Filling Israel’s Geriatric Dentistry Gap



By Maayan Jaffe-Hoffman/JNS.org

Chaya Sela is an 81-year-old Holocaust survivor. A volunteer at the Yad Vashem World Center for Holocaust Research, Documentation, Education and Commemoration, she tells her story to visitors from all over the world.

Sela spent four years hiding in a horse stable in Briennon, France, surviving solely on the kindness of a local priest and a handful of Catholic villagers. She wore rags and survived on scraps of food her father could scrounge. Finally, her family came to Israel in 1945.

The deprivation Sela suffered during her younger years led her to suffer from various ailments, including problems with her teeth. During her first years in Israel, dentists tried to save them, but eventually they were all extracted. As Sela aged, much of the dental work — dentures in place of her upper teeth, implants, and a bridge at her lower teeth — had to be redone. On a limited pensioner’s budget, she turned to Yad Sarah’s geriatric dental clinic. A series of weekly appointments restored Sela’s mouth — and the ability for her to use it to deliver her lectures at Yad Vashem.

Sela’s story is not atypical. The Yad Sarah geriatric dental clinic in Jerusalem sees roughly 115 elderly patients per week, many of them Holocaust survivors, according to the clinic’s director, Dr. Tamar Kartin Gabbai.

Similar to the situation in the United States, where Medicare — which covers medical care for people 65 and older — doesn’t include routine dental care, the Israeli government’s health fund also has an extremely limited dental policy. Most seniors lived on limited or fixed budgets, making expending funds for dental care difficult. According to a 2015 study by the American Dental Association, a fifth of people age 75 and older haven’t seen a dentist in the past five years.

Further, many elderly patients are at risk for complications when undergoing dental work, explains Dr. Albert Zickmann, a Chicago-based oral and maxillofacial surgeon. For example, patients with diabetes, heart disease, or high blood pressure, as well as those who are taking multiple medications, may be negatively impacted by anesthesia or the stress of undergoing a dental procedure. At the same time, many chronic illnesses and medications can worsen oral health.

Patients with dementia might experience anxiety, Zickmann says. Others are not mobile enough to get to a dental office.

“Beside the physical pain and discomfort, when people get older, one of the only few pleasures they have in life are eating or communicating with others,” says Zickmann. “There appears to be a correlation between oral health and one’s lifespan, but moreover, quality of life is tremendously important [for seniors], and this is certainly negatively impacted by poor oral health.”

Zickmann became a donor to Yad Sarah in order to help fund the organization’s mobile dental clinic. Three vans — one each in Jerusalem, Be’er Sheva, and Kiryat Motzkin — allow patients to receive treatment, including minor procedures, without ever leaving their home. Yad Sarah’s Gabbai says this helps not only the elderly, but also their caregivers, who might otherwise be tasked with taking the seniors to and from dental visits.

The Yad Sarah clinic and its vans are run almost entirely by volunteers. Aside from Gabbai, herself a dental specialist trained in treating the elderly, there are 17 volunteer dentists as well as multiple hygienists and assistants. New dentists can enter a three-year volunteer program and internship that trains them in how to treat elderly patients. They leave the program with a certification in that specialty.

The Rosenbojm-Komor Foundation, which is dedicated to social service support in Israel, recently donated $500,000 to Yad Sarah for its geriatric clinic. Paul Komor, the foundation’s president, says he spent a day visiting the organization and was thoroughly impressed by the staff’s professionalism, dedication, and commitment. But he was also struck by the pressing need for the services. Some patients, depending on the severity of their dental issues, needed to wait up to a month to receive treatment.

“With a toothache, you don’t want to wait a month,” says Komor. “You don’t want to wait a day.”

Komor says he hopes his gift will enable Yad Sarah to expand its services. Gabbai says the team is considering the establishment of an additional clinic, in central Israel, as well as planning to upgrade its equipment and other amenities.

In a note from Holocaust survivor Sela to the clinic, she writes, “Thank you…for the excellent and dedicated treatment you gave me… Every time I came for an appointment, I felt at home and was received warmly. I always knew I was getting the best possible treatment.”


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