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CDC-Sponsored Water Fluoridation Training

CDC offers limited training in water fluoridation engineering and operations and does not have the staff resources to provide special training for groups, organizations, or utility systems. CDC offers the following courses to assist with managing state fluoridation programs and water treatment facility operations. Enrollment in these courses is open to any state program official, water utility system staff, trainers of water facility operators and support personnel, and registered engineers.

Water Fluoridation: Principles and Practices presents basic information on community water fluoridation, including engineering and administrative guidance. The course is conducted over three days and is available periodically in Tennessee and California. Attendance is limited because of space and facility considerations, so pre-registration and approval are necessary, with preference given to state employees. There is no tuition fee for accepted state program employees, though attendees are responsible for their own travel and per diem expenses. CDC awards participants 1.8 Continuing Education Units (CEUs) or 18 professional development hours for completing the course. See a sample agenda.

Using the Water Fluoridation Reporting System (WFRS) is an optional half-day course (0.3 CEUs) for those responsible for maintaining state program records. This course immediately precedes the Water Fluoridation: Principles and Practices course.

Future training dates:

  • Murfreesboro, Tennessee:
    CDC will offer Water Fluoridation: Principles and Practices on September 16–18, 2014, along with an optional half-day course on the Water Fluoridation Reporting System on September 15, 2014, at the Doubletree Hotel and the Julian R. Fleming Training Center in Murfreesboro, Tennessee. Murfreesboro is located in the southern sector of metropolitan Nashville. Course attendance is limited to 25.

  • Sacramento, California:
    CDC will offer Water Fluoridation: Principles and Practices from February 10–12, 2015, with an optional half-day course on February 9 on the Water Fluoridation Reporting System (WFRS). Training will be held at the Capitol Plaza Holiday Inn and at the City of Sacramento Fairbairn Water Treatment Facility. Course attendance is limited to 21.
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A 6-hour Water Fluoridation Training Course offers assistance to states in providing water treatment facility operator training. The template can be customized by individual state programs. CDC does not offer CEU credits for this course, but state program sponsors often do provide credit. Contact your state dental director, drinking water administrator, or trainers of water treatment facility operators to learn when this training will be offered in your state.

CDC has been reviewed and approved as an Authorized Provider by the International Association for Continuing Education and Training (IACET), 8405 Greensboro Drive, Suite 800, McLean, VA 22102. CDC awards 0.3 CEUs to participants who successfully complete the WFRS training and 2.0 CEUs for completing Water Fluoridation: Principles and Practices training.

Contact CDC at if you have questions about any training.

Sample Agenda

Water Fluoridation: Principles and Practices is a CDC-sponsored course on basic community water fluoridation. It is intended to build the skills needed to manage and operate a state water fluoridation program, as well as to train engineers in drinking water programs and water fluoridation specialists on the principles of fluoridation engineering.

Operators of water treatment facilities and engineers in private practice have also found this course to be useful in building their skills and knowledge. CDC awards 1.8 Continuing Education Units (CEU) or 18 Professional Development Hours to participants who complete it.

The training is normally preceded by an optional half-day course on the use of the Water Fluoridation Reporting System for those who are responsible for maintaining records for a state program.

The following is a sample three-day agenda for a typical course.

View a typical course agenda by clicking the bar below.

± Day 1

8:00 a.m.
Opening Remarks 
Course Objectives  

8:30 a.m.
Fluoridation and Public Health
The Problem of Tooth Decay 
Fluoride's Mechanism of Action 
Dental Benefits 
Dental Fluorosis  

10:45 a.m.
Fluoride Additives 

Fluoride Compounds 
Commonly Used Additives 


1:00 p.m.
EPA Regulatory Perspective 

EPA and Water Fluoridation 
Maximum Contaminant Level (MCL) and Secondary Maximum Contaminant Level (SMCL) 
Monitoring Requirements 
Public Notification  

2:00 p.m.
Fluoridation Equipment 

Method of Feeding
Fluoride Additives 
Metering Pumps 
Fluoride Additive Equipment 
Day Tanks 
Ancillary Equipment  

3:00 p.m.
Design of Fluoridation Systems
Water Treatment Context 
Planning and Permitting 
Design Basis 
Selecting Pumps  

4:00 p.m.
Risk Communication
Overview of Risk Communication 
Communication Tips  

± Day 2

8:00 a.m.
Health Effects and Current Issues  

Charges and Claims of the Opposition 
How to Address Allegations of Health Effects  

9:50 a.m.
Chemistry of Fluoride Analysis
SPANS Colorimetric Determination 
Specific Ion Electrode Determination 
Errors and Methodology Interferences  

10:50 a.m.
Laboratory Safety and Session Directions 

11:00 a.m.
Management of State Programs
How State Programs Are Organized 
Engineering and Administrative Recommendations for Water Fluoridation (EARWF) 
Association of State and Territorial Dental Directors (ASTDD) Best Practices   

11:30 a.m.
Data Management and CDC Responses
General Information 
Water Fluoridation Reporting Systems (WFRS) 
Proficiency Testing 
My Water's Fluoride 
Oral Health Maps 
Program Support  


1:30 p.m.
Laboratory Session 

Hands-on Testing of Fluoride Content in Water  

3:45 p.m.
Laboratory Discussion
Results and Statistics  

4:15 p.m.
Water Treatment Plant Tour
Context of Water Fluoridation  

± Day 3

8:00 a.m.
Operation of Water Fluoridation Systems 

Maintenance Inspections  

9:00 a.m.
Operator Safety 

Planning for Safety in Fluoride
Handling Fluoride Exposure 
Toxic Exposures: Chronic and Acute 
Personnel Safety Gear and Techniques  

9:45 a.m.
Managing Fluoride Levels and Defluoridation
Well Blending 
Alternative Sources 
Methods for Fluoride Removal  

10:15 a.m.
Fluoridation Costs
Equipment Costs 
Additive Costs 
Installation Costs  

10:40 a.m.
Running Successful Community Fluoridation Campaigns
Community Support 
Coalition and Program Capacity  

11:15 a.m.
Implementing Improvements in Your State Program

Course Closeout



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