Use of Dental Services During the Period of the Dental Health Reform for Older Adults (2019

Background

Over the past decades, the oral health status of older adults in Israel has improved, yet it remains poorer than that of older adults in many other developed countries. This gap can be partly attributed to barriers that hinder access to dental services. In 2019, a reform of dental health services for older adults was implemented with the goal of improving accessibility and reducing these barriers. The reform began by including preventive and restorative dental treatments for adults aged 75 and over in the National Health Insurance benefits package. In October 2019, rehabilitative (prosthetic) care for adults aged 80 and over was added, and in September 2022, this eligibility was expanded to adults aged 72 and over.

Objectives

To examine trends in the use of dental services among older adults during the first six years of the dental health care reform.
To analyze utilization patterns of dental services since their inclusion under the National Health Insurance Law. Based on prior research on the dental health reform for children, the assumption was that there would be a rapid increase in utilization during the initial years of the reform, followed by gradual stabilization.

Methodology

A secondary analysis was conducted of administrative data provided by the health plans (HMOs) to the Ministry of Health on patients aged 65 and over who received dental care.

Key Findings

Between 2019 and 2024, the number of older adults receiving dental treatments in HMO clinics rose 2.8-fold – from 46,200 to 129,400 patients. This is an increase from approximately 10% to approximately 17% of the insured patients in the relevant age groups during those years. Significant increases were observed in the proportion of insured patients receiving preventive care (2.7-fold increase), emergency care (2.2-fold increase), surgical treatments (1.8-fold increase), and restorative treatments (1.6-fold increase).
Between 2020 and 2024, the proportion receiving rehabilitative (prosthetic) treatments increased 1.5-fold. The findings also point to substantial variation among the HMOs in the delivery of dental services to older adults under the reform.

Conclusions

A considerable rise was observed in the proportion of older adults receiving dental treatment during the first six years of the reform, particularly in preventive and emergency services. However, the proportion of older adult patients is still low.

Policy Implications

In light of the low proportion of older adult patients, efforts to raise awareness of the reform and its benefits for oral health among eligible older adults should be continued.
Follow-up studies should be conducted to track ongoing trends in dental service utilization and to explore patients’ perspectives on the care they receive.

Citing suggestion: Berg-Warman, A., Sadeh, A., Kermel-Schiffman, I., Zusman, S., & Natapov, L. (2025). Use of Dental Services During the Period of the Dental Health Reform for Older Adults (2019–2024). RR-064-25. Myers-JDC-Brookdale Institute. (Hebrew)