The street children of Manila are affected by early-in-life periodontal infection: description of a treatment modality: sea salt

Refuat Hapeh Vehashinayim (1993). 2013 Jan;30(1):6-13, 67.


Thousands of street children of Manila are affected by early-in-life oral infection. The aim of the present investigation was to evaluate the effectiveness of a sea-salt mouthrinse solution in street children of Manila affected by mild to severe forms of periodontal disease. These children were all in need of special protection: abandoned, abused, exploited, neglected, orphaned, poor. During 3 oral-health missions in 2003, 2004 and 2005, 617 abandoned children (5 to 13 year-old), received oral examination at a non-sectarian child-caring institution in Metro Manila (Virlanie Foundation) by calibrated examiners. A treatment based on what could be done was proposed: 1. Teaching of a precise tooth brushing technique with sea-salt, controlled and reinforced every two days for one week by calibrated health educators, 2. The application of sea-salt water mouthrinse (2.5 gram in 20 ml). Periodontal measurements were repeated at the end of each mission. All children returned to child-caring institution for the followup examinations. In 2003, 10 male and 11 female (n=21) were diagnosed with aggressive periodontitis. In 2009 and 2010, none was affected by aggressive periodontitis. For all patients, the gingival index decreased from 1.08 at the first mission to 1.04 at the end of the second mission and 0.98 at the end of the third mission. The periodontal index decreased from 1.33 at the first mission to 0.98 at the second mission and 0.92 at the last mission. The present investigation confirms that prevention and early diagnosis can result in success with minimum cost. The provided oral health program empowered street children in the most desperate circumstances to be educated and become self-reliant, independent, and responsible. We propose here an antimicrobial approach which has a high degree of efficacy and tolerability, and can be implemented in virtually all parts of the world using low-cost resources.

MeSH terms

  • Adolescent
  • Child
  • Child, Orphaned
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Homeless Youth
  • Humans
  • Male
  • Medical Missions
  • Mouthwashes / therapeutic use*
  • Periodontal Diseases / pathology
  • Periodontal Diseases / therapy*
  • Periodontal Index
  • Philippines
  • Poverty
  • Seawater
  • Severity of Illness Index
  • Sodium Chloride / administration & dosage*
  • Treatment Outcome


  • Mouthwashes
  • Sodium Chloride