Miller Middle School

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Free Dental Cleanings

FREE preventive dental services available for your child, provided by a Registered Dental Hygienist:
 Dental screening
 Fluoride varnish application                     
 Oral hygiene education (i.e. good brushing, etc.)
 Sealants (as needed, see below)                            
 Referrals to a dentist (if decay/cavities or other concerns are suspected)
Additional Service at low cost or covered 100% by Health First Colorado (Medicaid):
 Teeth Cleaning: $50.00(or we bill Medicaid)
We accept Health First Colorado (Medicaid) as well as cash/check payments. All services are covered
by Health First Colorado (Medicaid) and we will bill this for you. If your child does not have Medicaid
and you would like a cleaning, please see attached form for prices. Please make checks out to SJBPH.
Dental sealants are thin, plastic coatings painted on the chewing surfaces of the back teeth in order
to keep out the germs and food that cause cavities. The American Dental Association recommends
that children receive sealants on their permanent molars as soon as those teeth come in. If your child
is 5 to 7 years old or 11 to 14 years old, he/she may be eligible to have sealants placed on their
Step 1: Fill out the consent form and decide which services you want for your child
Step 2: Return it to your child’s teacher with your child’s Medicaid number or a check

For further information or questions, please call San Juan Basin Public Health at 970-335- 2034 or talk
to your school nurse.
San Juan Basin Public Health School Dental Program
Supplies provided in part by Oral Health America’s corporate sponsors: 3M ESPE and PULPDENT Corporation.