In a groundbreaking effort to combat the high prevalence of dental caries among children on the island of Sal, Cape Verde, the Academic Centre for Dentistry Amsterdam (ACTA) is spearheading the CAVORAH study. This school-based initiative, generously supported by The Borrow Foundation, aims to implement and evaluate two key oral health interventions—daily group toothbrushing with fluoride toothpaste and the use of silver diamine fluoride (SDF) to arrest existing caries.
The Oral Health Crisis in Cape Verde
Dental caries remains one of the most prevalent chronic diseases globally, but the problem is particularly severe in Sal, where over 80% of school-aged children suffer from untreated cavities. Left unaddressed, this leads to pain, infections, poor school attendance, and even broader health complications. ACTA’s previous research on the island highlighted the urgency of implementing accessible, effective interventions to curb this growing oral health crisis.
Innovative School-Based Interventions
With a focus on long-term oral health improvement, the CAVORAH study will introduce two evidence-based interventions. First, children aged 5 to 13 will participate in daily group toothbrushing with fluoride toothpaste at school, a proven method to reduce plaque and prevent caries. Second, SDF will be applied to treat active caries, especially for children who may not have access to more conventional dental treatments. SDF is a low-cost, non-invasive method that has shown to be highly effective in arresting dental caries in high-need populations.
Mixed-Methods Approach for Real-World Solutions
The three-year study (2024–2027) combines clinical research with interviews and observations to ensure the feasibility and appropriateness of these interventions within the local context. ACTA will closely monitor the availability of necessary infrastructures, like water facilities and toothpaste supplies, as well as measure compliance through plaque scores and other clinical markers.
Parents, teachers, and school administrators will play a critical role, providing feedback on how well the interventions fit into school routines and identifying potential barriers to success. This participatory approach will ensure that the solutions are not only effective but sustainable.
Local Partnerships and Sustainability
ACTA is working closely with the Municipality of Sal, school directors, and the Intercambios Foundation, which links Cape Verde and the Netherlands. This collaboration ensures that the interventions will be deeply embedded in the community, increasing the likelihood of long-term success and scalability to other regions.
Outcomes and Future Impact
The results of this study will guide oral health promotion strategies not only for Cape Verde but also for other low- and middle-income countries facing similar challenges. With the support of The Borrow Foundation, this project aims to create a model for cost-effective, scalable solutions that can be integrated into existing school systems, offering children a healthier, brighter future.
 Dr Catherine Volgenant, Associate Professor, Head of the Department of Cariology, Academic Centre for Dentistry Amsterdam (ACTA) |  Dr Denise Duijster, Associate Professor, Academic Centre for Dentistry Amsterdam (ACTA) |  Egija Zaura, Professor, Department Chair, ACTA |