Toothbrush donation requests 

A toothbrush is the most basic oral health necessity, and we appreciate your interest in providing them to people who need them. Read below how to request toothbrushes for your organization. 


  1. Requesting organizations must be located in South Dakota.
  2. The organization must be, or must be affiliated with, a 501(c)3 charitable organization; a government agency or public school; or a Tribal organization.
  3. Donations are limited to 1 request per organization per calendar year.
  4. If the request is for more than 3,000 toothbrushes, you must first contact Cori Jacobson at or 605-494-2552 before submitting the form.


  • We will review and respond to your request within 30 days.
  • Please allow up to 5 weeks lead time to fulfill your request. Details for pickup/shipping will be discussed when responding to your request.
  • Donations to organizations in Sioux Falls, Rapid City, and Pierre must be picked up at the local Delta Dental office location.

Submitting a request

  • Complete the form below to submit your request.
  • The entire form is displayed below.
  • The form must be completed in one sitting. If you exit the page before submitting the form, your information will not be saved.


Contact Cori Jacobson at or 605-494-2552 if you have any questions about requesting toothbrushes for your organization.