Fill out the information below. There is absolutely no obligation, the mouthguards won’t cost you a penny and we’ll even deliver them to your school or facility free of charge. This program is one more way Delta Dental supports better oral health.
Please use the notes section at the bottom of this form to customize your order with different size or color parameters. (e.g., 100 youth green, 50 adult clear, 50 adult black with strap)
Youth size is typically used for ages 10 and under. An adult mouthguard can be trimmed to size down. Please email email@example.com with any questions. View warranty information here.