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Reducing Tooth Decay and Improving Nutrition
Collaboration between ASAPROSAR and University of California
Karen Sokal-Gutierrez, MD, MPH
University of California Berkeley, School of Public Health 
From 2004 to the present, ASAPROSAR has engaged in a unique collaboration with the University of California (UC) Berkeley and San Francisco to reduce childhood malnutrition by focusing on reducing tooth decay. Over recent decades, with the increase in children’s consumption of sugary snacks and soda, an epidemic of tooth decay has emerged throughout Latin America. Currently, the majority of Salvadoran children suffer from tooth decay, and many of them have such severe decay that it causes mouth pain and difficulty eating, sleeping and playing.
For the past 5 years, a team of health volunteers from UC—including doctors, dentists, medical/pre-medical students, and teachers—has visited ASAPROSAR for a week in July to work with the promotoras de salud and the children and families in the nucleos and Brotes de Esperanza programs. The project has provided the following:
- Training for the promotoras on oral health and nutrition, which they incorporate into their work with the children and families.
- Toothbrushes and toothbrushes for the promotoras to distribute to all of the children and their family members
- Fluoride varnish, which can be applied to the children’s teeth 3 times a year by dentists from the Ministry of Health and other Salvadoran dentists who have volunteered to help the project.
- Yearly dental exams of the children and interviews with the mothers about their nutrition and oral health practices. Children found to have tooth decay are referred to their local dentists for treatment. In addition, we help the promotoras develop an individual plan for each child and family for the health education and dental treatment needed.
To date, the project has served approximately 1,500 children and 1,000 mothers in the villages where the promotoras work. The results have been impressive:
- Mothers have increased their knowledge about the causes of tooth decay and how to prevent it by breastfeeding, healthy diets and toothbrushing.
- Children’s diets have improved.
- Children and parents are brushing their teeth more.
- Children have less tooth decay and less mouth pain, and are better able to eat, sleep and play.
- Children have lower rates of malnutrition, and improved growth and overall health.
The project has been well-received by ASAPROSAR’s administration and promotoras. “The partnership with University of California and Dr. Sokal-Guiterrez has been great,” says Lucy Luna, Program Manager for the ASAPROSAR Children’s programs. “We have used our model of reaching the communities with promotoras, house visits and workshops and added the knowledge of proper oral health. We didn’t have a dental aspect in our program before our collaboration with University of California and now we are able to educate children and parents on the importance of oral health and connection between nutrition. We now have a new way to help the children we work with.”
Over the past 5 years, the families have observed dramatic improvements in their children’s health. One mother summed up the value of this project, “We used to think there was nothing we could do about our children’s rotten teeth and their mouth pain—it was just a fact of life here. But now childhood doesn’t have to be a time of pain and malnutrition—it can be a time of good health and happiness.”
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