KENNEBUNK — Now that the question is destined for the general election ballot Nov. 8, the long fight over whether to add fluoride to the public water supply has entered a new advocacy phase.

At a public hearing before the Arundel Board of Selectmen on Monday, Sept. 26, Kennebunk resident Jan Hanson and other members of her grass-roots group, “The Campaign to Reconsider Water Fluoridation,” lobbied about 30 audience members to vote no on the question.

Although it was Hanson’s group that petitioned to put the question on the ballot in the seven towns served by the Kennebunk-Kennebunkport-Wells Water District, it is actually advocating for a no vote because of the wording of the question — “Shall fluoride be added to the public water supply for the intended purpose of reducing tooth decay?”

“That’s set by the state. We don’t have any control over that,” Hanson said, noting a certain amount of confusion among voters during the petition drive, which may carry over to the voting booth.

Following a public dust-up in 2014 when Hanson’s 10-member group last tried to get fluoride removed from the water supply, two legislators, Rep. H. Stedman Seavey (R-Kennebunkport) and Sen. Ron Collins (R-Wells) tried to push through new rules that would allow customers of a water system to petition for the use, or not, of fluoride. But that bill died in committee, meaning the decision still goes to all voters in the water district’s towns, even if not connected to the public water supply.

In addition to Kennebunk, Kennebunkport and Wells, KKWWD services parts of Arundel and Ogunquit, along with coastal areas of Biddeford and York, reaching about 13,500 metered customers.

The Maine and U.S. Centers for Disease Control, the American Medical Association, the Environmental Protection Agency, and the American Dental Association all support adding fluoride to water, for the purposes of reducing tooth decay.

The practice began in Michigan in the 1940s and has since spread to public water systems serving about 66 percent of the total U.S. population. In Maine, 67 public water systems serving 132 towns add fluoride, although that only covers about 40 percent of all state residents, due to the number of private wells in use.

Hanson and her group question the effectiveness of fluoride in promoting strong teeth. Instead, they are more concerned about the chemical’s long-term effects on the human body, including brittle bones, pitted teeth, decreased mental clarity and lack of energy from fluorosis, or over-exposure to fluoride.

A 2011-2012 National Health and Nutrition Examination Survey conducted by the U.S. CDC found that 58 percent of American children now exhibit some form of fluorosis, with 21 percent displaying moderate fluorosis in at least two teeth, up from and average of just two percent measured in surveys conducted between 1999 and 2004.

According to water district Superintendent Norm Labbe, district water sources have fluoride in them as a naturally occurring element, at about 0.2 to 0.3 parts per million. Since 2004, when the district began adding additional fluoride, it has spent about $20,000 per year, to bring the level up to the 0.7 parts per million recommended by the EPA and the Maine Drinking Water Program, Labbe said.

Because fluoride is now found in many processed foods and beverages, as well as in the cryolite used as a pesticide in farming, and because studies show it’s useful in fighting tooth decay only when in direct contact with teeth — losing all benefits as soon as a person swallows the fluoridated water — the water district board of directors voted unanimously in February to support a “no” vote.

“It’s unquestionably the most toxic substance we deal with,” Labbe said. “This stuff is used to etch glass, so what does that tell you,” Labbe said. “The general population is now getting so much more fluoride than was ever conceived of when fluoridation was originally founded 60 years ago. So, why add more?”

“If you take fluoridated drinking water and swish it around your mouth, yes, you’re getting, fluoride on your teeth,” Labbe said. “But once you swallow it, it’s known to have minimal if any benefit for the teeth. And yet it is already known from many scientific studies that there are risks to the human anatomy by consuming fluoride at the levels we are now seeing.”

One study, conducted by Ashley Malin and Christine Till of Ontario-based York University, and published last year in the journal Environmental Health, even suggests a link between fluoride use and attention deficit hyperactivity disorder (ADHD).

Hanson noted that the kind of fluoride used by the district is not a naturally occurring element, as some may suppose. Instead, it is a by-product of Environmental Protection Agency rules set up for the cleaning of industrial smoke stacks.

“The EPA requires wet scrubbers on the smoke stacks to collect the fluoride gas and this toxic waste substance is what is actually used to be put into our drinking water,” Hanson said.

“Natural fluoride is not dangerous the way the hydrofluorosilicic acid [added to water] is,” Hanson said. “The hydrofluorosilicic acid that is added to water is highly reactive because it doesn’t have calcium added to it. So, therefore, when that is ingested into your body it goes straight into your bones, and that creates porosity, because it changes the crystalline structure of the bones. And, it is bio-accumulative, so, over time it creates problems with weakness in the bones. That’s one of the reason we have so many hip fractures in this country.”

Speaking to the other side of the issue Monday was Kennebunk dentist Ross Wyman.

“Adding fluoride to water has been a fabulous success and nobody has ever suffered from any kind of disease when fluoride has been added,” he said. “Very young children seem to benefit very much from the ingestion of the water.

“I’ve seen such a change here in York County,” Wyman said, claiming that tooth decay among his younger patients has fallen to “virtually zero.”

Selectman Dan Dubois asked if that change could be attributed to societal factors other than fluoridation of water.

“I have a tough time believing that all of a sudden the next generation decided they would be better brushers than their parents were, or that they would eat less sugar,” Wyman said. “I just don’t think that happens.

“All the studies that dentists receive show that fluoridation of water is the best, cheapest way to fight tooth decay,” Wyman said. “I’m against taking it out of our water supply.”

“Well, I think any time we take any chemicals out is a good thing,” said Sol Fedder, who favored Dubois line of reasoning over Wyman’s to explain the drop in tooth decay among youngsters, when compared to older generations.

“Kids are eating healthier because we’re educating them to eat healthier,” he said. “Everybody nowadays knows how bad sugar is and how it will rot your insides. There’s education all over the place to eat better, and I think that makes a big difference. So, I think any chemical we can keep out of anything is better.”

Meanwhile, Jack Reetz said the debate over fluoridation of water has been waged for decades, without resolution.

“All I can say is that as a random sample of one person, me, who has aged to age 85 and been thoroughly fluoridated, I’m still here,” he said. “I don’t have a strong opinion one way or the other, but I don’t think the issue is all that serious, frankly.”

The water district sponsored a community forum on the fluoride issue in August and has posted a variety of informational links on its website, www.kkw.org.

York County advocacy group Healthy Teeth, Healthy Smiles will stage an informational forum of its own at 7 p.m. Monday, Oct. 3 at Kennebunk Town Hall.