American-Armenian Dentist Proposes Preventative Oral Care Program for Kids but Officials Appear Uninterested. Jack Saroian, a Doctor of Dentistry,  has been practicing dentistry in San Francisco for the past forty years. He also teaches at the Faculty of Dentistry at Pacific Ocean University. His first familiarity with dentistry began at the age of fifteen through his sister who was a dental technician and pharmacist at the time. After graduating from high school, he studied at Berkeley and later at San Francisco University. Upon graduating, he served for two years as a military dentist and then continued his professional training in San Francisco, while also teaching. For the past few years he has also taught public health classes at the American University in Yerevan. Mr. Saroian started to visit Armenia back in 1983. He says that he was interested to see the level of the development in the field of dentistry back in Soviet Armenia and today. After the independence of Armenia, Jack Saroian was granted the opportunity, as a member of the California Armenian Dental Association, to travel to Armenia and offer free dental services to children. He was worked in all of Armenia's regions, both urban and rural, and in the towns of Shushi and Stepanakert in Artsakh. He has toured Armenia five times between 1999 and 2005, dispensing free dental care to Armenia's children. "I've been to large and small towns, to the villages, so I know the prevailing situation. The problems of kids when it comes to dental hygiene and care are tremendous. Dentistry, as a profession, is at a very low level. Dental services are provided free to children up till the age of six. Older kids have to pay, but people aren't accustomed to paying for dental care. Then, too, there are financial restrictions. I realize that what is needed in Armenia is a preventative dental care system to avert dental disease before it occurs," Mr. Saroian said. Professor Saroian, in his capacity as a lecturer at the Science and Research Center at the American University's Faculty of Health, he got a chance to study the dental health of pupils at various Armenian schools. Some five hundred pupils, aged 5-7 and 12-14, from all the regions and two Yerevan schools, participated in the study. Results showed that, on average, the kids in the target age groups had on average eight rotten, broken or missing teeth. This compares with an international standard of 3-4 such teeth for kids aged 5-7. Interviewed pupils and dentists alike agreed that a majority of the children in the age groups specified complain of tooth aches. Professor Saroian presented his findings at a conference devoted to adolescent dental health that took place in Yerevan last November. He also proposed that table salt contain fluoride, a measure that would at least partially prevent the onset of dental diseases. Mr. Saroian noted that salt is not fluoridized in America and that not many are aware that some two million Americans drink fluoridized water. However, this method is widely practiced in about twenty five countries, including France, Switzerland and Germany. He says that by using fluoridized salt and water, tooth decay has been prevented for the past fifty five years. He says that the application of fluoride in the salt supports the health  of the oral cavity and the strengthening of tooth enamel, which, in turn, decreases dental disease by 50-60%. "This means cutting dental visits by half, 50% less cavities and 50% less physical and mental stress. Still, we need to get regular check-ups," he said. Changing the composition of the salt we eat to prevent tooth decay is just one of the components of his overall preventative plan. "We also have to retrain teachers in the schools, so that they can show the kids the right way to brush and care for their teeth. We have to instruct parents regarding providing their kids with healthy nutrition and less sweets. Tooth decay can be cut by 60-80% through better diet, better cleaning and less sweets," he said. Professor Saroian said that all the interested parties in the field were present at the conference; representatives from the World Health Organization, to which Armenia belongs, UNICEF, specialist from the University's Department of Dentistry, managers from the salt production plant, and others. "They listened to my report and replied that Armenia wasn't ready for such a program," Mr. Saroian said. The Minster of Health was not present at the conference, but Deputy Health Minister Tatul Hakobyan noted that this was the first study of its kind in Armenia. After the conference, Mr. Saroian met with Diaspora Minister Hranush Hakobyan and she later filed a brief about the proposals with RA President Serzh Sargsyan. "I have brought back with me from the U.S. a person who is a specialist with the technology. In his report he explained how the equipment can be utilized to inject fluoride into the salt. We can have this program up and running in the next 8-9 years at a cost of $700,000. I was also able to locate a benefactor who is ready to finance the project over this period," wrote Minister Hakobyan. With Jack Saroian's active assistance, representatives of Armenia's Health Ministry were able to attend a conference in Geneva in 2007 devoted to the health of the oral cavity, since Armenia is a member of the WHO. It was noted at the conference that if governments weren't able to fluoridize the water, the next best thing would be to fluoridize the salt.. "The ministry representatives heard and saw it all; it was taking place in front of them. But two years ago, when he presented the findings of our study, the ministry said it wasn't yet ready to implement such a scheme. They said that maybe Armenia didn't need it because the country's air, water and soil contained all which we need," Mr. Saroian said. "They belittled my study," was his answer. He recounts that what truly amazed him was that Armenia did not oppose the program, presented twelve years ago by UNICEF, to iodize the salt as a way to fight against goitre. The ministry of commerce arranged the whole thing and directed salt manufacturers to implement the plan. At the time, salt was supposed to be fluoridized as well, but it never happened. Professor Saropian decided to expand the study since, as he says, "there are many here who approach the issue with skepticism." To give further weight to his study and the ensuing proposals, Professor Saroian decided to examine the amount of fluoride ions in children aged 3-5. So he traveled the regions and laboratory tested the drinking water to see the amount of fluoride ions it contained. Her says that such tests are unnecessary in those countries where the water is fluoridated. To conduct a new research study, Professor Saroian set down some implementation deadlines after meeting with official from the Ministry of Health in November 2009. According to the agreement reached, he was supposed to have started on May 11. The ministry said it was ready to place a laboratory at his disposal, as well as a car and a nurse, to take samples from the kids for analysis. "Last week, however, when I arrived in Armenia, they told me at the ministry that the issue was still being reviewed and that a final decision had yet to be reached," Mr. Saroian said. He was forced to call his colleagues to postpone their arrival to Armenia, even though they had paid for the flight and hotel. Professor Saroian say that the ministry has known about the project for the past 3-4 months but that no preparations were made. "I am still waiting for a meeting with the Minister of Health. I am very disappointed since they assured me that the project would take place and they knew I was bringing other doctors with me. We could have completed the study in eight days. The other two doctors are specialists in public health and I have collaborated with them for four years to get this program off the ground. I am not a specialist, so I had to invite them from the States," said Mr. Saroian, adding that he's tried to meet with the Minister of Health to resolve the issue, but to no avail. Narineh Beglaryan, who heads the Department of International Relations at the Ministry, who faciitatated a review of the proposal to carry out the study, finally called. "I am not the person who can help you. Speak to someone else," she said On May 4, Professor Saroian met with Deputy Health Minister Tatul Hakobyan, who promised to discuss the matter with the minister and to get back with the American-Armenian dentist the following day. "The Deputy Minister never called. We've decided to put the whole thing on ice for a while or to call it off. You just can't go into schools and take samples from the kids without permission." Professor Saroian hopes that the minister will at least wish to meet with one of the specialists who has flown in from London. Otherwise, they will have to decide their next move. "Every time I come to Armenia, I am forced to spend more time here on this program. But I wouldn't want to spend the time I have left on this earth only on this one project," says Jack Saroian. Editor - We await some clarification on the matter from the Ministry of Health