At Sheba Medical Center, a man in his 40s with a disability lies in the dental operating room waiting for general anesthesia to take effect before a long treatment begins. After the anesthesiologist approves, the team first assesses his mouth and dental X-rays, then one staff member goes to the waiting room to present the treatment plan to the family member or guardian and obtain approval before returning to the operating room.
The patient is Shoshana’s son, who has dystonia, a chronic neurological disorder that causes involuntary movements and abnormal posture. Shoshana says he is physically 100% disabled but cognitively intact, lives with her and a caregiver, and communicates through a communication computer because he cannot speak. After an initial visit at Beit Issie Shapiro, where he had local anesthesia and two teeth extracted, the clinic recommended hospital treatment under full anesthesia when he could no longer tolerate the drill noise. She says she is very satisfied with the care at Sheba, where the planned treatment included tartar removal, at least one root canal, and 10 fillings.
The article says many families with people on the autism spectrum, with intellectual, developmental, psychiatric or cardiac disabilities, or with extreme dental anxiety, do not realize that the health basket covers only Form 17, which pays for the operating room and anesthesiologist. The dental work itself can cost thousands, sometimes tens of thousands, of shekels, and families must pay the hospital immediately, then later receive only partial reimbursement from their health fund and cover the rest themselves. Prof. Noam Yirum, head of Sheba’s oral medicine unit, says he has seen heartbreaking cases, including one mother who produced three credit cards to make the payment.
One father from northern Israel, identified as Sh., said he had to raise 120,000 shekels for his 30-year-old son, who has a rare syndrome marked by underdeveloped jaw bones, missing teeth and hair, as well as severe mental illness. The treatment, done in several stages at Poriya Medical Center under full anesthesia, included bone grafting, jaw reconstruction and implants. He says the health fund approved Form 17 without delay, but the problem came when the family had to pay the hospital upfront and wait for reimbursement, with no bank willing to grant him a loan because the family is in Israel’s lowest income decile.
Yirum says the field suffers from two main problems, a structural gap between health funds and hospitals, and severe shortages of appointments. At Sheba, waits are one to one and a half years, and in some other hospitals even longer. Sheba runs two operating rooms five days a week and also uses sedation rooms, drawing families from all over the country. Because many patients cannot cooperate with routine tests, the team uses the anesthesia window to bring in other services, such as blood tests or ENT exams. The article says ministries of health and welfare should create an interim funding mechanism, while ALUT says it is already pressing the Health Ministry on the issue. The Welfare Ministry says dental care is the Health Ministry’s responsibility and that residents of its housing frameworks receive 22 free clinics, including under general anesthesia. Sheba says the shortage of appointments is nationwide and needs a national solution.
