The Oral health Resources Exchange (OH-REx) is a place to share sample documents from community and school-based dental programs. The OH-REx was developed as a State of New Hampshire LEAN/quality improvement project with the goal of supporting and improving community and school-based oral health programs.

The links below will take you to sample documents that anyone may adapt.

• Sample Silver Diamine Fluoride (SDF) Informed Consent for school programs offering services that include Interim Therapeutic Restorations (ITR) and SDF
• Sample Silver Diamine Fluoride (SDF) After Treatment Take-home for school programs offering services that include Interim Therapeutic Restorations (ITR) and SDF
• Sample Screening and Treatment Permission Form for school-based program
• Sample Treatment Permission Form for school-based program
• Sample Treatment Record for school-based program
• Sample Treatment Results form for school-based program
• Sample Emergency Procedures for school-based program
• Sample Equality of Treatment Statement for school-based programs
• Sample Volunteer Data, Policy and Procedure for school-based programs
• Sample Volunteers for Dental Screening, Policy and Procedure for school-based programs
  

To request a Word document version, contact the Oral Health Program.

Additional Resources

• NH Oral Health Program Letter to Parents in Support of School-Based Dental Programs School-based dental programs may share this document with parents demonstrating the support of the Oral Health Program for the various services provided by such programs.
• NH Oral Health Program Letter of Support for School-Based Cavity Prevention Programs for Professionals School-based dental programs may share this document with partners such as school administrators, nurses, dentists, and funders.
• Oral Health America’s (OHA) April 2016 report, “A State of Decay, Vol III” demonstrates that older adults face many barriers to accessing oral health care.
• Presentation: School Based Oral Health Program Annual Reporting

Adobe Acrobat Reader format. You can download a free reader from Adobe.