Homepage > Research abstracts > Disparities in self-perceived oral health status, utilization of dental services within the dental profession reform, attitudes toward the use of Telehealth, and positive oral health and wellbeing among senior citizens in the center compared to the periphery in the State of Israel
Disparities in self-perceived oral health status, utilization of dental services within the dental profession reform, attitudes toward the use of Telehealth, and positive oral health and wellbeing among senior citizens in the center compared to the periphery in the State of Israel
Researchers: Berta Harel1,2, Yuval Vered2, Avraham Zini2, Nirit Yavnai2, Nurit Kot-Limon2, Galit Almoznino2
- Hebrew University of Jerusalem
- Hadassah Hospital
Background: In 2019, Israel implemented a dental reform extending publicly funded dental services to senior citizens.
Objectives: To study the post-reform knowledge, and barriers to utilizing services among Israeli senior citizens aged 70+ and suggest policy recommendations.
Method: This cross-sectional study included 503 Israeli individuals, aged 70+ years, selected through stratified random sampling from a national database. Questionnaires were administered in Hebrew, Arabic, and Russian. Associations between knowledge about dental reform and independent variables were analyzed using univariate and multivariate statistical models as well as decision tree analysis.
Findings: Only 36% of respondents were familiar with the reform, only 4.2% correctly identified the eligible age range, and 7.4% correctly identified the range of services included. Multivariate analysis indicated that knowledge of dental reform was positively associated with: general practitioner consultation in the prior year [OR=2.361 (1.056-5.278)], gaining knowledge about telemedicine from media sources [OR=2.351 (1.286-4.300)], engaging in social networks [OR=1.652 (1.040-2.625)], having an accessible Health Maintenance Organization (HMO) affiliated dental clinic [OR=1.633 (1.034-2.583)], and having chewing difficulties [OR=2.134 (1.148-3.966)]. Religious Jews were less aware of the reform compared to secular Jews [OR=0.376 (0.164-0.860)].
According to the decision tree, those aged 75+, who are provided with an HMO username and have a proximate HMO-affiliated dental clinic, are more knowledgeable about the reform. Alternatively, respondents who have not immigrated from the Former Soviet Union, who visited a private dentist, and without accessible HMO-affiliated dental clinic are less knowledgeable about the reform.
According to the decision tree, those aged 75+, who are provided with an HMO username and have a proximate HMO-affiliated dental clinic, are more knowledgeable about the reform. Alternatively, respondents who have not immigrated from the Former Soviet Union, who visited a private dentist, and without accessible HMO-affiliated dental clinic are less knowledgeable about the reform.
Conclusions: This first nationwide post-reform survey highlights persistent gaps in knowledge, attitudes, and use of publicly funded dental services among Israeli elderly, with disparities shaped by sociodemographic factors, service accessibility, digital orientation, and self-perceived oral health.
Recommendations: Strengthen reform implementation include raising awareness, addressing cultural barriers, improving digital literacy, and expanding HMO dental facilities in underserved areas.
Research number: R/45/2022
Research end date: 12/2025