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Dental Public Health Activities: Descriptive Summaries

Fluoridation Program

Practice Number: 16007
Submitted By: Division of Oral Health, Illinois Department of Public Health
Submission Date: April 2002
Last Reviewed: February 2013
Last Updated: February 2013
Best Practice Approach Example Fluoridation Program

Illinois is one of only thirteen states with a mandatory fluoridation law.  The Illinois Fluoridation Statute was enacted in 1967 and requires all community water systems to adjust their fluoride to optimal levels.  Currently, more than 90 percent of the Illinois population receives the benefit of fluoridated water.  Approximately 800 of the 1,800 community water systems in Illinois adjust their fluoride levels.  The remainders are either connected to an adjusted system, have adequate natural levels or are exempt due to having less that ten properties or lots.  Nearly every one of the 12.5 million residents of Illinois enjoys the oral health benefits of fluoridation with nearly 1,800 water systems and the halo effect of water fluoridation. All of the urban water systems, including the City of Chicago, and a majority of the rural water systems maintain perfect fluoridation levels monthly.  This surpasses the Healthy People oral health objective for water fluoridation. 

In 1970, the public water supply control program was transferred from Illinois Department of Public Health (IDPH) to the newly created Illinois Environmental Protection Agency (IEPA).  Since the health benefits of fluoridation are most beneficial when the fluoride level is maintained within the optimal range, the Division of Oral Health (DOH) works closely with the Illinois Environmental Protection Agency to monitor community water supplies and provide education and technical expertise to the water supply operators in order to keep fluoride levels optimal.

Reflecting changes in society and technology, on 6/28/2011 Governor Pat Quinn signed Public Act 97-0043 that would require the adjustment of fluoride levels in water systems from a range of 0.90 - 1.20 milligrams per liter to specific recommendations from the proposed by the U.S. Department of Health and Human Services.

DOH fluoridation program activities consist of surveillance, education and compliance monitoring. Fluoridation status of every system in the state and the fluoridation performance of those systems that adjust their fluoride levels are monitored by DOH.  IEPA regulates adherence to the state law.

DOH works collaboratively with IEPA on all aspects of its fluoridation program

The Division of Oral Health:

  • Maintains records of fluoridation status for all community water systems (CWS). 
  • Receives and inputs into the database all fluoride level test result data from CWS in Illinois.
  • Compiles a compliance data report from the fluoridation database and IEPA files. 
  • Follow up on variant fluoride test results. 
  • Notifying noncompliant CWS regarding monthly and daily testing problems. 
  • Work with IEPA to improve compliance, testing and reporting procedures. 
  • Report fluoridation status for all CWSs to the CDC. 
  • Provide educational workshops and present information at water association meetings to water system operators and other key stakeholders including The American Water Works Association - Illinois Section (ISAWWA), the Illinois Potable Water Supply Operators Association (IPWSOA) and the Illinois Rural Water Association (IRWA). 
  • Recognize water systems for perfect and near perfect compliance with the fluoridation statute. 
  • Evaluates Community Water Fluoridation program performance based on the Healthy People 2020, Oral Health Objective 21-9:  to increase proportion of U.S. population served by community water systems with optimal levels of fluoride.  Sixty-two percent of the U.S. population was served by community water systems with optimally fluoridated water in 1992.  Eighty-five percent of the Illinois population was served by community water systems with optimal levels of fluoride in 1997.  Ninety-five percent of the state’s population is served by CWSs with either adjusted or natural fluoridation.

The two agencies partnered to develop the water system operators’ awards of performance excellence. Additional accomplishments of the Illinois Community Water Fluoridation Program include:

  • Surpassed the Healthy People oral health objective of the population receiving the benefits of optimal levels of fluoride
  • Implements an awards program recognizing water system operators for excellence
  • Developed a Fluoridation Training Manual specific to Illinois’ needs and requirements
  • Maintains a fluoridation monitoring and surveillance database
  • Facilitates private well testing for fluoride levels with follow-up education and consultation

Contact Person(s) for Inquiries:

Julie A. Janssen, RDH, MA, Program Administrator, Division of Oral Health, Illinois Department of Public Health, 535 W. Jefferson Street, Springfield, IL 62761, Phone: 217-785-4899, Fax: 217-524-2831, Email:


Rose Mutzbauer, Fluoridation Program Manager, Division of Oral Health, Illinois Department of Public Health, 535 W. Jefferson Street, Springfield, IL 62761, Phone: 217-785-4899, Fax: 217-524-2831, Email: