FLUORIDE PROGRAM
Please carefully consider the fluoride program for your child. Please feel free to call the DuPage County Health Dept. at 682-7400 for further information on this program which will begin in October3 for students in K-8 only.
Our school, in cooperation with the DuPage County Health Dept. offers a fluoride mouthrinsing program. This simple method of applying fluoride has been demonstrated to be safe and effective in reducing and prevention of tooth decay. Participants will rinse their mouths with a 0.2% neutral sodium fluoride solution for one minute once a week. This rinsing is done in the classroom and takes no more than 5 minutes. The solution used is tasteless, odorless and harmless even if swallowed accidentally. This preventive program is a practical way to supplement the benefits from fluoride your child may already be receiving in water, in dental office treatments or from tablets or drops which may have been prescribed by your dentist or physician.
This program offers an excellent opportunity to help improve your child's dental health. Participation is voluntary and without cost to you. We encourage you to allow your child to participate in this valuable health program. Please return the completed form without delay to school.
.......................
Name
of students:
Grade Age
Gr. K-8 only Grade Age
Grade Age
Grade Age
______ I hereby consent to my child's participation in the fluoride mouth rinse program during the current school year.
______ I do not consent to my child's participation in the fluoride mouth rinse program.
______ I would like to volunteer to help conduct the fluoride mouth rinsing program during the current school year.
Signature of Parent or Guardian _______________________________________