BoI: Dental care belongs in health basket

Preventive dentistry for children would save money, central bank’s report says.

April 14, 2010 06:51
3 minute read.
dentist 298

dentist 298. (photo credit: )


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Basic dental care for children should be included in the health basket because it provides preventive measures at relatively low cost, according to the Bank of Israel.

“The benefits of preventive medicine, including preventive and preservative dental care, are very high given its relatively low cost, which reinforces the importance of introducing it into the health basket, with an emphasis on children,” the Bank of Israel says in its annual report, which will be published April 21. “Adding the service to the public basket is expected to improve accessibility to dental treatment for weaker segments of the population, especially children.”

Most developed countries include preventive and preservative dentistry for children, the elderly and pregnant women in their public health basket, the report says. But in Israel, most dental care is not included in the health basket.

Dental services provided in many developed countries include education and instruction in oral hygiene, routine annual checkups, semiannual visits to a hygienist, filling cavities, application of fluoride, removal of plaque and X-rays.

Last December the government decided to allocate NIS 65 million from the budget earmarked for new medical technologies to the introduction of preventive and preservative dental treatment for children into the public health basket. The estimated budgetary cost of dental treatment for children ranges between NIS 250m. and NIS 650m.

The lower estimate is based on the addition of preventive and preservative treatments to children up to 12 years old, and the higher estimate is based on the inclusion of children up to 18 years. Both estimates assume co-payments and are likely to change depending on the treatment, the age groups entitled to treatment and the size of the co-payments.

Public funding of dental care in Israel covers less than 5 percent of the national expenditure in this area, while in the United States funding covers 5.1% of national expenditure, according to the report.

Health funds provide basic dental treatment to children (up to six or eight) as part of their supplementary health-insurance policies. “But this only applies to the more expensive clauses of the supplementary insurance that most of the weak population cannot afford,” the report says. “The financial expenditure on dental treatment per capita is similar for the poor and the rich, but the household size in poor households (the lowest quintile) is far greater and their income is lower.”

As a result, poor households spend 1.7% of their net monthly income from all sources on dental treatments, compared with 1.2% in the upper quintile.

“Many of the poor are forced to forgo the treatments because they cannot afford them,” the report says. “By forgoing dental services, the weak households cause harm mainly to the children. The proportion of children up to age 18 in households of the lowest quintile reaches 50%, as opposed to 20% in the upper quintile.”

The report suggests that inclusion of preventive services for children in the health basket would likely reduce the cost of dental treatments for the population as a whole.

Routine preventive dental treatments reduces treatment costs over five consecutive years by 40%, the US Centers for Disease Control and Prevention said in a report. Preservative treatments are 3.5 times as likely to reduce dental disease.

“In Israel it was found that the return on preservative dental care among pupils during their years of schooling was at least 9%,” the Bank of Israel report says.

A large proportion of children already receive the treatments through supplementary medical insurance, the report says, and the addition of the service to the health basket would release funds for medical technologies.

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