Oregonians long skeptical of fluoridation.

Byline: The Register-Guard

Today, less than a quarter of Oregon residents drink fluoridated water. Only two other states have lower percentages of use.

Despite the fervent efforts of dentists to persuade water districts and city councils to add the substance, the chemical additive is in decline. Portland is the largest city in the United States without fluoridated water.

Some states have passed laws mandating fluoride in all public drinking water systems. In Oregon, such an effort failed to make it out of a legislative committee in 2001 and hasn't been attempted since.

Still, dentists in some of the state's cities remain undaunted.

In 2000, a Scappoose dentist convinced city councilors to add fluoride to the drinking water. In November 2002, citizens in Beaverton passed a measure to add fluoride to the city's water, and two weeks later, the Tualatin Valley Water District - which covers 170,000 residents in Beaverton, Hillsboro and Aloha - decided to add the substance.

Currently, dentists in Medford are working to gather signatures to add fluoride to that city's water, but they haven't gotten enough support after a year and a half of trying.

Nationally, the debate has played out a thousand times since cities across America took the advice of public health officials and started pumping fluoride - a byproduct of industrial waste - into municipal water systems.

If pharmaceutical fluoride is good for the teeth, the government reckoned, so must be the fluoride created from the mining of phosphate ore - which emits fluoride as the ore is cooked for use in the phosphate fertilizer industry. Another fluoride source comes from the production of aluminum.

But some people didn't trust the notion that this kind of fluoride ingestion had the same benefits as the stuff the dentist smears on teeth. For one thing, industrial fluoride has been shown to accompany harmful substances such as arsenic, even after it's diluted in the water. In 2000, a union of 200 Environmental Protection Agency scientists, lawyers, engineers and other professionals called for a nationwide moratorium on the addition of fluoride to public drinking water.

The group cited studies that linked fluoride to cancer in lab rats, weakening of bone density in older Americans and a growing number of citizens suffering from fluorosis, a condition that causes yellowing of the teeth after overexposure to fluoride, said William Hirzy, a senior scientist with the EPA's risk assessment division since 1981.

The group believes that the government is sticking to outdated theories about fluoride and ignoring new science that shows the dangers of fluoride, Hirzy said in an interview.

"What you have is the government investing its credibility - prematurely and erroneously," he said, "and now, having done that, it's very difficult to say, 'You know what we said 60 years ago? It's not really so.' It's amazing to me that we persist in this practice."

What's amazing to dentists is that people would question the long-standing practice.

According to the American Dental Association, research about the beneficial effects of fluoride dates to the early 1900s, when a young dentist named Frederick McKay opened a practice in Colorado Springs, Colo., and discovered that many local residents had strange brown stains on their permanent teeth.

McKay and another dentist discovered the cause to be mottled enamel, which is known today as fluorosis.

But McKay noted that these teeth, however stained, were surprisingly resistant to decay, thanks to high levels of naturally occurring fluoride in the drinking water.

That led to a series of studies and the first community water fluoridation program, in Grand Rapids, Mich., in 1945. The ADA claims water fluoridation can reduce the amount of cavities children get in their baby teeth by as much as 60 percent; it can reduce tooth decay in permanent adult teeth by nearly 35 percent.

"The opposition will say it's toxic waste of the phosphate fertilizer industry," said Kurt Ferre, a Portland dentist who has led fluoridation efforts in different parts of the state. "It's a useful byproduct of the phosphate fertilizer industry.

`If you look at the side of a soda can, the fourth ingredient is phosphoric acid - that too is a byproduct of the phosphate fertilizer industry."

While Ferre says it's "difficult to quantify" whether states such as Oregon suffer higher rates of cavities, he argues that states with low fluoridation rates show a greater disparity in dental health between rich and poor citizens. Those with adequate dental benefits or money can afford fluoride treatments and don't have problems as a result. Those who can't afford it have higher cavity rates.

"From a public health standpoint, it's a benefit to all members of the community," Ferre said. "It doesn't discriminate on the basis of race, status, religion or age."