The cabinet decided unanimously to approve the allocation of NIS 80 million to provide basic dental care for children aged 13 and 14 starting in 2016, thus expanding a reform Health Minister Ya’acov Litzman began in 2010.
But despite the fact that parents are today not charged for basic dental care from birth through age 12, only 30 percent of them take advantage of the service, for which 300,000 more children will soon be eligible.
The treatment is available at health fund dental clinics, and will be expanded to the new age group starting on January 1. Clalit, Maccabi and Meuhedet have their own dental clinics, but the smallest insurer, Leumit, has none and carries out the program through contracts with around 250 private dentists. The vast majority of the dentists are general dentists who treat patients of all ages and not pediatric dentistry specialists.
When the program was launched, it included children up to the age of eight; in July 2011, it was expanded to those up to the age of 10. A year later, it encompassed those up to the age of 12. It was not expanded when MK Yael German was health minister. Now that Litzman has replaced her, he again expanded it to 14; on January 1, 2017, it will include children up to age 15, then in 2018, to age 16. In 2019 it will include teens up to age 18.
Litzman praised the government decision, noting that “dental care is an inseparable part of medical care,” and expressed regret that it expansion was halted by the previous government.
The expansion does not come at the expense of the NIS 300 million that has been added every year to the national basket of health service for medical technology.
A total of 2.3 million children will be entitled to get dental care in 2016 at a cost of NIS 480m., but as only about a third of children and their parents take advantage of it, the figure may change.
Dr. Shlomo Zusman, head of the dental health department of the ministry, could not explain why the majority of parents fail to take advantage of the service or whether the bulk of such families are ultra-Orthodox; many haredi families had been known to be unable to access dental care for their children before this. Some 800 clinics offer the service, he said.
The free care includes a dental checkup once a year; x-rays, dental hygiene counseling up to twice a year; and preventive coating of back teeth. For NIS 20, children can get dental first aid, amalgam fillings, root canal treatments; temporary crowns; extractions; use of laughing gas or sedation; and, if necessary, treatment under anesthesia for children up to the age of five who suffer from premature caries.
Although Prof. Jonathan Mann, head of community dentistry at the Hebrew University- Hadassah Dental School, had suggested at the launch of the reform that there was a risk of “overtreatment for money” by dentists paid little for the standard treatment, Zusman insisted he had received “very few complaints.”
Mann offered in 2010 that independent dental researchers in his school examine how well the free dental care is implemented, rather than leaving it to a handful of ministry supervisors. Litzman rejected the idea.
“I will be happy if the range of ages will increase to 18 and if the geriatric population is included,” Mann said last May when the State Comptroller’s Report on the Health Ministry was critical of the reform for its “underuse partially due to parents’ preference of taking them [their children] to private dentists or to inadequate ministry publicity about the coverage, especially among Arabs and haredim.” The comptroller added that the National Health Council was supposed to supervise the program, but it did not hold a single meeting on the subject in more than two years. The ministry’s “budget for children’s dental care has fallen below costs because it was not calculated according to the number of children in each health fund.” A separate study recently found that condition of children’s teeth in the country has not improved since Litzman’s program was launched.
Zusman promised that his office would release a report on utilization of the children’s dental service for 2015. As for Litzman’s planned reversal of German’s decision over two years ago to cancel mandatory fluoridation of all drinking water, Zusman said it requires changing regulations in the Knesset and that he hoped “we will finally accomplish this in the near future.” A date for the discussion has not yet been set by the relevant Knesset committee, added Zusman.