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Missouri’s Innovative Technology Pilot Project of the New Wave Fluoridation Feeder System


by GWEN SULLENTRUP C


ommunity water fluoridation (CWF) is the adjustment of the natural fluo- ride level in the water by adding a fluoride additive to reach an optimal level of 0.7 milligrams per liter (mg/L or ppm). CWF has been in existence since 1945 in Grand Rapids, Mich. In Missouri, the first water system to add fluoride to the water supply began in St. Louis in 1953.


Data from 2021 shows Missouri has 90 com- munity water systems (CWS) that adjust the fluoride level in their water system. These systems serve a total of 3.78 million people or 71.5% of Missouri’s population. 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 fund- ing 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.


Although CWF has been around for more than 75 years, there has not been any advancement in fluoridation technology until March 2021. At that time, new fluori- dation technology became available for use specifically to meet the needs of rural water systems. The New Wave Fluoridation Feeder System was developed by KC Industries and Dubois Chemicals in collaboration with and funding from the Centers for Disease Control and Prevention (CDC). The New Wave system was built to be a plug-and-play system that would change the landscape of CWF for rural, underserved areas.


The Office of Dental Health (ODH) began working with KC Industries, Dubois Chemi- cals and the Department of Natural Resourc- es (DNR) to determine if this equipment would be viable for use in Missouri. After several meetings, emails and discussions,


18 focus | MAY/JUN 2022 | ISSUE 3 Statewide, Multichannel CWF Media Campaign Launching This Summer


THIS APRIL, ODH RECEIVED ADDITIONAL FUNDING through the Preventive Health and Health Services Block Grant that it will use to launch the largest CWF media campaign to date. The campaign will span the entire state and run June through August 2022, and will include print media through selected newspaper distribution, traditional radio spots, internet radio (Pandora and Spotify), Connected TV (CTV) (Hulu), YouTube and on social media through Facebook and Instagram. ODH is working with Bucket Media to launch the internet radio, CTV, YouTube and social media markets. This portion of the media campaign is targeted for age groups 13-44 years and will be accessible across all media platforms (desktop, mobile, tablet and television). The traditional newspaper distribu- tion will reach more than 368,000 people of all age groups and the radio spots will run on 86 different radio stations across Missouri. All these components of the media campaign will have one message, which is to provide education on the safety, effectiveness and benefits of water fluoridation! Watch/listen for the messages and check your local paper for an insert!


it was determined this system would not function as it was originally built. ODH staff began conversations with outside entities, including other states, and it was determined an outside engineering firm would need to be hired to work with DNR through this pro- cess. In August 2021, ODH staff discovered an engineering firm, Horner and Shifrin, that was open and ready for the task of redesign- ing the system to meet Missouri DNR and the Ten State Standards requirements.


Work began on the redesign in September 2021, which resulted in the development of ODH’s Innovative Technology Pilot Proj- ect. ODH along with Horner and Shifrin developed a list of 10 CWS that would benefit from the New Wave system. The first pilot system, Butler County PWSD 3, is located near Horner and Shifrin’s office in Poplar Bluff, Mo. Horner and Shifrin delivered a tentative redesign and profes- sional engineering report (PER) to DNR for review in November 2021. In January 2022, DNR responded with questions, comments, concerns and requests for clarification. Those were all answered, and on March 3, 2022, a final PER and Innovative Technology Plan


was submitted to DNR. DNR completed the review and gave final approval to begin the Innovative Technology Pilot Project for But- ler County PWSD 3 on April 28, 2022.


Since the approval of the pilot project, ODH has been busy ordering the equipment and securing a contract with Butler County PWSD 3. The first New Wave system will ar- rive in Brosley, Mo. at Butler County PWSD 3 on May 15, 2022 and construction is sched- uled to begin by June 1, 2022. The redesigned system includes several components that Horner and Shifrin must construct on-site to meet DNR requirements. ODH’s goal is to have the New Wave system completed and fully operational by July 1, 2022.


Missouri will have the first operational tablet feeder system for fluoride not only in the U.S., but in the world! ODH has embarked on a new path—that of being a leader in fluoridation advancement—and as we move through this pilot project all eyes will be on ODH and Missouri.


Gwen Sullentrup is the Community Water Fluoridation and Dental Sealant Coordinator at the Missouri Office of Dental Health (573-619-8849 or gwen.sullentrup@health.mo.gov).


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