ATHENS, Ohio — Think the controversy about adding fluoride to tap water is as dated as the Cold War? Think again.

A plan to fluoridate the municipal water supply in Athens early next year has stirred public debate in this college town about 65 miles southeast of Columbus.

Opponents have confronted the City Council with their arguments, and there’s talk of putting a referendum on the November ballot to try to keep fluoride out of the water.

That’s Athens for you, some residents say with a shrug and a roll of the eyes.

In fact, the flap about fluoride is broader. And it’s not just about whether fluoride and communism are linked, as opponents suggested decades ago.

Nearly 80 percent of Ohioans have fluoridated tap water, according to the state Department of Health. But two dozen cities across the state do not, despite occasional local attempts to introduce the compound.

A 1969 state law ordering that fluoride be added to public drinking water lets cities opt out through an ordinance or a ballot referendum.

Athens opted out of the fluoride law until four years ago, when the council voted to fluoridate. The compound couldn’t be added earlier because the city’s water-treatment plant needed improvements.

Councilwoman Nancy Bain, a Democrat, said it’s about time that Athens residents, especially children, had access to fluoride.

Children in Appalachian Ohio deserve to have the good dental care that children elsewhere in the state take for granted, she said.

In Athens County, there is one dentist for every 6,525 residents, according to the state Department of Health.

By comparison, Franklin County last year had one dentist for every 1,500 residents.

“It is a positive thing to do to improve the water supply,” said Bain, chairwoman of the Ohio University Geography Department. “This is a public-health issue.”

Dr. Beth Welsh, an Athens dentist, welcomes the planned addition of fluoride.

“It’s going to be beneficial to everybody, especially kids,” she said. “It will make a big difference in the tooth-decay rate around here.”

As it is, Welsh said, she sees more tooth decay among Athens city children than in children from outside the city whose homes are connected to the Le-Ax rural water supply, which has fluoride.

She said she tells her patients’ parents to give their children chewable daily multivitamin tablets that include fluoride.

Fluoride is endorsed by the U.S. Centers for Disease Control and Prevention, which has called it one of the “10 great public-health achievements,” and by the American Dental Association and the state Health Department.

Its use is credited with dramatically lowering the incidence of tooth decay.

Opponents say fluoride is poisonous and contributes to cancer, lowered IQ in children, osteoporosis, Alzheimer’s disease and other ills. A spate of Web sites supports their viewpoint.

“We’ve done fine without it,” argued Dan Dillaha, an Athens chiropractor. “Why push something that’s controversial and not proven?”

In addition, he said, the old notion that fluoride makes people susceptible to communism and other forms of thought control is not so far off.

“It still holds true,” Dillaha said. “It makes people more passive.”

Ed Baum, a Republican city councilman and an OU political-science professor emeritus, voted against adding fluoride to the water. He uses a fluoride toothpaste, he said, and his dentist gives him an annual fluoride rinse.

Baum said he doesn’t like government telling him he must drink it in his water.

“I don’t think a city should be in the position of medicating its people automatically through its water supply because it’s ‘good for you,’ ” he said.

Andreas Quinones, an Athens native who works at a drugstore and a sub shop, agrees.

“I don’t really think it’s a good idea to add unnecessary chemicals to the water,” he said.

Not everyone in Athens feels passionately about fluoride. Some OU students say they are baffled that it is even a topic of debate.

“I’m kind of indifferent toward it,” said Matt Temple, a senior from Delaware, which added fluoride to its water supply this year.

He paused and thought some more: “I’m sure it’s beneficial.”

Adam Thome, a sophomore from Cleveland, said, “It couldn’t hurt.”

State law permits cities that opted out of fluoridation to opt back in.

To avoid confusion, state Rep. Kerry R. Metzger, a New Philadelphia Republican who is a dentist, is sponsoring a clarification bill that makes clear that cities that decided earlier not to fluoridate can reverse the position through a vote.