The voters of District 2 made a decision yesterday. They selected the two candidates who will face each another for the office of district counciloror come November.

The voters’ selection came too late to be discussed in this column, but during the final week of the preliminary election campaign the five District 2 candidates all did something very interesting. They all refused to endorse the fluoridation of the city’s water supply.

Fluoridation was ordered by the Board of Public Health in June and is under challenge by Worcester Citizens for Total Health, who succeeded in collecting thousands of signatures to place the issue on the November ballot. At a candidates forum last week, three of the five District 2 candidates said they were opposed to fluoridation. Two avoided taking a definite stand.

This was not a scientific poll of public opinion in District 2. It was rather a political pulse-taking, and the results were impressive. People running for office soon find out what’s on people’s minds, and if at all possible they line up on the popular side of controversial issues. When six out of six candidates fail to come up with a kind word for fluoridating the public water supply, you probably have a good idea what people in their district are thinking.

District 2, made up of Wards 3 and 4 on the East Side, contains only a fifth of the city’s population and happens to be the only district in the city that needed a preliminary election this year to narrow the field to two. Thus there haven’t been candidate forums in the other districts that we might compare to the one in District 2. There is at least a possibility that the anti-fluoridation sentiment evident there is not typical.

But don’t bank on it. In 1996 the voters of the city rejected fluoridation 62 percent to 38 percent. Reversing that outcome would under any circumstances be a major challenge. In the light of the District 2 evidence, anyone who has been anticipating a change of heart this year would probably do well to think again.

Since the mid-1950s Worcester has gone through many rounds of debate over fluoridation. Perhaps the most significant difference this year is the presence of a $400,000 pro-fluoridation campaign fund in the hands of the Central Massachusetts Oral Health Initiative. The cash came from the Health Foundation of Central Massachusetts, which was established with funds realized from the sale of the nonprofit Central Massachusetts Health Care to a for- profit corporation. Closely allied in support of fluoridation is the Worcester District Dental Society.

If the pro-fluoridation coalition is going to change many minds, it will have to find a way to avoid the unattractive tone of a parent telling a child, “Do as I say, because I know better than you what’s good for you.” It’s a problem that always bedevils people who try to bring their professional expertise into the political arena. Expertise serves as the basis of a claim to authority, but that claim can be interpreted as an arrogant assertion of superiority.

Associated with this danger is another one, into which the proponents have already stumbled. People with open minds are not going to be impressed with attempts to ridicule or insult those who oppose fluoridation. If anything, such personal attacks only intensify the determination of the opponents to achieve a smashing victory.

One of the most powerful arguments in favor of fluoridation is that it would have a dramatically positive effect on the dental health of poor children. A prominent local dentist told the Board of Health in June, “I would think this community would not only accept fluoridation but would demand it … It’s about choosing to give those without adequate dental insurance or no dental insurance a cost- effective and practical way of maintaining good oral health.”

Using such an argument will require that proponents come up with an effective response to the charge that, as one petition-drive organizer put it, “Fluoridation is just an excuse for dentists to not provide dental services to the poor.” It was reported some months ago that about a third of the children in the city are refused fluoride treatments by dentists in Worcester because the state-funded MassHealth insurance doesn’t pay enough.

According to health officials, only five dentists in the area accept children covered by MassHealth.

By far the biggest challenge, this year as in past years, will be to convince people that the fluoride dose that works such wonders in preventing tooth decay does not at the same time expose the public to danger. Experts who claim that fluoride is “not toxic” may be hearing a great deal about articles such as the one published in last weekend’s Sunday Telegram. In a survey of fluoride controversies around the world, reporter John J. Monahan touched upon UNICEF’s concern that “dangerous naturally occurring fluoride levels in water supplies have made fluorisis, or fluoride poisoning, endemic in at least 25 countries. The illness causes serious health problems for tens of millions of people.”

Those levels of fluoride are, of course, vastly higher than anything proposed for Worcester’s water. However, such information reminds people that fluoride is, indeed, toxic at some level, and makes them wonder whether the level (1 part per million) regarded as safe and effective is so in reality. To succeed in this campaign, advocates need to understand that skepticism and to somehow persuade people to put some faith — as they normally do — in the broad mainstream of scientific and medical opinion.

We should get to observe another, and much more significant, political pulse-taking about midway to the election. On Oct. 9 the City Council’s Health Committee plans to present its recommendations, and all councilors are expected to vote for or against the fluoridation program, even though their approval is not legally required. That should provide good evidence about the political lay of the land throughout the city. We can then make a fresh estimate of how high a hill the fluoridation reformers have yet to climb.

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