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Dental Public Health Activities: Descriptive Summaries

Indiana's Community Water Fluoridation Program- Archived Summary

Practice Number: 17001
Submitted By: Oral Health Division, Indiana State Department of Health
Submission Date: May 2002
Last Reviewed: June 2011
Last Updated: June 2011
Best Practice Approach Example Indiana's Community Water Fluoridation Program

Indiana’s water fluoridation program began in 1951, and is currently proving fluoridated water to over 4,300,000 people from 477 water systems throughout the state.  Indiana does not have a mandatory fluoridation law, but instead has been successful through the years, taking each city, one at a time, and assisting them by funding the equipment and providing technical assistance. A total of 95% of those individuals served by city water lines or who reside in areas with optimal levels of naturally-occurring fluoride are presently getting the tooth decay preventing benefits of fluoridated water.

Thus, by working diligently with local officials, Indiana has been able to develop and maintain an enviable record on community water fluoridation which is probably the single most important intervention for preventing dental decay in Indiana.  However, adverse economic conditions in some locals have strained these local communities’ ability to maintain and update their fluoridation equipment.  Currently, the ISDH is working with communities throughout the state to try to identify those in the most need of updating their fluoridation equipment, and to seek funds to implement the needed updates.

The program has four fulltime employees assigned specifically to fluoridation activities.  Three field employees, assigned to different areas of the state, report to the Fluoridation Program Manager in Indianapolis.   In case of an emergency or technical difficulty that may occur at a water treatment plant, the field fluoride specialist could be at the facilities the same day to correct the problem.  Field staff performs over 1,500 site visits yearly and are constantly involved in monitoring and surveillance.  All have taken the CDC basic and advanced fluoridation courses in Murfreesboro, TN.  In addition, Indiana requires weekly samples for laboratory analysis rather than monthly sampling.  The program also focuses on preventing systems currently online from discontinuing fluoridation. 

The program budget of $272,000 comes from the Maternal and Child Health Services Block Grant.

Lessons Learned:

It is possible to develop a successful state-wide CWF system, one community at a time.

However, without state support, economically weaker communities often have difficulty maintaining and updating their community water fluoridation systems.

Contact Person(s) for Inquiries:

James R. Miller, DDS, MSD, PhD, State Oral Health Director, Indiana State Department of Health, 2 N. Meridian Street, Section 7-G, Indianapolis, IN 46204, Phone: 317-233-7427, Fax: 317-233-7001, Email: