Together we can help spread smiles across Iowa!

The Delta Dental of Iowa Foundation shares your commitment to improving the oral health of Iowa’s children. As a dentist, you are a resource for your community and local organizations to educate children on good oral health habits. Through our Give Smiles program, we will provide 288 children’s toothbrushes for educational events in your community.*

Simply complete the form below by August 6, 2021 to request toothbrushes.

*The Delta Dental of Iowa Foundation will donate up to a total of 50,000 toothbrushes for the Give Smiles program.

All fields marked with * are required.

Dentist First and Last Name *

Office Name (Please note: for dentists with multiple practice locations, supplies will be sent to one location) *

Shipping Address *

City *

State *

Zip *

County *

Phone Number (with area code) *

Email *

Please describe the community event or engagement activity in the box below where you will be educating children on oral health. Please note that we cannot donate toothbrushes for in office patient appointments, parades, overseas mission trips, or activities where an education component is not included.

Describe event *

Date(s) and location(s) of proposed outreach activity. *

Rethink Your Drink dental office education kits will be sent to the first 65 dentists who submit. Please indicate if you already have a kit (sent during 2019 Gives Smiles request) and do not need an additional kit.

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Together we can help spread smiles across Iowa!