e adjustment addition or removal of fluoride in from drinking water to achieve good oral health and reduce tooth decay - has been practiced since the 1950s. This manual provides essential information for decision makers planning fluoridation installations, engineers designing them, and water utility personnel operating them. Coverage includes history of use, health effects, calculating dosage and managing levels as well as equipment considerations (installation, operation, and maintenance). This edition is a substantial rewrite to update content and features a new chapter for small and simplified systems that addresses their unique concerns. Additionally, strategies for customer communication and community outreach have been added. Of particular value are the new appendix with example calculations, FAQs, inspection checklists, and more.