What began as a simple assessment quickly revealed a crisis—and ultimately led to one of the most impactful, evidence-based interventions in COAF’s health programming.

The Reality, Widespread Decay in Permanent Teeth

Early screenings conducted in rural communities such as Bagaran and Yervandashat painted a stark picture: Nearly 99% of children had tooth decay. Six-year-olds were found to have up to 12–14 decayed baby teeth, while nine-year-olds already showed damage in their permanent teeth.

“It’s tragic reality when you walk into a first-grade classroom and see that the first permanent molars, which emerged only a few months earlier, have already decayed.”

“It’s tragic reality when you walk into a first-grade classroom and see that the first permanent molars, which emerged only a few months earlier, have already decayed,” explains Lusine Sahakyan, the manager of COAF's dental programs.

These findings pointed not only to a health issue, but to a deeper systemic gap—limited access to dental care, low awareness of oral hygiene, and, in many cases, even a lack of running water in homes. This moment became a turning point.

From Observation to Intervention

Rather than responding with treatment alone, COAF designed a preventative, school-based model—one that could reach children consistently and early.

As later documented in a peer-reviewed study, COAF implemented a program that combined:

• daily supervised toothbrushing with fluoride toothpaste in schools
• oral hygiene education for both children and parents
• the installation of dedicated brushing spaces, known as Brushodromes

This model was intentionally designed for rural realities—where access to dental services and even basic infrastructure was limited.

Measuring Impact: What Changed

The study compared dental health data before the intervention (2013) and four years after (2017) among children aged 6–7 and 10–11 in participating villages. The results were clear:

• Among 10–11-year-olds, the number of decayed permanent teeth decreased by 31.1%
• Both younger and older age groups showed statistically significant reductions in decay levels
• Children who participated in the program consistently had fewer cavities than those who had not

While overall prevalence of cavities remained high, a reflection of long-standing structural challenges, the severity and intensity of decay declined meaningfully.

This distinction is important: it showed that change was not only possible, but measurable.

‍Why This Approach Worked

The success of the program was not accidental—it was rooted in behavior change. The study highlights several key realities:

• In many rural Armenian households, twice-daily toothbrushing was not a common practice
• Preventative systems like water fluoridation were not available
• Access to dental treatment was extremely limited, with very low numbers of filled teeth compared to untreated decay

By bringing prevention into schools, where habits could be formed daily, COAF addressed the root of the issue, not just its symptoms.

A Model That Continues to Shape the Future

This study marked a shift in COAF’s approach, from reactive care to a data-driven, preventative health model. It laid the foundation for:

• school-based hygiene systems across multiple communities
• integration of oral health into broader education and family programs
• continued expansion of preventative care, including fluoride treatments and sealants

Importantly, it also demonstrated that low-cost, community-based interventions can deliver real results, even in resource-limited settings.

Spring Appeal 2026—From Proof to Scale

More Prevention, Earlier Intervention, More Resources

The lessons were clear. Focusing on prevention, changing habits, and meeting kids in schools works—however there were still gaps. COAF was not connecting with children early enough, and the lack of access to fluoridation was notable.

This spring, COAF is expanding preventive dental care to every kindergarten across Armavir, reaching approximately children at the earliest and most critical stage of development.

This expansion builds directly on what our 2010-2013 study demonstrated: that consistent, early intervention can significantly reduce the severity of dental disease and lay the foundation for lifelong health. The model remains the same in principle, but broader in reach:

• Meet kids EARLY: preventive care delivered in every kindergarten in Armavir
• Build Habits: education for families and caregivers works. Let’s scale
• Support for Advanced Cases: regular, structured interventions through mobile dental units

What was once a proof of concept is now becoming an evidenced based system regional transformation. Now, the vision needs your help to make it a reality. 

In 10 villages, we learned what works. Help us scale that impact across 67 villages today.