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.*

Complete the toothbrush request form below by July 31st.

*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 *

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. *

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Together we can help spread smiles across Iowa!