(iStock)

Doling out the cash to get a toothache treated can hurt almost as much as the tooth itself. That’s because about 40 percent of people in the United States have no dental benefits. And most who are insured lose their coverage once they retire.

But ignoring dental problems or skipping preventive care can harm you. Some studies suggest that chronic gum infection is associated with an increased risk for heart attack. So how can you maintain oral health without wrecking your budget? Consumer Reports’ experts recommend these steps:

Get a dental plan through work if you can. Most employers who offer one pay half or more of the premium cost, and most plans fully cover exams, X-rays and cleanings; 80 percent of basic procedures such as fillings; and 50 percent of bigger-ticket work such as crowns, says Evelyn Ireland, executive director of the National Association of Dental Plans. Expect an annual deductible of $50 to $100; the yearly maximum many insurers pay out is usually $1,000 to $1,500.

Consider dental savings plans. No work coverage? Participants in these buying-club-like programs pay an annual fee of $80 to $200 to access a large network of dentists who offer discounts of up 50 percent for members. Get details at dentalplans.com.

See whether a dental HMO may work. Dental health maintenance organizations, most often available in larger urban areas, charge $200 to $300 per person per year. Participants get twice-yearly cleanings and exams with no additional fee, and pay a few dollars to a few hundred for fillings, root canals and crowns. About 20 percent of dentists nationwide participate. Search for plans at nadp.org. Click “Find a Dental Plan,” then check “DHMO” and your state.

Consider ACA coverage. If you get health insurance through the Affordable Care Act (at healthcare.gov), you may be able to purchase optional dental coverage.

Check veterans benefits. If you have a service-connected disability, you’re eligible for free comprehensive dental care from the Department of Veterans Affairs. Other veterans can buy comprehensive insurance at a reduced rate. Get information at va.gov/healthbenefits/vadip.

Bargain-hunt. Look up local rates for dental procedures at fairhealthconsumer.org or at healthcarebluebook.com, and then ask your dentist for a discount. In a 2012 survey, Consumer Reports readers who asked for a break were often successful.

Create an emergency dental fund, and put aside money every month. “Unpredictable things happen, and you have to have a way to pay for it,” says Julia Hallisy, president of the nonprofit Empowered Patient Coalition in San Francisco. “You could bite on a peach pit and crack a tooth.”

Check community health centers. Some offer low-cost dental care, though they may have limited services and waiting lists. To find a center, call the local health department or state dental association, or go to toothwisdom.org.

Try university dental schools. Many charge 30 to 40 percent less than private dentists, and you’ll be treated by supervised students. “The quality of care is excellent,” says Judith Jones, a professor of dentistry at Boston University and an American Dental Association spokeswoman. Find schools at ada.org/267.aspx.

Help your teeth last longer. Brush for a full two minutes — most of us stop after 30 seconds — twice each day with a soft-bristle manual or electric toothbrush, and floss before bed. Drink tooth-friendly beverages, including plain water. (Soda and drinks with lemon and lime can erode enamel and weaken teeth.) Increase your production of saliva, which helps protect teeth, with sugar-free hard candy and gum. Avoid sugary foods and drinks. See a dentist once a year — more often if you have periodontal disease or are still getting cavities.

Copyright 2016. Consumers Union of United States Inc.

For further guidance, go to www.ConsumerReports.org/Health, where more detailed information, including CR’s ratings of prescription drugs, treatments, hospitals and healthy-living products, is available to subscribers.