The idea that water fluoridation is a vast Communist conspiracy aimed at undermining public health is largely a thing of the past. However, the facts surrounding the continued use of fluoride in public drinking water seem to vary greatly depending on whom you talk to.

According to the Center for Disease Control, 4.7 million residents across the commonwealth receive fluoridated water. That is 70.4 percent of all residents on community water systems.

Ria Convery, of the Massachusetts Water Resource Authority, said the MWRA — which provides full or partial water service to many communities north of Boston — has added fluoride to water for more than 30 years. It maintains a target fluoride level of 1.0 part per million in drinking water as recommended by the CDC.

“The strong position taken by the CDC, one of the world’s leading public health institutions, is important to understanding MWRA’s addition of fluoride to reduce tooth decay and promote community public health,” Convery said.

The state’s Department of Public Health takes a similar stand.

In a statement issued in 2010, which, according to spokesman Scott Zoback is still valid today, DPH calls fluoridation a safe, cost-effective and practical way to prevent tooth decay and argues that it benefits all residents regardless of age or income status.

“There is no public safety concern about fluoridation in Massachusetts,” the statement from Zoback reads. “DPH continues to support the benefits of community water fluoridation for dental health.”

According to Salem Pediatric Dental and Orthodonic Associates, Salem, along with Beverly and Danvers, was among the first community to add fluoride to its water supply. It has been fluoridating since 1952.

The city gets its drinking water from the Ipswich River and three reservoirs: Wenham Lake, Putnamville and Longham. Salem Health Agent Larry Ramdin said the water is fluoridated but unlike Topsfield, Rockport and several other north shore communities there is no movement to have it removed. Ramdin said he’s received no calls or complaints regarding its inclusion.

U.S. Surgeon General Regina Benjamin, M.D., has called community water fluoridation “one of the most effective choices communities can make to prevent health problems while actually improving the oral health of their citizens.”

Yet there is a growing movement that believes to fluoridate or not to fluoridate should be an individual choice, which raises the inevitable question: Does the good outweigh any potential bad when it comes to fluoridated water?

Magic or mayhem

Communities in the United States have been fluoridating water systems since the mid-1940s, and fluoridation became an official policy of the U.S. Public Health Service by 1951. By 2006, nearly 70 percent of the country’s population serviced by public water systems (and nearly 62 percent overall) were receiving fluoridated water.

“When this started in 1945, the belief was you had to swallow fluoride so the teeth below the gums wouldn’t decay,” said Carol Kopf, of the Fluoride Action Network, or FAN. “They thought fluoride was a magic bullet.”

FAN’s mission is to “broaden awareness about the toxicity of fluoride compounds among citizens, scientists, and policymakers alike.” Kopf and many others in Massachusetts and across the country now believe that, not only is fluoride not the answer to perfect teeth, it’s harmful in other ways.

Topsfield resident Jeffy Demeter was studying nutrition when she stumbled on the subject of water fluoridation several years ago. She said she learned that a great number of people suffer from iodine deficiencies, which is a side effect of over-fluoridation. Further research showed that too much fluoride is also potentially harmful for infants and the elderly.

Another concern is the risk of dental fluorosis, which leaves white, almost lacy markings on tooth enamel. Kopf, who has been fighting mandated water fluoridation since the 1980s, said it comes from over-fluoridation and estimates that 40 percent of American teenagers have those markings.

Demeter calls fluoride a chemical that if taken in too large a dose by a small child could prove fatal.

“That’s really just a dramatic situation to prove a point and it’s never happened that I know of, but it could,” she said, adding that is why there are warning labels on items such as toothpaste that contain fluoride.

The DPH instead calls fluoride a natural occurring mineral that when added to water can prevent tooth decay by as much as 60 percent in baby teeth, and by as much as 35 percent in adult or permanent teeth.

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