In January 2010, the College of Dentistry launched the first phase of a three-year program, “Smile Grenada,” designed to develop a sustainable pediatric oral healthcare model for the tri-island nation of Grenada.
The most comprehensive oral health assessment and disease prevention initiative ever undertaken in a Caribbean country, “Smile Grenada” was conducted in collaboration with the Grenada Ministry of Health, with corporate support from Henry Schein, Inc. and Colgate-Palmolive. The strategy was to transfer well-established technologies in a regionally sensitive manner with the aim of developing a long-term solution, rather than simply fix a tooth or alleviate pain on a temporary basis.
To assess the oral health status of Grenadian children, the NYU dental team utilized a modified World Health Organization basic oral health pathfinder methodology and the stratified (age, gender, and location) cluster sampling technique. Children ages 6 to 8 and 14 to 15 from the six parishes across the main island, plus the sister island of Carriacou, were examined to determine the mean number of demineralized, decayed, missing, and filled tooth surfaces. Twenty-five percent of children had never used a toothbrush.
Mark Wolff, professor and chair of the Department of Cariology and Comprehensive Care, associate dean for predoctoral clinical education, and codirector of the Grenada outreach, led the team that screened approximately 1,100 children and found almost 10,000 cavities. “Multiply that by the 26,000 children on the island and it gives you some idea of the magnitude of decay—nearly 84 percent of children had dental decay,” says Wolff.
The team distributed toothbrushes, toothpaste, and other dental supplies to teachers whom they taught to oversee and reinforce children’s brushing habits in the classroom and to carry out fluoride varnish applications. They left the teachers with sufficient supplies of simple-to-apply, premeasured fluoride varnish packets to be used in the NYU dental team’s absence. In addition to forming close relationships with teachers, the team also reached out to school principals, local dentists, dental auxiliaries, hygienists, nurses, and other healthcare providers so that they could take the reins of the program once the College of Dentistry transitioned to an advisory role.
As of September 2013, the team had provided 117,000 fluoride treatments and 70,000 sealants to prevent cavities, distributed a total of 70,000 toothbrushes and toothpastes, and reached a total of 24,000 children. The result, according to Wolff, has been a reduction of between 45 and 70 percent in tooth decay, and, especially important, a locally sustainable, globally relevant model that has been embraced by the people of Grenada.