Many institutionalized patients with psychiatric disease have been discharged into the community and the patients who remain hospitalized are at a particularly high risk for dental disease. This study assessed the oral health and treatment needs of chronically hospitalized patients with psychiatric disease in Israel. A random sample of 301 patients hospitalized for more than 1 year in 14 of 18 psychiatric institutions in Israel was drawn from the National Psychiatric Hospitalization Registry, and 84.4% of them were examined. Their dental status was evaluated using decayed, missing, filled teeth (DMF-T) index and demographic and medical data were retrieved from the patients' files. Of the 254 patients examined, 4 (1.6%) were caries-free, 176 (69%) patients had only a partial natural dentition, while 66 (26%) were edentulous. The average DMF-T score was 23.8. The caries component accounted for 2.7 of the DMF-T, the missing teeth component was 20, and the restored teeth component was only 1.1. There was a negative correlation between age and treated caries, and a positive correlation between age and missing teeth. Not all edentulous patients had dentures. These findings confirm the need to improve the oral health of chronic psychiatric inpatients and the need for dental treatment. The existing policy should be adjusted to integrate the currently separated delivery of the dental services for institutions and community settings. Dental professionals in the health service should be rewarded to restore teeth in this population rather than just to extract them.

BackgroundEpidemiological studies have shown deterioration in dental health accompanying the ageing process. Tooth loss increases with age. Chewing ability is closely correlated with number of natural teeth present: there is a threshold of 20–21 teeth, below which chewing ability declines. The government of Israel is currently considering adding dental treatment for elderly to the basket of services of the National Health Insurance Law. Information on the influence of elderly’s dental health on nutrition and general health status can contribute to the decision making process.MethodsSecondary analysis of data collected on a subsample (N = 1776) of the cross-sectional Mabat Zahav - National Health and Nutrition Survey of the Elderly was done. Intakes of energy, fiber, protein, fruits and vegetables, associations with dental visits, dentures presence and functional ability were analyzed. Linear regression adjusted for confounders was performed.ResultsStatistically significant differences in dietary intake of energy, fiber, protein and vegetables were found between elderly who visited a dentist in the last year and those who did not. Elderly who possessed dentures had lower dietary intakes than their dentate counterparts. Elderly with functional problems such as impaired chewing had worse dietary intakes than the others. This was so after controlling for education, degree of interest in the relationship between nutrition and health and reading the nutrition label.ConclusionsThe findings in our study suggest that those who visited a dentist in the last year, had natural teeth and no denture/s and reported no chewing problems had better dietary intake. The results emphasize the importance of maintaining adequate dental health, preserving natural teeth and regular dental visits in the elderly to assure adequate nutrient status in this age group.

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BackgroundThe National health insurance law enacted in 1995 did not include dental care in its basket of services. Dental care for children was first included in 2010, initially up till 8 years of age. The eligibility age rose to 12 years in 2013.The dental survey of 6 year-olds in 2007 found that the average of decayed, missing and filled teeth index (dmft) was 3.31 and 35 % of children were caries free. The current cross sectional survey of dental health for 6 year-olds was conducted as a comparison to the pre-reform status.MethodsTwenty-three local authorities were randomly selected nationwide. Two Grade 1 classes were randomly chosen in each. The city of Jerusalem was also included in the survey because of its size. The children were examined according to the WHO Oral Health Survey Methods 4th ed protocol. The dental caries index for deciduous teeth (dmft: decayed, missing, filled teeth) was calculated.ResultsOne thousand two hundred ten children were examined. 61.7 % of the children suffered from dental decay and only 38.3 % were caries free. The mean dmft was 2.56; d = 1.41 (teeth with untreated caries), f = 1.15 (teeth damaged by decay and restored), virtually none were missing due to caries. Dental caries prevalence was rather consistent, an average of over 2 teeth affected per child. Although there is no major change in comparison to former surveys, there is more treated than untreated disease. In the present survey the f component is higher than in the past, especially in the Jewish sector where it is the main component. It is still lower in the Arab sector.ConclusionsAlthough the level of dental disease remained rather constant, an increase in the treatment component was observed. In order to reduce caries prevalence, preventive measures such as school dental services and drinking water fluoridation should be extended and continued. Primary preventive dental services should be established for children from birth, with an emphasis on primary health care and educational settings, such as family health centers and kindergartens.

Objectives: Health care workers are at an increased risk of SARS – CoV-2 transmission. The risk of infection for dental teams is assumed to be high, due to work settings, proximity to mouth, exposure to saliva and aerosols. There is a lack of evidence that quantifies the risk of SARS-CoV-2 transmission for dental patients and staff. Our objective was to assess SARS-CoV-2 transmission risk for dental staff members (DSMs) and patients following exposure in dental clinics during the second wave of the pandemic in Israel. Methods: The study analyzed new positive SARS-CoV-2 cases following exposures in dental clinics from May to September 2020. Two data sources were used: case report forms (CRFs) and epidemiological investigations. CRFs were developed by the MoH and distributed to dental clinic s to identify DSMs exposed to SARS-CoV-2 positive patients, and patients exposed to positive DSMs. SARS-CoV-2 status was diagnosed using MoH approved tests in certified laboratories and verified against the National COVID-19 database. Statistical analysis on a non-identified basis was performed. The population incidence rate and dental setting transmission rates were calculated for the study period with 95% Confidence Intervals. Results: From May 1 st to 30 th September, SARS-CoV-2 incidence rate in dental clinics was significantly lower when compared to the population. Following 962 reported exposures of DSMs to 508 SARS-CoV-2 positive patients, 7 DSMs were SARS – CoV-2 positive with a 0.7% cumulative transmission rate. Following 507 reported exposures by 43 SARS-CoV-2 positive DSMs, 3 patients were SARS – CoV-2 positive, with a 0.6% cumulative transmission rate. Conclusions: The transmission rate of SARS-CoV-2 in dental settings was very low for both patients and DSMs. Clinical significance: Our results suggest that routine dental care could be safely provided during the pandemic. Continuous monitoring should be performed due to the emergence of new variants and the vaccination programs.