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Engineering and Operations

Water Fluoridation Training Program

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CDC provides water fluoridation training designed to build the capability of state fluoridation programs and to help water treatment professionals develop and refine their skills related to operations. Courses include a 3-day annual training on the Principles and Practice of Water Fluoridation and a newly developed 6-hour water plant operator training course template designed for use by state fluoridation programs. More information on these training programs may be found at the CDC-sponsored training page.

Technical Assistance to State Programs

  • CDC provides technical assistance to state programs regarding engineering support, facility management, and operational support and also provides responses to public health-related questions on community water fluoridation.
  • CDC serves as a resource to other federal government agencies, state programs, and professional organizations and associations.

Fluoridation Data Applications

WFRS logo

The Water Fluoridation Reporting System (WFRS) is the main tool used by CDC to help state and tribal water fluoridation programs. WFRS also is the basis for national reports on the percentage of the U.S. population receiving fluoridated drinking water. State and tribal officials approved by the state dental director or a tribal authority can participate in this password-protected system, entering state fluoridation data, and printing operational reports.

Recommendations for Fluoridation

Engineering and Administrative Recommendations for Water Fluoridation, 1995. MMWR, September 29, 1995;44(RR–13):1–40 [PDF–338KB] provides specific recommendations for water fluoridation, including administration, monitoring and surveillance, technical requirements, and safety procedures for community public water supply systems.

Water fluoridation quality award

Awards for Outstanding Fluoridation Efforts

CDC recognizes water systems that achieve optimal fluoridation levels for all 12 months each year with the annual Quality Award. Water systems that adjust the water fluoride level within the optimum range in a sustained manner are eligible for this award if their state documents the performance in the CDC Water Fluoridation Reporting System.

Water Facility Operator Fluoridation Poster

Water Facility Operator Fluoridation Poster
CDC has prepared state-specific resource posters for use by water facility operators. The poster provides important information to water treatment facilities using dry additives or fluorosilicic acid, including the following:

  • Safety information.
  • Operational guidance.
  • Optimal fluoridation levels.
  • Community benefits of fluoridation.
  • State drinking water program contact information.

To obtain a poster for your water facility, please contact the state drinking water administrator or the oral health program for your state.

Related Resources

The American Water Works Association (AWWA) is the principal organization of water systems, operators of treatment facilities, engineers, and others affiliated with the drinking water industry.

AWWA Manual of Practice #4, Water Fluoridation, Principles and Practices (2004), Fifth Edition is a useful reference on the design and operation of water fluoridation systems.

Fluoridation of Public Water Supplies is AWWA's policy statement on fluoridation. AWWA, with many other public health organizations like CDC, supports the fluoridation of public water supplies in a safe, effective, and reliable manner.

The World Health Organization's 2005 publication, Nutrients in Drinking Water identifies fluoride as a beneficial nutrient and includes information on water fluoridation.

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