When Cierra Nakamura asked herself a little more than a year ago what "a simple 13-year-old" could do to contribute to Aloha Medical Mission’s work in Southern Asia, the answer turned out to be more than she imagined.

After learning of the health care hardships faced by people living in Nepal, the ‘Iolani School freshman took it upon herself to set a lofty goal of collecting 2,000 toothbrushes to send to middle schoolers in Lahan, a small city near the country’s southeastern border with India.

"After a couple days, I thought of something simple that I could do to help, and I thought of collecting toothbrushes," said Cierra, now 14.

Starting on Wednesday,1,500 toothbrushes, 800 tubes of toothpaste and 500 spools of dental floss will begin making their way across the Pacific with volunteers participating in an AMM trip to Nepal, all thanks to Cierra’s determination to help.

"I realized that I was really fortunate to have all these privileges, just like brushing my teeth," she said. "Kids in Nepal don’t really have that … (and) me having privileges and them not having privileges made me want to give them the privilege of doing simple things like that."

Once Cierra set her goal, she began what she described as the nerve-racking task of getting adults that she had never met to donate to her cause. She said she then took a flier she created, titled "Sharing Smiles Across the Miles," to a dental convention in January at the Hawai‘i Convention Center in hopes of gaining some support.

She initially got "a lot of rejects going from vendor to vendor," she said. "It was pretty scary, but it was for a good cause, so I just had to try my best."

The flier starts out by saying, "Happiness lives in all of us and the window to one’s heart is evident through a smile."

It continues: "I am a 13-year-old who wants to change the face of Asia through improved dental care. … For a vast majority of Nepalese, dental care is not a priority and cavities often progress to advanced oral disease, which in turn gravely affects everyday activities."

Craig Holbrook of Patterson Dental in Kapolei was on board with Cierra’s mission almost instantly.

"I was at the convention and she came up to me with a piece of paper in her hand and kind of took a deep breath … and she got about five words out and I said, ‘Yes, whatever you need,’" said Holbrook, who manages the dental supply distribution company’s Hawaii region. "This is not a service project for school. This is something that she saw on her own as a need, and she did a great job filling that need and was very convincing."

The company donated 2,000 toothbrushes, along with 2,000 tubes of toothpaste and 2,000 spools of floss, which Holbrook said amounts to about $6,000 worth of supplies and is the largest donation to come out of Hawaii.

"I was just trying to go for the toothbrushes, but having that, too, was really good," Cierra said.

Not all of the items can be shipped to Nepal, for space reasons. The remainder will head to the Philippines with an upcoming Aloha Medical Mission trip in March.

Dr. Brad Wong, Aloha Medical Mission president, said it can take patients as long as three days to reach the town where they set up a clinic and full operating room, and that the mission performs medical and dental procedures on about 100 to 150 patients for free in a 10- to 14-day period.

"There’s no way that they can afford (health care) even if it’s a major problem for them," he said. "Same thing with teeth — they never see a dentist because it cost too much money, so a lot of our work is pulling rotten teeth because they haven’t had the care you would expect."

Cierra said she hopes that donating tools for dental hygiene will help prevent such advanced decay. She can’t participate in the mission to Nepal because of school, so she filmed an instructional video with Nepalese subtitles for the children to watch.

Wong said he’s excited about Cierra’s project because he is always trying to involve nonmedical people in AMM’s work.

"She’s a high school kid and for her to show the desire and ingenuity to go to a dentist and get them to donate all this stuff — that’s really good because that’s teaching her skills that are going to be worthwhile, and it’s gotten her interested in world heath, which is what we’re all about."

Cierra said she hopes to expand the project and make it sustainable enough to donate toothbrushes each year, and eventually in multiple countries.