Cost is a bigger factor than fear when it's time to visit the dentist, a new government report shows.

The national survey on oral health shows 4 out of 10 adults in the U.S. say cost is the main reason they don't visit the dentist with an oral health problem like a toothache or loose teeth "in the past six months."

Fear was the motivating factor to forgo the dentist for only 1 in 10 adults when they had an oral health problem.

Researchers say the results suggest cost and lack of dental coverage is a major factor influencing oral health in the U.S.

Overall, the study shows about three-quarters of adults aged 18-64 in 2008 had very good or good oral health, 17% had fair, and 7% had poor.

People with Medicaid were almost five times as likely as adults with private health insurance to have poor oral health.

What Your Teeth Say About Your Health
Oral Health in the U.S.

In 2000, the U.S. surgeon general issued a report calling attention to the "silent epidemic" of dental and oral diseases in the U.S. and emphasizing the need for more information about the status of peoples' oral health.

In this study, researchers analyzed information from the 2008 National Health Interview Survey to check on the status of oral health in the U.S.

The results show 6 out of 10 adults aged 18-64 visited a dentist or other dental health professional "within the past year."

Researchers found several health and economic factors were related to oral health and frequency of dentist visits. For example:

    People with diabetes were nearly twice as likely to have worse oral health than others the same age without diabetes (29% vs. 16%).
    People with diabetes were also nearly twice as likely as those without diabetes to have not visited a dentist in more than five years.
    Those in poor families were more than twice as likely as adults in families that were not poor to have worse oral health than others (28% vs. 13%).
    Among those with one or more mouth or tooth problems, more than half who were uninsured had an unmet dental need due to cost, vs. one-tenth of those with private health insurance.

Education also seemed to play a role in overall oral health. The study shows people with less than a high school diploma were nearly twice as likely to have poorer oral health than others their age (39% vs. 20%).