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Interview: Saskia Estupiñán

A dentist specializing in public health and Regional Advisor for Oral Health to the Pan American Health Organization (PAHO) in Washington since 1993, Ecuadorian Saskia Estupiñán-Day has worked for more than 25 years developing oral health strategies for Americas. One such project was salt fluoridation in Latin America and the Caribbean, implemented to reduce the prevalence of dental caries in poor rural communities in the region. The technique consists of adding fluoride directly to table salt, ensuring that the product consumed by the local population will help strengthen and protect their teeth from decay. The history of the success of this project is traced in the book Promoting Oral Health: The Use of Salt Fluoridation to Prevent Dental Caries, published recently by PAHO, with funding from the Kellogg Foundation. The project is part of the Foundation’s strategy to support innovative health initiatives that are capable of influencing the creation of public policies for the underprivileged population.

What diference salt fluoridation makes?
In some countries in the Americas, as many as 90% of children of school age have caries. There is an historic lack of oral health strategies in this region. Salt fluoridation is recognized as one of the most effective ways of reducing the prevalence of dental caries, particularly among the poorer brackets of society. In 1994, the Pan American Health Organization created an assistance program for countries in Latin America and the Caribbean based on the fluoridation of water and salt. The cost of salt fluoridation is very low – US$ 0.06 per person per year. Over the past 10 years, about 200 million people in the Americas have received the required dose of fluoride as a result of salt fluoridation.

What positive results have been achieved?
In 1998, 18 PAHO member states declared their intention to adopt salt fluoridation. Since then, 11 countries have developed their own projects, with the support of PAHO, that today are well advanced. In Jamaica, the reduction of dental caries between 1984 and 1995 was 83.9%. In Costa Rica, 72.5% from 1988 to 1999. These results have influenced other countries to adopt the program, after making adaptations to their current circumstances.

The experience with salt fluoridation is documented in a new Paho’s book.
Yes. Documenting experiences is an important part of our work. The aim of this new book is to provide examples of the fact that actions coordinated between government, industry and local communities in the area of oral health, with the support of PAHO, produce concrete results. Tooth decay is the most common disease among children, but we now have proof that it can be avoided with salt fluoridation.


Published in Interaction nº 12

Photo: Pan American Health Organization

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