Show Me About Missouri’s Community Water Fluoridation – General Public

Show Me About Missouri’s Public Water systems and Fluoride – Water Operators

Dental Health Facts + Benefits of Fluoride

Community water fluoridation is one of the most practical, cost-effective, equitable, and safe measures communities can take to prevent tooth decay and improve oral health.

Dr. Vivek H. Murthy, former U.S. Surgeon General (2014-2017)

Recent News

Community water fluoridation helps prevent tooth decay by adjusting the fluoride in the water supply to an optimal level. Many drinking water supplies contain some fluoride naturally, however, to prevent tooth decay, it is important to supplement and maintain an adequate level of fluoride to achieve this goal.

Facts About Water Fluoridation

Approximately 100 communities in Missouri are currently supplementing the natural fluoride level in the water system to the optimum for dental decay prevention.

Fluoride: Small Solution. Big Benefits.
Graphic used with permission from ADA.

What is fluorosis?

Dental fluorosis is a condition that causes changes in the appearance of tooth enamel. It may result when children regularly consume fluoride during the teeth-forming years, age 8 and younger. Most dental fluorosis in the U.S. is very mild to mild, appearing as white spots on the tooth surface that may be barely noticeable and do not affect dental function. Moderate and severe forms of dental fluorosis, which are far less common, cause more extensive enamel changes. In the rare, severe form, pits may form in the teeth. The severe form hardly ever occurs in communities where the level of fluoride in water is less than 2 milligrams per liter.

Fluorosis is not a disease. The effect of fluorosis, in most cases, can only be determined by a dentist during an examination. Fluorosis in the United States will not effect tooth function and may make teeth more resistant to tooth decay.

My Water’s Fluoride

  • Visit Missouri's "My Water’s Fluoride" page to find out whether your local water system optimally fluoridates its water. For more specific information, contact your local water district.
  • The Missouri Department of Natural Resources maintains a website containing Consumer Confidence Reports on each community water supply in Missouri.


What Do the Leading Health and Medical Authorities Say About Community Water Fluoridation?


Fact Sheets

Standards and Regulations

Learn More: Water Fluoridation Training

This is John & Joe. You don't know them, but you've been protecting them for years. Thank you.
  • Missouri Water Resources Research Center (MOWRRC) offers CEU credits in Community Water Fluoridation Basics - Training The course consists on three modules for water administrators and the public, and three additional modules for water facility operators. Topics covered are Fluoridation Introduction, Fluoridation Costs and Benefits, Drinking Water Treatment Overview, Fluoridation Technology and Equipment, Fluoride Analysis/Laboratory Techniques/Safety, and Fluoridation System Design. Courses are free.
  • CDC Fluoridation Learning Online
    Currently no CEC/CEUs available. Courses are free.
  • American Water College (AWC) is a training organization, devoted to helping the professionals in the Water and Wastewater fields achieve their career goals. AWC was established by operators to help other operators get the training necessary to maintain certification as well as pass certification exams. All courses have been developed and reviewed by professionals with "real life" experience. This helps to ensure the information presented is relevant to the operator. Courses are not free.
  • Water Fluoridation Summit Agenda

Technical Recommendations

Fluoride Systems

  • Recommended Standards for Water Works
  • Fluoride Systems Design is covered in the courses offered through MOWRCC. For more information, see course information under Fluoridation Training.

Fluoride Notification Statute Information

Missouri Revised Statute 640.136 was signed by the Governor in June of 2016. This statute requires that any public water system or district must notify the Missouri Department of Natural Resources (DNR), Missouri Department of Health and Senior Services (DHSS), and its customers of its intentions to make modifications to fluoridation of its water supply.

  • To review the state law: Missouri Revised Statute 640.136.
  • A change in practices includes any addition or discontinuation of fluoridation.
  • The notification must take place at least 90 days prior to any vote or meeting where a change in fluoridation practices is decided.
  • Notification of customers may be accomplished through any combination of the following: radio, television, newspaper regular mail, or electronic means.
  • The Notification of Fluoride Modification form must be submitted to both DNR and DHSS. To access this form, visit: