Missouri Leads Way In CWF Technology by the State of Missouri Office of Dental Health M


issouri is looking to be a world leader in community water fluoridation (CWF) advancements by launching a


pilot program for the first operational tablet feeder system for fluoride. The pilot pro- gram is set to begin in summer 2022. CWF, engineered in 1945 in Grand Rapids, Mich., adjusts the natural fluoride levels in the water by adding a fluoride additive to reach an optimal level of 0.7 milligrams per liter (mg/L or ppm). In 1953, Missouri's first water system to add fluoride to the water supply started in St. Louis.


According to data from 2021, there are 90 Missouri community water systems (CWS) adjusting fluoride levels in water systems statewide. These systems serve a total of 3.78 million people or 71.5% of Missourians. This means most of these CWS are in urban areas of the state that include, St. Louis, Kansas City, Springfield and Columbia to name a few. Most of the remaining CWS (1,178 systems) are in rural, underserved areas of Missouri. Many of these areas do not have the funding to begin a water fluoridation program in their community, do not have the space for a safe fluoridation equipment setup, or lack the education on the benefits, effectiveness and safety of CWF.


Advancements in fluoridation technology were lacking for the past 75 years. In March 2021, the New Wave Fluoridation Feeder System became available for use to meet the needs of rural water systems. KC Industries and Dubois Chemicals developed, in collab- oration with and funding from the Centers for Disease Control and Prevention (CDC), the new fluoridation technology. This plug- and-play system changed the landscape of CWF for rural, underserved areas.


The Office of Dental Health (ODH) began working with KC Industries, Dubois Chemicals and the Department of Natural Resources (DNR) to determine if the equip- ment would be effective for use in Missouri. After several meetings, emails and discus- sions, the group discovered the system


would not function as designed. ODH staff began conversations with outside entities, in- cluding other states, to find a viable solution. An outside engineering firm would need to work with DNR through the process of a new system. ODH and Horner and Shifrin, an engineering firm headquartered in St. Louis, embraced the opportunity of redesigning the system to meet the requirements of DNR and the Ten State Standards.¹


Work began on the redesign in September 2021, which resulted in the development of ODH’s Innovative Technology Pilot Project. ODH, along with Horner and Shifrin, devel- oped a list of 10 CWS that New Wave system would benefit, with the first pilot system to be Butler County PWSD 3, located near Horner and Shifrin’s office in Poplar Bluff, Mo. Horner and Shifrin delivered a tentative redesign and professional engineering report (PER) to DNR for review in November 2021. In January 2022, DNR responded with ques- tions, comments, concerns and requests for


clarification. Horner and Shifrin responded to the questions, and on March 3, 2022, DNR received a final PER and Innovative Technology Plan. DNR completed the review and provided final approval to begin the In- novative Technology Pilot Project for Butler County PWSD 3 on April 28, 2022.


Since the approval of the pilot project, ODH as been busy ordering the equipment and se- curing a contract with Butler County PWSD 3. The first New Wave system will arrive in Brosley, Mo. at Butler County PWSD 3 and construction will begin by June 2022. The redesigned system includes several compo- nents that Horner and Shifrin must con- struct on-site to meet DNR requirements. ODH’s goal is to have the New Wave system completed and operational by July 2022.


REFERENCES


1. https://www.epa.gov/wqs-tech/water-quality-stan- dards-regulations-missouri


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ISSUE 4 | JUL/AUG 2022 | focus 31


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