With all the attention paid to affordable health care, experts say standard dental coverage has changed little over the last 20 years while leading to greater out-of-pocket costs for consumers.

As with the rising costs of overall health care, many times only the wealthiest have access to important dental care.

Dr. Paul Glassman DDS, professor of dental practice and director of community oral health at University of the Pacific, said dental benefits and the cap on dental health plan benefits have not changed much in the past 20 years. But the cost of dental care has increased "dramatically."

"A plan that covered $1,000 used to get a lot," he said. "Now if you have an exam and get fillings, you've used your maximum."

As a result, more people are paying out of pocket if they want additional work done, he said.

And those who struggle to afford oral health care may find even more problems down the line, with gum disease possibly contributing to ailments like diabetes and heart disease.

Real out-of-pocket dental expenditures increased to $332 in 2008 from $270 in 1996, according to the American Dental Association's (ADA) report published in April called, "Breaking Down Barriers to Oral health for All Americans: The Role of Finance." The ADA said the figure dropped to $323 in 2009, but "this likely reflects the state of the economy, rather than any improvement in dental benefits."

Real per capita expenditures on overall personal health care reached $6,819 in 2009.

Glassman said a number of issues have contributed to dental care's higher costs. One major reason is that labor costs have increased in dental offices.

"Despite the recession, demand for their services was pretty good," he said. "So they were able to raise prices and still able to have busy practices."

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Dental Plans: Paying More For Less?