Dental caries and periodontal disease can result in even more serious health consequences. For example, periodontal disease can spread throughout the bloodstream and contribute to problems ranging from low birth-weight babies to stroke to heart disease.

Regular dental cleanings, X-rays, and fluoride treatments – which could help prevent the problems, are not actively being practiced in the dentist offices, nor do all Bolivian dentists promote brushing and flossing. Citywide fluoridation in Cochabamba is impractical. The water supply is contaminated by previous mining operations and most residents buy their water in containers from private sources.