Dental Fluorosis Affects Generations on Brava Island, Prompting Project Intervention

Dental fluorosis, a condition caused by prolonged consumption of water with excessive fluoride, has long plagued the residents of Brava Island in Cape Verde, affecting multiple generations. Iva Valdez, now an adult, recalls noticing discolored spots on her teeth at age 12, initially attributing them to poor oral hygiene. Growing up on Brava, she was aware of popular remedies like using whale feces, but these proved ineffective against the ingrained stains. The condition often led to her being identified as being from Brava solely by her teeth, causing insecurity and discomfort. Upon moving to Praia, she faced questions about her hygiene and the potential for bad breath, making explanations about the water-borne cause a recurring challenge.

Seeking a solution as an adult, Valdez consulted a dentist and underwent dental abrasion and resin restoration, costing approximately 19,000 escudos, which helped restore her confidence. She believes many on Brava remain untreated due to a lack of motivation, unawareness of available treatments, or financial concerns, often assuming dental care is prohibitively expensive. To address this widespread issue, the "Fluorescer Brava" project has launched an initiative aiming to treat around 500 individuals over two years using minimally invasive techniques. The project was inspired by a successful treatment of a child using these methods, leading the family to seek broader access for the island's population.

The "Fluorescer Brava" project involves a Cape Verdean team, coordinated by dentists Carla Freire and Laura Lisa Graça, and a Brazilian team led by Professor Sandra Kalil, comprising seven researchers and six professors. In its initial phase, 14 Cape Verdean dentists treated approximately 80 people, primarily children and young adults aged 6 to 25, in just two days. The scale of fluorosis on the island surprised the Brazilian team, who observed that nearly all residents exhibited the condition. Fluorosis manifests as stains, structural changes, and in severe cases, tooth tissue loss, occurring during tooth development, typically between ages one and eight, due to excessive fluoride intake from water.

While the project focuses on treating the consequences of high fluoride levels, Carla Freire emphasizes the critical need for water treatment to prevent future cases, as fluorosis impacts developing teeth. The treatments employ techniques such as deproteinization, microabrasion, teeth whitening, resin infiltration, and resin restorations for more severe damage, tailored to each individual's needs. Challenges for the project include securing funding, equipment, and managing logistical costs associated with the island's accessibility. The initiative's continuity relies heavily on partnerships for acquiring consumables and equipment. Beyond fluorosis, the team also identified other oral health issues like cavities and gingivitis requiring attention. The long-term vision includes expanding the project to other fluorosis-affected areas in Cape Verde, with Brava remaining the top priority due to its significant need.