Dental treatment planner

Dental Treatment Planner

Use this skill to convert a proposed dental-treatment list into a practical Israeli-context plan: treatment phases, likely visits, cash-flow estimate in ₪, provider comparison, clinic questions, and warnings requiring licensed dental review.

The skill is planning support only. Do not diagnose, prescribe, override a dentist, or present an estimate as a binding quote.

Core outcomes

Produce:

1. A normalized treatment list with tooth numbers, urgency, missing diagnostics, and dependencies.
2. A cost estimate in ₪ with explicit assumptions.
3. A comparison across private dentist, Maccabident, Clalit Smile, and selected alternatives.
4. A visit schedule and payment phasing plan.
5. A consumer checklist for written quotes and eligibility checks.
6. A risk section covering medical, financial, administrative, and timing uncertainty.

Required inputs

Input	Example	Use
Patient type	adult, child, senior, employee-supported	Eligibility and scheduling
Provider route	private, maccabident, clalit_smile	Provider cost factor
Region	tel_aviv, center, jerusalem, haifa, north, south, periphery	Local price assumption
Treatment items	exam, cleaning, filling, root canal, crown, implant	Cost and sequence
Tooth number	16, 46, 11	Procedure mapping
Urgency	routine, soon, urgent, emergency	Triage and urgency factor
Insurance	discount %, annual cap, waiting period, covered categories	Coverage model
Start date	15/07/2026	Schedule generation
Budget constraints	max visits/month, payment ceiling	Cash-flow phasing

When information is missing, use conservative assumptions and label them clearly.

Treatment-code examples

Basic restorative plan:

[
  {"code": "exam"},
  {"code": "xray_bitewing"},
  {"code": "cleaning"},
  {"code": "filling_small", "tooth": "16"},
  {"code": "root_canal_molar", "tooth": "46", "urgency": "soon"},
  {"code": "crown_porcelain", "tooth": "46"}
]

Implant planning:

[
  {"code": "exam"},
  {"code": "panoramic_xray"},
  {"code": "extraction_surgical", "tooth": "36"},
  {"code": "implant", "tooth": "36"},
  {"code": "implant_crown", "tooth": "36"}
]

Child prevention:

[
  {"code": "exam"},
  {"code": "cleaning"},
  {"code": "fluoride_child"},
  {"code": "sealant_child", "quantity": 4}
]

Decision tree

flowchart TD
    A[Receive treatment proposal] --> B{Pain, swelling, fever, trauma, or uncontrolled bleeding?}
    B -->|Yes| C[Classify as urgent/emergency and recommend same-day clinical triage]
    B -->|No| D{Diagnostics present?}
    D -->|No| E[Add exam and relevant X-ray assumption]
    D -->|Yes| F{Treatment has dependencies?}
    E --> F
    F -->|Root canal| G[Sequence: exam/X-ray -> root canal -> crown decision]
    F -->|Implant| H[Sequence: exam/imaging -> extraction or graft review -> implant -> crown]
    F -->|Cosmetic| I[Sequence: exam/cleaning -> disease control -> cosmetic treatment]
    F -->|Basic restorative| J[Sequence by urgency and tooth risk]
    G --> K[Estimate cost and visits]
    H --> K
    I --> K
    J --> K
    K --> L{Supplementary plan or HMO discount?}
    L -->|Yes| M[Apply waiting period, category eligibility, cap, used benefit]
    L -->|No| N[Self-pay estimate]
    M --> O[Build provider comparison and cash-flow plan]
    N --> O
    O --> P[Output warnings, assumptions, and quote checklist]

Cost-estimation method

Use transparent arithmetic:

gross = catalog_midpoint × quantity × provider_factor × region_factor × urgency_factor
coverage = min(gross × eligible_discount_pct, remaining_annual_cap)
patient_before_vat = gross - coverage
vat = patient_before_vat × vat_rate only when include_vat=true; default vat_rate is 18% as verified on 04/06/2026
patient_total = patient_before_vat + vat

Planning provider factors:

Provider profile	Factor	Use
private	1.00	Independent clinic or specialist-led plan
maccabident	0.78	HMO-affiliated route planning
clalit_smile	0.80	HMO-affiliated route planning
leumit_dental	0.82	Additional Kupat Holim route
meuhedet_dental	0.83	Additional Kupat Holim route

Planning region factors:

Region	Factor
tel_aviv	1.12
center	1.05
jerusalem	1.06
haifa	1.00
north	0.95
south	0.94
periphery	0.90
eilat	0.92

Replace default factors with dated, source-backed local prices before production use. Provider factors are heuristic planning coefficients, not official discount percentages or binding tariffs.

Web-validated Israeli source snapshot

Use these source-backed facts for 2026 planning and keep local data dated:

Topic	Verified planning fact	Action
Israeli VAT	Standard VAT rate is 18% from 01/01/2025 and remains the checked rate for 2026.	Keep vat_rate=0.18 when include_vat=true; still verify invoice classification.
Children	Children from birth to age 18 are eligible for preventive dental care without payment and preservative/restorative care with a low copay through HMO routes.	Ask the HMO clinic which items are included and what copay applies.
Seniors	Age 72 and above: Ministry of Health guidance describes preventive, preservative and some rehabilitative dental care through HMOs, with some items free and some low copay.	Check age, frequency limits, copays and required forms before estimating.
Maccabident	Official 2026 tariff and benefits pages show item-level prices and benefit categories, including first annual checkup benefits and plan-specific reductions.	Do not convert these pages into one fixed discount; load item-level prices when available.
Clalit Smile	Official pages describe 25% discounts for certain Clalit Mushlam routes and 34 ₪ preservative treatments for Platinum ages 18-72.	Model as eligibility rules only after confirming membership, age and waiting period.
Public APIs	No public provider webhook or live tariff API was confirmed for this package.	Treat /v1/... examples as local interface contracts, not external endpoints.

See references/verification-log.md for source URLs, quotes, access dates and the second-pass validation result.

Sequencing rules

Treatment	Check first	Typical phase
Cleaning	Active pain, infection, periodontal status	Preventive / prep
Filling	Exam and decay depth	Disease control
Root canal	X-ray, restorability, crown need	Urgent/restorative
Crown	Tooth structure, root-canal status, lab material	Rehabilitation
Implant	Imaging, bone volume, smoking/diabetes risk, surgical consult	Surgical/prosthetic
Whitening	Decay, gum disease, cleaning status	Elective
Aligners	Orthodontic consult, gum health, compliance	Elective/long-term
Denture	Healing after extractions, bite, remaining teeth	Prosthetic

Provider comparison guidance

Compare at least three routes when appropriate:

1. Current or recommended private clinic.
2. HMO-affiliated clinic such as Maccabident or Clalit Smile.
3. Specialist route for implant, surgery, complex endodontics, periodontal disease, orthodontics, or full-mouth rehabilitation.

For freelancers and small businesses:

• Separate urgent care from elective and cosmetic work.
• Map payments to expected income months.
• Ask for a written quote split by visit, lab milestone, and treatment stage.
• Keep receipts organized by tax year, but do not assume deductibility without tax advice.
• Avoid delaying infection or acute pain solely for cash-flow smoothing.

Edge cases

Pain before a planned cleaning

Classify as triage first. Do not present cleaning as sufficient if pain, swelling, fever, trauma, or uncontrolled bleeding exists.

Implant quote without imaging

Add a warning. A binding implant quote usually requires imaging and clinical evaluation. List possible additions such as bone graft, sinus lift, temporary tooth, surgical guide, sedation, or specialist fee only as optional risk items.

Root canal without crown

Flag crown uncertainty. Molars often need crowns after root canal, but the decision depends on remaining tooth structure and dentist assessment.

Whitening with untreated decay

Sequence disease control before whitening. Elective aesthetic work should wait until active problems are treated.

Supplementary plan waiting period

Apply zero discount until the waiting period is satisfied. Add a clinic question: “Has the waiting period ended for this treatment category?”

Annual cap nearly exhausted

Apply only remaining benefit. Show used benefit and remaining estimated cap clearly.

Child treatment

Mention that Ministry of Health guidance states children from birth to age 18 are eligible for preventive dental care without payment and preservative/restorative care with a low copay through HMO dental clinics or contracted clinics. Verify the exact treatment, copay, and clinic route before quoting.

Business-paid dental care

Separate medical planning from bookkeeping. Mark reimbursements, employee benefits, and deductibility as matters for a licensed accountant or tax adviser.

VAT uncertainty

Use the verified standard Israeli VAT rate of 18% for simulations dated 2026 when include_vat=true. Do not automatically add VAT to clinical dental services. Use include_vat=true only for taxable invoice modeling or non-clinical business items. Verify invoice classification with the clinic and accountant.

Anti-patterns

Avoid:

• “This is the exact price.” Use “planning estimate” and show assumptions.
• “Choose the cheapest provider.” Balance urgency, complexity, specialist need, availability, and scope.
• “Implant is always better than bridge.” Present trade-offs and require clinical review.
• “Delay urgent care for cash-flow reasons.” Recommend same-day triage for red flags.
• “Insurance covers it.” Use “coverage may apply if eligibility, waiting period, cap, and category rules are satisfied.”
• “VAT always applies” or “VAT never applies.” Verify invoice classification.
• “Aesthetic treatment first.” Treat pain, infection, decay, and gum disease first.

Output template

# Dental treatment plan

## Summary
- Provider route:
- Region:
- Start date:
- Patient objective:
- Estimate confidence: low / medium / high

## Treatment sequence
| Phase | Treatment | Tooth | Visits | Why now |
|---|---|---:|---:|---|

## Cost estimate
| Item | Gross | Estimated coverage | Patient estimate |
|---|---:|---:|---:|

## Cash-flow plan
| Month | Visits | Estimated payment |
|---|---:|---:|

## Provider comparison
| Route | Estimated patient total | Pros | Questions |
|---|---:|---|---|

## Warnings
- ...

## Questions for the clinic
- Is this quote final and written?
- Which items are excluded?
- Does the quote include lab work, temporary crown, imaging, medication, sedation, and follow-up?
- Which dentist or specialist performs each stage?
- What is the cancellation and emergency policy?

CLI quick use

python scripts/dental-treatment-planner-cli.py sample --output plan.json
python scripts/dental-treatment-planner-cli.py validate plan.json
python scripts/dental-treatment-planner-cli.py estimate plan.json --markdown
python scripts/dental-treatment-planner-cli.py compare plan.json
python scripts/dental-treatment-planner-cli.py schedule plan.json

Troubleshooting shortcut

Symptom	Likely cause	Fix
Unknown treatment code	Code not in local catalog	Run catalog list and map clinic wording
Estimate too low	Missing crown, imaging, lab, surgery, or specialist add-on	Add dependencies and risk items
Estimate too high	Provider profile too conservative or duplicate quantity	Check quantity, tooth number, and provider
Coverage not applied	Waiting period, category filter, cap exhausted	Inspect insurance fields
Schedule too dense	Visit limit too high	Lower max_visits_per_month

Production checklist

• Replace default catalog values with current clinic/provider price tables.
• Record source date for every tariff.
• Verify current Ministry of Health, HMO, consumer, privacy, and tax requirements.
• Add privacy review before storing medical data.
• Avoid storing ID numbers unless legally required and protected.
• Encrypt files containing health information.
• Add consent text for patient-uploaded plans.
• Add audit log for price-table changes.
• Validate that no output states or implies medical diagnosis.
• Validate Hebrew and English output with local professionals.
• Test emergency red-flag handling.
• Test annual cap and waiting-period scenarios.
• Test child, senior, implant, orthodontic, and business-expense scenarios.
• Keep provider comparisons labeled as estimates.