Americans are putting off dental checkups and care because of higher costs even though they may have insurance, according to a new Consumer Reports survey that asked readers about their dental visits over the past five years.

Forty-three percent of the 51,768 surveyed by the popular product testing organization cited cost as the main barrier to having dental health and cosmetic treatments delayed.

The survey also found that 23 percent of those surveyed put off needed treatments because their insurance would not cover it. In addition, the survey also revealed that "some patients might be paying for cosmetic treatments they don’t need" because they are pushed by their dentists to have the procedures.

"Consumers worry about pain when it comes to the dentist, but the financial burden of yet another medical expense is the greatest concern of all," said Consumer Reports Senior Program Editor Nancy Metcalf.

"Because cost is an issue, consumers need to be clear about the line between dental care that is necessary and the procedures they can live without," Metcalf added, noting that "many dentists are trained to push for procedures, both cosmetic and non cosmetic, that will boost their bottom line."

"We were struck by the finding that nearly half of those who had had a cosmetic procedure had been prompted to do so by their dentist," she said.

According to the February issue of Consumer Reports magazine, there are ways to keep dental costs down. They include:

• Shopping around and bargaining for the best prices. One way is to check typical insurance-paid rates for treatments at FairHealthConsumer.org and HealthCareBlueBook.com.
• Getting dental checkups and treatments through a free or low-cost clinic that can be found by checking with the local health department.
• Having work done at dental and dental hygienist schools. A list can be found at www.ada.org/267.aspx.
• Investigating dental discount plans that offer inexpensive rates for annual fees of $50 to $100.