dentist Jerusalem- Tomer Appelbaum- Oct. 14, 2010.
A dentist at the Jerusalem clinic working on one of his patients this week. Photo by Tomer Appelbaum
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The Health Ministry will not allow new directives from the Meuhedet HMO to go into effect until it examines them - directives dentists say slash their pay at the risk of substandard dental care for children.

The Health Ministry said it should have been consulted on such extensive new rules. On average, the directives would cut pay to dentists by 40 percent for treating children. For hygienists, this would be a 63 percent cut.

The health maintenance organization's dentists signed a petition late last week stating that "the pay cuts are proof that economic considerations are coming at the expense of the children's good and reducing public [dentistry] to a treatment level that borders on neglect."

Meuhedet has rejected the allegation, saying that the recommendations meet the Health Ministry's medical standards.

Under the new directives, children at low risk for dental problems should have their teeth X-rayed only once every three years. This contravenes the once-a-year recommendation of both the American and Israeli dental associations. Moreover, the Health Ministry pays for annual and even biannual X-rays at the doctor's discretion.

Dentists say Meuhedet has also canceled treatments with fluoride gel for children at high-risk of tooth decay, but the HMO says the Health Ministry recommends this treatment only from age 6 and that it offers treatment equally as efficient.

The directives also limit treatments to two teeth per appointment, but Meuhedet told Haaretz this directive has been changed and treatment of a quarter of a child's mouth per appointment is permitted.

Meuhedet has also instructed dentists to use a different material to reconstruct back teeth, which dentists say is not always suitable and could deteriorate.

Meuhedet responded that this criticism showed "ignorance" and that the new material was "the most expensive on the market."

The directives say hygienists rather than dentists should treat children's teeth with sealants, but the directives reduce hygienists' pay for this treatment by 50 percent.

According to Meuhedet, "This treatment had until now been given by doctors, who now will have more time for expensive and expert treatments, and the hygienist will focus on oral hygiene. This is a significant rise in the quality of treatment."

The petition, started late last week, has been signed by 48 dentists and 20 hygienists working for Meuhedet, most in the Jerusalem area.