News Archive
CDC: Fluoridation Learning Online

Division of Oral Health, Centers for Disease Control & Prevention | Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion

To celebrate how new technologies can transform the public health landscape, CDC is pleased to announce the launch of Fluoridation Learning Online (FLO), a free training resource designed to build the capability of state fluoridation programs, and increase knowledge and refine skills to implement and maintain community water fluoridation.

Fluoridation Learning Online contains four modules. The first three modules describe the fundamentals of community water fluoridation, including how fluoride works and why we use it, how state programs support and communicate fluoridation’s benefits, and how water treatment systems are designed and operate. Each of these modules can be completed in about an hour.

The final module contains detailed technical information on fluoridation operations, including lessons on fluoride additives, safety, operations, and testing. This extended, 12-lesson module may take up to 4 hours to complete.

Fluoridation Learning Online is designed to save learners’ progress, meaning that the course can be completed over several learning sessions. The entire course can be completed in about 8 hours if taken during one session.

Note: CDC TRAIN is troubleshooting an issue with courses not issuing certificates once completed. To receive updates about this issue, be sure to enable email communications from TRAIN in Your Profile under the Account tab.

Intended Audience

  • State oral health staff and practitioners
  • State drinking water regulatory engineers
  • Water system operators
  • Governmental officials
  • Anyone who desires peer-reviewed information on community water fluoridation

508 Accessibility: If you experience any difficulty in using this course with assistive technology, please contact the Centers for Disease Control and Prevention (CDC) Oral Health mailbox: oralhealth@cdc.gov. 

Learning Objectives

CDC TRAIN is experiencing unusually high number of users, which is causing courses and videos to load slowly.

Module 1 – Water Fluoridation Background

Lesson 1 – What is Community Water Fluoridation?
• Define community water fluoridation
• Describe the steps in the naturally occurring cycle of fluoride
• Identify the recommended level of fluoride in drinking water

Lesson 2 – Fluoride’s Oral Health Benefits
• Define tooth decay
• Explain how fluoride reduces the incidence of tooth decay and helps prevent it
• Describe the general trend in the decrease of tooth decay in children since the 1970s

Lesson 3 – Dental Fluorosis
• Describe fluorosis, how it occurs and who it might affect

Lesson 4 – Community Water Fluoridation as a Public Health Measure
• Summarize factors that make community water fluoridation an ideal public health intervention

Module 2 – State Water Fluoridation Activities

Lesson 1 – Building Foundational Capacity
• Outline recommended practices for implementing state or community water fluoridation activities.
• Outline recommended practices for maintaining water fluoridation activities.

Lesson 2 – Measuring Water Fluoridation’s Impact
• Explain the process for reporting data on water fluoridation activities.

Lesson 3 – Communicating the Benefits of Community Water Fluoridation
• Summarize best practices for communicating risk with promoting fluoridation.
• Identify common myths about community water fluoridation.

Module 3 – Water Treatment Background

Lesson 1 – Overview of the Water Treatment Process
• List the four essential elements of a water system’s infrastructure
• Construct a simplified diagram of a water treatment system
• List the objective and method for each water treatment step

Lesson 2 – Water Fluoridation’s Objectives
• State the objective and summarize the methods for community water fluoridation
• Determine whether community water fluoridation is an appropriate intervention for a water system

Lesson 3 – Water Fluoridation System Design
• Construct a project checklist of factors and conditions that influence the design of a new water fluoridation system

Lesson 4 – Water Fluoridation System Selection Factors
• Distinguish between equipment requirements for water fluoridation and water treatment systems
• Summarize the trend in fluoride system selection with regards to water system size
• Apply water fluoridation best practices when choosing to add fluoridation to a water treatment system

Lesson 5 – De-Fluoridation of Naturally High Levels of Fluoride
• Select an appropriate target concentration for the de-fluoridation of water containing a high level of natural fluoride

Module 4 – Water Treatment Operations

Lesson 1 – Properties of Fluoride Additives
• Explain the difference between a chemical and an additive
• Compare the properties of natural fluoride minerals
• Identify the fluoride compounds that are approved for drinking water fluoridation in the United States

Lesson 2 – Fluoride Additive Standards
• Make use of information on the quality and grade standards of fluoride additives

Lesson 3 – Fluoride Additive Safety
• Identify the three elements of a safe practice
• Contrast the hazards associated with chronic and acute exposure to concentrated fluoride additives
• List the personal protective equipment required when handling concentrated fluoride additives

Lesson 4 – Water Fluoridation Process with the Fluorosilicic Acid Additive
• Outline a generic process for water fluoridation operations with the FSA additive
• Summarize best practices for water fluoridation operations with the FSA additive

Lesson 5 – Water Fluoridation Process with the Sodium Fluoride Additive
• Outline a generic process for water fluoridation operations with the Sodium Fluoride additive
• Summarize best practices for water fluoridation operations with the Sodium Fluoride additive

Lesson 6 – Water Fluoridation Process with the Sodium Fluorosilicate Additive
• Outline a generic process for water fluoridation operations with the Sodium Fluorosilicate additive
• Summarize best practices for water fluoridation operations with the Sodium Fluorosilicate additive

Lesson 7 – Additive Dosage and Feed Rate
• Model the process control calculation for delivering a desired dosage of fluoride additive at a target fluoride additive feed rate

Lesson 8 – Operational Quality Management
• Construct a simplified process control scheme
• Compare methods for calibration water fluoridation system control points

Lesson 9 – Operational Troubleshooting and Maintenance
• Identify water fluoridation operational situations requiring the need for troubleshooting
• Summarize best practices for successful water fluoridation operational control
• Summarize best practices for periodic maintenance of water fluoridation equipment

Lesson 10 – Sampling and Analysis
• Summarize best practices for the testing and analysis of fluoride in water

Lesson 11 – Colorimetric Sampling Method
• Outline the steps in the colorimetric method of testing for fluoride in water
• Summarize the sources of error when conducting a lab analysis using the colorimetric method

Lesson 12 – Ion Specific Electrode Sampling Method
• Outline the steps in the ion specific electrode method of testing for fluoride in water
• Summarize the sources of error when conducting a lab analysis using the ion specific electrode method