Regular teeth cleanings and preventative dental healthcare are the best ways to avoid serious and expensive teeth problems.
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For some, time, distance, or even fear of the dentist are reasons enough to skip the trip.
The University of Michigan found that a majority of middle-aged Americans do routinely see the dentist.
But neither Original Medicare nor Medigap supplement plans include dental coverage for seniors, and Medicaid coverage for low-income adults and seniors varies from state to state and year to year.
The Affordable Care Act's (ACA) expansion plan was meant to extend dental coverage in some states through Medicaid, but a few - Alabama, Arizon, Delaware and Tennessee - offer no base Medicaid dental coverage to begin with, even to adults.
Eighty percent of people without dental insurance don't go to the dentist regularly.
The problem of dental care for middle-aged Americans, is a compounding one, according to Dr Erica Solway, associate director for the research for the University of Michigan poll.
These groups reported skipping the dentist when they knew something was wrong at much higher rates.
Across the board, the most common reason that people ages 50-64 forewent dental care was cost, with 69 percent reporting cost as a major cause for their lackluster dentist attendance.
The longer teeth go unattended, the worse dental problems get, and the more expensive the care becomes.
STATE OF MEDICAID DENTAL COVERAGE: Dental healthcare through Medicaid varies widely from state to state, and fluctuates annually with state government budgets.
One in three middle-aged Americans are in pain, missing work and embarrassed because of their teeth, according to a new report.