- Association between low fluoride exposure and children's intelligence: a meta-analysis relevant to community water fluoridation
- Community Water Fluoridation Levels to Promote Effectiveness and Safety in Oral Health - United States, 2016-2021
- Water Fluoridation Basics: What Operators Need to Know
- National Academies: NTP’s Conclusion about Fluoride Is Not Backed by Science, 3/10/2020
- AADR Comment on Effect of Fluoride Exposure on Children’s IQ Study
- AAP Pediatrics Video Abstracts
- Fluoride and IQ Scores: A Closer Look at the Green Study
- AAP continues to recommend fluoride following new study on maternal intake and child IQ
- ADA Statement on Study in JAMA Pediatrics
- ADA.org - Fluoride
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
- Fluoridation is safe.
- Fluoridation is the least expensive and most effective way to reduce tooth decay.
- People drinking fluoridated water have 20 to 40 percent less tooth decay.
- Community Water Fluoridation Infographic
- Fluoride: Fact vs. Fiction Quiz
- Fluoride Fact Sheet for Consumers
- Fluoridation Map of Missouri
- How Fluoridation Works English | Spanish
- Know the Facts - Fluoridation
Approximately 100 communities in Missouri are currently supplementing the natural fluoride level in the water system to the optimum for dental decay prevention.
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.
- American Academy of Pediatrics (AAP) I Like My Teeth
- American Dental Association (ADA) Optimal Fluoride Level in Drinking Water
- ADA Mouth Healthy Fluoridation
- American Fluoridation Society
- Center for Disease Control and Prevention (CDC), Community Water Fluoridation
- Community water fluoridation and the integrity of equitable public health infrastructure
- Fluoride Exposed
- Fluoride Missouri
- Fluoride Science
- How to Read a Study about Fluoride or Fluoridation
- Missouri Coalition for Oral Health - Resources
- The Story of Fluoridation
Standards and Regulations
Learn More: Water Fluoridation Training
The Missouri Department of Health and Senior Services (DHSS) and the Missouri Water Resources Research Center (MOWRRC) have teamed up to develop an online training for drinking water treatment process operators and water administrators. The objectives of the training covers how to provide fluoridated water through a community water system, answers questions and dispels myths about community water fluoridation.
This training consists of six modules. Each module has three parts. Each part consists of information and a set of questions pertaining to what you just learned. The focus and time range for each module varies. Before you begin, verify the length of the training provided in each title to complete each module within one setting. Completion of all six modules provides one (1) free CE credit.
The course works to your advantage to complete the modules in order. Click a module link below to begin:
- Module 1 – Fluoridation Introduction (10 minutes)
- Module 2 – Fluoridation Costs/Benefits (7 minutes)
- Module 3 – Drinking Water Treatment Overview (19 minutes)
- Module 4 – Fluoridation Technology and Equipment (13 minutes)
- Module 5 – Fluoride Analysis/Laboratory Techniques/Safety (12 minutes)
- Module 6 – Fluoridation System Design (33 minutes)
- Water Fluoridation Basics: What Operators Need to Know
- CDC Engineering and Administrative Recommendations for Water Fluoridation
- How to Neutralize Acid Leaks and Spills
- Scientific Statement on Community Water Fluoridation
- Water Fluoridation Additives (CDC)
- Drinking Water Pipe Systems (CDC)
- Water Fluoridation Guidelines and Recommendations (CDC)
- 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: https://dnr.mo.gov/document-search/notification-fluoride-modification-mo-780-2685.