Dr. G. Robert Evans said he was always determined his kids wouldn’t have any cavities.

As a dentist, he had his children use fluoride drops, fluoride tablets and fluoride gels, especially his son, a budding actor.

“Then his permanent teeth came in,” said Dr. Evans, who runs a holistic medical and dental practice in Groton. “And I thought, ‘Oh my God, what have I done?’ ”

The enamel was severely mottled, blemished by unsightly brown and white spots.

“This was a kid who grew up on stage acting. He can’t have ugly teeth.”

The dentist says he no longer uses fluoride in his practice, nor does he carry any fluoride products in his office. He said his son uses veneers to hide the mottling.

You may have heard of his son. His name is Chris. Some people know him as Captain America.

Dr. Evans was convinced the mottling occurred because of the fluoride treatments his son had, something considered by many to be a dental staple. He began to do some research and his findings floored him, launching his anti-fluoride crusade. He is an especially staunch opponent of community water fluoridation, which the federal Centers for Disease Control and Prevention calls one of the 10 great public health achievements of the 20th century. He has traveled to different communities in Massachusetts since, including Worcester, to speak out against it.

A report released Feb. 8 by the Massachusetts Health Council and the University of Massachusetts Medical School’s Center for Health Law and Economics strongly supports community water fluoridation, an opinion not everyone shares. It is a biennial report the health council puts out called the Common Health for the Commonwealth on social determinants of health and preventable health conditions.

Worcester has a long history when it comes to community water fluoridation. Despite the strong endorsements by the American Dental Association, the American Academy of Pediatrics, the U.S. Public Health Service and the World Health Organization, Worcester remains one of the few Massachusetts communities that remains non-fluoridated, along with Barnstable, Brockton, Chicopee and Springfield. Worcester’s voters have rejected ballot questions to fluoridate the local public water supply four times since 1963, with the last referendum in 2001.

Janice B. Yost, president and CEO of the Health Foundation of Central Massachusetts, which led the 2001 pro-fluoride campaign, does not think Worcesterites will change their minds any time soon.

“Every time there’s a movement to do it again, and the resistance rises up again with a little more fervor,” she said. “I think Worcester has probably voted it down as much as anybody in the state has. They’re sort of leaders in that.”

Yost’s organization spent $400,000 on pro-fluoridation ads and education efforts during the 2001 referendum, but voters still rejected fluoridation 56 percent to 44 percent.

According to the CDC’s Division of Oral Health, community water fluoridation is a cost-saving, effective way to prevent and reduce tooth decay in both children and adults.

“The nice thing about fluoridation is everyone benefits,” said Dr. Myron Allukian Jr., president of the Massachusetts Coalition for Oral Health and former president of the American Public Health Association. “While the teeth are growing, the fluoride becomes part of the tooth and gets stronger, but there’s also a topical benefit … as it flows over the teeth and the ions get into the saliva and the plaque.”

“One of the most beneficial effects is in low-income communities because they tend to have poor diets, heavily laden with sugar,” said Dr. Raymond K. Martin, president of the Massachusetts Dental Society.

He acknowledged that fluoride can cause enamel mottling at high levels. “But down at the right concentrations, it’s very effective and very cost effective,” he said.

Most of the arguments against fluoridation cluster around consent, autonomy and the idea that fluoride is toxic.

• Original article online at http://www.telegram.com/news/20170226/fluoridation-remains-complicated-matter-for-worcester