Dekel Dan, Dadosh Hazav, Herman Hagit Domb, Yellon David, Zusman Shlomo Paul, Natapov Lena
Division of Dental Health, Ministry of Health, Jerusalem, Israel.
Isr J Health Policy Res. 2025 Aug 25;14(1):52. doi: 10.1186/s13584-025-00714-3.
The Child Dental Care Reform introduced in Israel in 2010 aimed to provide universal dental coverage for children, addressing high caries morbidity and inequalities in access to care. The reform initially covered ages 0-8 and expanded to include all children up to age 18 by 2019. This study examines age-related patterns of dental service utilization during the first decade of its implementation.
This retrospective study analyzed anonymized dental service data from 2011 to 2022, submitted by the four Health Maintenance Organizations to the Israeli Ministry of Health. The data included the number of children treated, categorized by age group, and the types of treatments provided.
Service utilization showed distinct age-related patterns, with rates peaking at age 8 (48%) and gradually declining through adolescence (p < 0.001). Restorative care consistently outnumbered preventive care across all age groups (p < 0.001), with children aged 3-5 receiving the most restorative procedures per child. Preventive treatments increased with age, from 1.0 per patient in young children to 1.5 in teenagers, transitioning from mainly dental examinations in younger children to hygienist visits in adolescents. Restorative treatments included dental restorations (peaking at 50% at ages 8-9), extractions (25% at ages 10-11), and pulp treatments (25% at ages 6-8). Emergency dental visits were most common in infants and increased by 83% over the course of a decade (p < 0.001). General anesthesia utilization increased significantly in the younger age groups, with the 4-5 age group showing the most dramatic increase (2.39-fold increase, p < 0.001).
This study highlights distinct age-related patterns in dental service utilization among children in Israel, emphasizing the need for targeted prevention strategies and policy reforms to address current challenges disparities, including the increasing rate of treatment under general anesthesia. Preventive interventions, such as community water fluoridation and early childhood programs, alongside improved access to specialized dental care, are essential for fostering better long-term oral health outcomes. Integrating quality indicators will facilitate better incorporation of dental services into the national health system, ensuring comprehensive and equitable oral care.
2010年以色列推行的儿童牙科护理改革旨在为儿童提供全面的牙科覆盖，解决龋齿发病率高和获得护理机会不平等的问题。改革最初覆盖0至8岁儿童，到2019年扩大到包括所有18岁以下儿童。本研究考察了改革实施头十年期间与年龄相关的牙科服务利用模式。
这项回顾性研究分析了2011年至2022年期间由四个健康维护组织提交给以色列卫生部的匿名牙科服务数据。数据包括按年龄组分类的接受治疗的儿童数量以及提供的治疗类型。
服务利用呈现出明显的与年龄相关的模式，使用率在8岁时达到峰值（48%），并在青春期逐渐下降（p < 0.001）。在所有年龄组中，修复性护理的数量始终超过预防性护理（p < 0.001），3至5岁儿童接受的修复性治疗程序最多。预防性治疗随着年龄增长而增加，从幼儿期每位患者1.0次增加到青少年期的1.5次，从幼儿期主要是牙科检查转变为青少年期的口腔卫生保健员就诊。修复性治疗包括牙齿修复（8至9岁时达到峰值50%）、拔牙（10至11岁时为25%）和牙髓治疗（6至8岁时为25%）。急诊牙科就诊在婴儿中最为常见，在十年间增加了83%（p < 0.001）。全身麻醉的使用在较年轻年龄组中显著增加，4至5岁年龄组的增加最为显著（增加了2.39倍，p < 0.001）。
本研究突出了以色列儿童牙科服务利用中与年龄相关的明显模式，强调需要有针对性的预防策略和政策改革来应对当前的挑战和差距，包括全身麻醉下治疗率的上升。预防性干预措施，如社区水氟化和幼儿项目，以及改善获得专业牙科护理的机会，对于促进更好的长期口腔健康结果至关重要。纳入质量指标将有助于更好地将牙科服务纳入国家卫生系统，确保全面和公平的口腔护理。
