums and bone around the teeth. It’s a progressive, chronic infection caused by bacteria,” Cram says. Periodontal disease can destroy bone and cause you to lose teeth, which have to be replaced with implants or bridges. “Those are big, costly things,” Cram says. 

A deep cleaning can stabilize periodontal disease, while a gum graft can protect the tooth and bone, says Amato. 

“If you suffer from bleeding gums now, chances are, without appropriate treatment, you’ll be facing procedures like root canals in the not-too-distant future,” Harwood says.

Put together a plan of care with your dentist

“It’s a good conversation to have — I think your dentist will welcome that,” Cram says. 

She points out that you often have choices when you are treating dental problems. For example, you might want to weigh the pros and cons of a more invasive dental implant vs. a less invasive but higher maintenance bridge and crowns. 

Understand what your dental insurance covers

“Few of our patients truly understand how it works and what it covers. Because of this, they don’t always do a good job taking advantage of their insurance as well as they should,” says Bobbi Stanley of Stanley Dentistry in Cary, North Carolina. 

Most policies cover 50 to 100% of certain procedures, up to an annual maximum of $1,000 to $1,500. Some offer more coverage for in-network providers.

Be open with your dentist about your financial concerns

Your dentist may offer cash discounts, payment plans, or a membership plan that could include preventive services along with discounted restorative work. “Many times these options can be much more beneficial than traditional dental insurance,” says J.R. Demman, a dentist at The Dentists at Dundee in Omaha, Nebraska. 

Look into other dental insurance options

You can buy dental insurance, but be prepared to wait before you can have expensive treatment. “It’s not uncommon to see waiting periods of up to a year for things like root canals, bridges, and crowns,” says Adam M. Hyers, an insurance broker with Hyers and Associates in Columbus, Ohio.

And you can add in Medicare coverage for dental care. “Most Medicare Advantage plans include some amount of dental, and there are a few Medicare supplements that cover dental as well,” Hyers says.

Keep in mind, you’re not getting any younger

“The older you get, the more factors your surgeon has to take into account when planning your surgery. We almost always recommend that patients get those major surgeries done now instead of later,” Stanley says.

Remember that good oral health is linked with good overall health

“Keeping your mouth healthy has the added benefit of keeping your whole body healthy. People with untreated gum disease and inflammation have higher risk of heart attack, stroke, diabetes, and kidney problems,” Cram says.