---
kind: "section"
citation: "42 U.S.C. § 247b–14"
title: "42"
title_heading: "The Public Health and Welfare"
number: "247b–14"
heading: "Oral health promotion and disease prevention"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/247b-14"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter II — General Powers and Duties"
  - "Part B — Federal-State Cooperation"
---

# §247b–14. Oral health promotion and disease prevention

- (a) **Grants to increase resources for community water fluoridation—**
  - (1) **In general—** The [Secretary](/usc/42/201.md?p=c), acting through the [Director](/usc/42/11851.md?p=5) of the Centers for Disease Control and Prevention, may make grants to [States](/usc/42/201.md?p=f) and Indian tribes for the purpose of increasing the resources available for community water fluoridation.
  - (2) **Use of funds—** A [State](/usc/42/201.md?p=f) shall use amounts provided under a grant under [paragraph (1)](#a-1)—
    - (A) to purchase fluoridation equipment;
    - (B) to train fluoridation engineers;
    - (C) to develop educational materials on the benefits of fluoridation; or
    - (D) to support the infrastructure necessary to monitor and maintain the quality of water fluoridation.
- (b) **Community water fluoridation—**
  - (1) **In general—** The [Secretary](/usc/42/201.md?p=c), acting through the [Director](/usc/42/11851.md?p=5) of the Centers for Disease Control and Prevention and in collaboration with the [Director](/usc/42/11851.md?p=5) of the Indian Health [Service](/usc/42/201.md?p=a), shall establish a demonstration [project](/usc/42/13641.md?p=2) that is designed to assist rural water systems in successfully implementing the water fluoridation guidelines of the Centers for Disease Control and Prevention that are entitled “Engineering and Administrative Recommendations for Water Fluoridation, 1995” (referred to in this subsection as the “EARWF”).
  - (2) **Requirements—**
    - (A) **Collaboration—** In collaborating under [paragraph (1)](#b-1), the [Directors](/usc/42/11851.md?p=5) referred to in such paragraph shall ensure that technical assistance and training are provided to tribal [programs](/usc/42/274l–1.md?p=4) located in each of the 12 areas of the Indian Health [Service](/usc/42/201.md?p=a). The [Director](/usc/42/11851.md?p=5) of the Indian Health [Service](/usc/42/201.md?p=a) shall provide coordination and administrative support to tribes under this section.
    - (B) **General use of funds—** Amounts made available under [paragraph (1)](#b-1) shall be used to assist small water systems in improving the effectiveness of water fluoridation and to meet the recommendations of the EARWF.
    - (C) **Fluoridation specialists—**
      - (i) **In general—** In carrying out this subsection, the [Secretary](/usc/42/201.md?p=c) shall provide for the establishment of fluoridation specialist engineering positions in each of the Dental Clinical and Preventive Support Centers through which technical assistance and training will be provided to tribal water operators, tribal utility operators and other Indian Health [Service](/usc/42/201.md?p=a) personnel working directly with fluoridation [projects](/usc/42/13641.md?p=2).
      - (ii) **Liaison—** A fluoridation specialist shall serve as the principal technical liaison between the Indian Health [Service](/usc/42/201.md?p=a) and the Centers for Disease Control and Prevention with respect to engineering and fluoridation issues.
      - (iii) **CDC—** The [Director](/usc/42/11851.md?p=5) of the Centers for Disease Control and Prevention shall appoint individuals to serve as the fluoridation specialists.
    - (D) **Implementation—** The [project](/usc/42/13641.md?p=2) established under this subsection shall be planned, implemented and evaluated over the 5-year period beginning on the date on which funds are appropriated under this section and shall be designed to serve as a model for improving the effectiveness of water fluoridation systems of small rural communities.
  - (3) **Evaluation—** In conducting the ongoing evaluation as provided for in [paragraph (2)(D)](#b-2-D), the [Secretary](/usc/42/201.md?p=c) shall ensure that such evaluation includes—
    - (A) the measurement of changes in water fluoridation compliance levels resulting from assistance provided under this section;
    - (B) the identification of the administrative, technical and operational challenges that are unique to the fluoridation of small water systems;
    - (C) the development of a practical model that may be easily utilized by other tribal, [State](/usc/42/201.md?p=f), county or local governments in improving the quality of water fluoridation with emphasis on small water systems; and
    - (D) the measurement of any increased percentage of Native Americans or Alaskan Natives who receive the benefits of optimally fluoridated water.
- (c) **School-based dental sealant program—**
  - (1) **In general—** The [Secretary](/usc/42/201.md?p=c), acting through the [Director](/usc/42/11851.md?p=5) of the Centers for Disease Control and Prevention and in collaboration with the [Administrator](/usc/42/4005.md?p=1) of the Health Resources and [Services](/usc/42/201.md?p=a) Administration, shall award a grant to each of the 50 [States](/usc/42/201.md?p=f) and territories and to Indians, Indian tribes, tribal organizations and urban Indian organizations (as such terms are defined in [section 1603 of title 25](/usc/25/1603.md)) to provide for the development of [school](/usc/42/300j–21.md?p=6)-based dental sealant [programs](/usc/42/274l–1.md?p=4) to improve the access of children to sealants.
  - (2) **Use of funds—** A [State](/usc/42/201.md?p=f) shall use amounts received under a grant under [paragraph (1)](#c-1) to provide funds to eligible [school](/usc/42/300j–21.md?p=6)-based entities or to public elementary or secondary [schools](/usc/42/300j–21.md?p=6) to enable such entities or [schools](/usc/42/300j–21.md?p=6) to provide children with access to dental care and dental sealant [services](/usc/42/201.md?p=a). Such [services](/usc/42/201.md?p=a) shall be provided by licensed dental health professionals in accordance with [State](/usc/42/201.md?p=f) practice licensing laws.
  - (3) **Eligibility—** To be eligible to receive funds under [paragraph (1)](#c-1), an entity shall—
    - (A) prepare and submit to the [State](/usc/42/201.md?p=f) an application at such time, in such manner and containing such information as the [State](/usc/42/201.md?p=f) may require; and
    - (B) be a public elementary or secondary [school](/usc/42/300j–21.md?p=6)—
      - (i) that is located in an urban area in which and[^1] more than 50 percent of the student population is participating in Federal or [State](/usc/42/201.md?p=f) free or reduced meal [programs](/usc/42/274l–1.md?p=4); or
      - (ii) that is located in a rural area and, with respect to the [school](/usc/42/300j–21.md?p=6) district in which the [school](/usc/42/300j–21.md?p=6) is located, the district involved has a median income that is at or below 235 percent of the poverty line, as defined in [section 9902(2) of this title](/usc/42/9902.md?p=2).
- (d) **Oral health infrastructure—**
  - (1) **Cooperative agreements—** The [Secretary](/usc/42/201.md?p=c), acting through the [Director](/usc/42/11851.md?p=5) of the Centers for Disease Control and Prevention, shall enter into cooperative agreements with [State](/usc/42/201.md?p=f), territorial, and Indian tribes or tribal organizations (as those terms are defined in [section 1603 of title 25](/usc/25/1603.md)) to establish oral health leadership and [program](/usc/42/274l–1.md?p=4) guidance, oral health data collection and interpretation,[^2] (including determinants of poor oral health among vulnerable populations), a multi-dimensional delivery system for oral health, and to implement science-based [programs](/usc/42/274l–1.md?p=4) (including dental sealants and community water fluoridation) to improve oral health.
  - (2) **Authorization of appropriations—** There is authorized to be appropriated such sums as necessary to carry out this subsection for fiscal years 2010 through 2014.
- (e) **Definitions—** For purposes of this section, the term “Indian tribe” means an Indian tribe or tribal organization as defined in [section 5304(b)](/usc/42/5304.md?p=b) and [section 5304(c)](/usc/42/5304.md?p=c)[^3] of title 25.
- (f) **Authorization of appropriations—** For the purpose of carrying out this section, there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 2001 through 2005.

## Footnotes

[^1]: So in original. The word “and” probably should not appear.
[^2]: So in original. The comma probably should not appear.
[^3]: See References in Text note below.

## Source credit

(July 1, 1944, ch. 373, title III, § 317M, as added Pub. L. 106–310, div. A, title XVI, § 1602, Oct. 17, 2000, 114 Stat. 1148; amended Pub. L. 111–148, title IV, § 4102(b), (c), Mar. 23, 2010, 124 Stat. 551, 552.)

## Notes

### Editorial Notes

### References in Text

Section 5304 of title 25, referred to in subsec. (e), has been amended, and subsecs. (b) and (c) of section 5304 no longer define the terms “Indian tribe” and “tribal organization”. However, such terms are defined elsewhere in that section.

### Amendments

2010—Subsec. (c)(1). Pub. L. 111–148, § 4102(b), substituted “shall award a grant to each of the 50 States and territories and to Indians, Indian tribes, tribal organizations and urban Indian organizations (as such terms are defined in section 1603 of title 25)” for “may award grants to States and Indian tribes”.

Subsecs. (d) to (f). Pub. L. 111–148, § 4102(c), added subsec. (d) and redesignated former subsecs. (d) and (e) as (e) and (f), respectively.