Sussex-Wantage Regional School District
Telephone 973-875-3175
"SAVE OUR SMILES"
PARENT PERMISSION SLIP

Dear Parent/Guardian,

The Clifton E. Lawrence School and the Wantage School, with funding from the New Jersey State Department of Health, is offering to all students a voluntary fluoride mouth rinse program to prevent dental decay. This simple method of applying fluorides has been demonstrated to be safe and effective in controlling tooth decay (an average of 35% fewer cavities). Under supervision, participants will rinse their mouths in school with a .2% neutral sodium fluoride solution for one minute once each week. The solution is not swallowed and is not harmful if accidentally swallowed. This program is very important to the oral health of your child and is perfectly compatible with any other dental disease prevention measures that your family might use. There is no cost to you.

Your child can receive this program only if you sign and return the flouride form. You are free to withdraw your consent for participation at any time. This preventive program does not take the place of proper dental care at home, and regular dental visits. This program will begin after October 1st. First graders will be done on Tuesdays, and second, third fourth & fifth graders on Thursdays. Please try to make an effort for your child to be in attendance on these days, in order that they can receive the most benefits from the treatments. Mrs. Flynn will need volunteer parents for each homeroom for first & second graders. Mrs. Fisher does not utilize parent volunteers for her program. If you can help every 3-4 weeks from 8:40 - 9:05 am please respond below. Return the completed form to your child's teacher by as soon as possible. Please contact Mrs. Pam Flynn at 875-8820 or Mrs. Fisher 875-4589 with any questions &/or concerns