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Community Water Fluoridation is a small part of the work managed by waterworks operators. Still, CWF programs position utility staff in the front and center of their community. Utility staff, owners, and boards can serve as education centers on CWF. They can help combat concerns and misinformation about fluoride. Catalyst wants to ensure water operators have the tools and information necessary to do their job well. The following information includes national and Virginia-specific resources that can help ensure the health and safety of the communities they serve.

In Virginia, the State Board of Health recommended that ALL community water systems (waterworks, utilities) deliver the recommended level of fluoride, as determined by the U.S. Public Health Service. This recommendation became effective on June 23, 2021.

The optimal fluoride concentration is 0.7 mg/L.

This is the concentration of fluoride in drinking water that provides the best balance of protection from dental caries while limiting the risk of dental fluorosis.

Which utilities participate in CWF?

The CDC compiles a list of all water utilities that actively fluoridate.

Support for Community Water Fluoridation

Community Water Fluoridation (CWF) is lauded as one of the top ten public health achievements of the 20th century. It is supported by the Center for Disease Control and Prevention, which provides awards to those utilities that “achieve optimal fluoridation for 12 months.” The America Water Works Association supports CWF. Both the Virginia Department of Health and the Virginia Department of Drinking Water support and provide resources for Community Water Fluoridation. These aren’t the only organizations that support CWF - the American Dental Association, the American Academy of Pediatrics, the US Public Health Service, and the World Health Organization are all vocal supporters of CWF.

General Resources

  • Engineering Fact Sheets - A webpage by the CDC that explains: the Water Fluoride Laboratory Testing Program, Water Fluoridation Additives, Corrosion of Pipes, the Water Fluoridation Reporting System (WFRS), and Calculating Fluoride Statistics.
    • Calculating Fluoride Statistics - How the CDC calculates fluoride statistics.
    • Drinking Water Pipe Systems - The CDC details how fluoride (at the recommended levels) does NOT influence corrosion or the amounts of corroded metals released into drinking water supplies. The optimal level is 0.7 mg/L.
  • Water Fluoridation Additives - The CDC explains how fluoride is added to community water systems. Click the link to better understand where fluoride additives come from, what fluoride additives exist, and the regulations and standards governing fluoride use.
  • Water Fluoride Laboratory Testing Program - A link to the WFLTP administered by the CDC.
  • Water Fluoride Reporting System (WFRS) - The WFRS is a data source that tracks CWF in states and tribes. This data may be publicly available depending on your state.

Funding CWF

Virginia provides grant-funded opportunities for Community Water Fluoridation.

Communications Resources

Utilities are in contact with their customers and are a source of information on drinking water. Here, Catalyst has collected a few resources to help guide utilities in conversations around community water fluoridation. Not only will the resources listed here better explain communication strategies, but they will better position utilities as clear advocates within their communities.

For Customers

  • Public Communications Toolkit - AWWA developed a toolkit for utilities on GENERAL communications. While this toolkit isn’t CWF-specific, it is useful for developing communications strategies to inform the public about CWF.
  • The Raftelis Report/Social Media Toolkit

For Industry Staff

Training and Educational Opportunities

The following resources provide general training opportunities that will be beneficial to utility staff, board, or owners.

  • A FREE CWF Training is available from the CDC and includes in-depth information on background, fluoridation system design and operations, fluoride additives, dosage, feed rates, and daily sampling.  Even better, water operators in Iowa can receive 4 CE credits for completing the course.
  • The American Water Works Association publishes a manual that includes essential information for decision-makers planning fluoridation installations, engineers designing them, and water utility personnel operating them. The manual contains a history of use, health effects, calculating dosage and managing levels, and equipment considerations (installation, operation, and maintenance). The manual can be found here.