Trends in Dental Health and Dental Care Utilization among Israeli Elderly in the last 20 years

Abstract Background Oral and dental diseases are largely preventable, yet only 31% of Israelis aged 65+ undergo annual preventive dental check-ups. The main barriers are a lack of awareness and the high cost of care. Significant disparities exist between SES groups, with higher SES individuals attending check-ups twice as often as those with lower SES. In 2019, 53% of older adults visited a dentist, primarily for prosthetic (33%) and preventive (33%) treatments. That same year, a reform integrated dental services into the National Health Insurance Law, entitling older adults to receive dental treatment with a small co-payment. Aim and Objectives To assess trends and patterns in dental health and dental service utilization among older adults in Israel between 2001 and 2020. Materials and methods Two telephone surveys were conducted among representative samples of individuals aged 65+: the first in 2001 (N = 181) and the second in 2020 (N = 512). Surveys covered oral health status, preventive behaviors, and dental service utilization. Results Significant improvements were observed: the rate of edentulism decreased from 52% in 2001 to 24% in 2020, and the average number of natural teeth increased from 11 to 14. However, inequalities widened: the edentulism gap between low and high SES increased from 1.6-fold to 2.2-fold, and the gap in the average number of natural teeth increased from 6 to 8. Dental visit rates rose from 40% annually in 2001 to 53% in 2019, with routine check-ups increasing from 20% to 31%, particularly among lower SES groups. Nevertheless, cost remained a barrier: 11% reported foregoing treatment, and 4% discontinued treatment due to financial reasons. Conclusions and Policy Recommendations Despite notable improvements in dental health and service utilization, financial barriers persist, especially among individuals with lower SES. These findings underscore the importance of including dental care for the elderly within the national health insurance services. Key messages • Despite the improvement in dental health of elderly Israelis in the last two decades, there are still disparities by SES. • The finding that cost is a barrier to receiving dental services, especially among the lower SES, is the rationale behind the dental reform for the aged.