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Dental work is not cheap. And insurance - whether employer-provided or bought on the open market - generally has lots of strings attached and covers only some procedures. Senior citizens may be in even more dire shape: Medicare covers almost no dental work.

The dental cash register can ring loudly. One crown in Phoenix - a modest cost city - may set you back $1,100. A simple filling is $225. A root canal on one tooth is $1250.

When dental needs are high and money is short, what are your options? The good news: you in fact do have options for getting dental care you can afford. You may even get a vacation in the bargain (more on that shortly).

The guiding principle?

“Generally, the best deals are available to those with more free time than money,” said dentist Edwin Allgair, who practices in Sterling, Alaska at Moose River Dental. Allgair offered more fundamental advice: “Private practices will position themselves in the market anywhere from high-fee comprehensive cosmetic services, to frugal basic family care. Ask your friends you trust, or just ask the person who greets you when you call or visit who they most serve.”

If what you want is basic, frugal dental care, probably that Beverly Hills practice with signed photos of movie stars on the wall isn’t the place to be.

A lot also depends upon your age and health. The elderly and disabled have easy choices. The young and healthy, not so much, but keep reading, because you will find what you need too.

Another fact: options for those 65 and older may be better than for those who are younger and that is despite Medicare’s dental blackout. A national organization - founded in 1974 and called Dental Lifeline Network - provides free, comprehensive dental care to those who cannot pay. It primarily serves the elderly and those with disabilities. It operates in every state.

More options are available via the federal government. A website - Find a Health Center - shows what local options are; dental usually is available. Federally Qualified Health Centers (FQHC) are open to anybody, and fees are based on ability to pay. Those earning no more than the Federal poverty limit, which varies by zip code, pay nothing.

Your income may be too high for an FQHC? Allgair has a suggestion: “If you are lucky enough to live near a large university with a dental school, quality care at a reduced fee can be obtained if you let a dental student care for you. Every step is checked and supervised by teaching faculty.”

There are 65 dental schools in the U.S., in 36 states; Washington, D.C.; and Puerto Rico. Many open their clinic doors to any who knock, there may be no income restrictions. But prices usually are low.

In Manhattan, for instance, Columbia University Dental School operates a clinic in Washington Heights and, said the school, “The fees for the dental services provided at Columbia Dental are significantly lower than most private practices.” The school added: “Appointments at the clinic may take longer than at private practice. Students and residents may work at a slower pace and are working with faculty to ensure high quality care.”

A related option: many community colleges offer dental hygienist training, and those schools typically provide low-cost cleanings. Said Tasha Kornegay in Apex, N.C.: “My family uses our local technical college, Wake Tech Community College. We get six month cleanings for $20.00.”

The last option: dental tourism, especially when the work involved is extensive (full sets of dentures for instance -- maybe $10,000 in the U.S. but much less abroad). Many developing nations actively seek to serve those dental needs of Americans. Ecuador, Hungary, Costa Rica, and Thailand all have active dental tourism practices aimed at English speaking patients.

What if your needs are less extensive? Or maybe you just want the work done closer to home. Think Mexico. Americans who live near the Mexican border - in California, Arizona and Texas especially - often walk across the border into Tijuana, Nogales or Juarez, where busy clinics want their business. Others fly - to Cancun, Puerto Vallarta or Mexico City - for a little vacation and a little dental work, too.

“I've been walking across the border and catching a taxi to Tijuana's Grand Hotel," said San Diego-based Elaine Masters, who blogs at TripWellGal. "The dental care I've had has been very good and a great savings.”

“Most recently I had a tooth extracted, three fillings, anesthetic and a sedative, plus a temporary bridge all for $995,” she added. Her guesstimate is that it would cost three times more in San Diego.

Bottomline: you can get the dental work you need. Just shop around - and maybe be prepared to hop on a jet plane.

This article is commentary by an independent contributor. At the time of publication, the author held TK positions in the stocks mentioned.