Dr. Johnny Smith knows as well as anyone that Greenwood’s teeth need help.

After 27 years of peering into mouths here, the dentist can recognize patients who grew up in other areas that have fluoridated water supplies because their teeth are stronger.

“I’ve seen tooth decay in all ages, from little kids all the way up to the old folks. And fluoride in the water will help all of them to some degree,” he said.

A new state Department of Health rule would require Greenwood to fluoridate its water, but only if outside funds can be obtained to pay for it.

Dr. Nicholas Mosca, state dental director, said a regulation passed in April requires water providers with more than 2,000 customers to add fluoride, a mineral that helps prevent tooth decay.

However, utilities only have to start fluoridating if the health department identifies grants.

Greenwood Utilities does not currently add fluoride to the city’s water, which serves about 19,000 people.

“We don’t feel the need for it. Greenwood has such perfect water,” said James Quinn, a member of the utilities commission.

The mineral occurs naturally in small amounts, about one-fourth of the recommended dose in Greenwood’s water.

Fluoride incorporates into teeth even from the womb and makes them more resistant to cavities, Smith said.

“The children grow up with stronger teeth,” he said.

He hopes the new state regulation will push Greenwood to start fluoridating.

Not everyone supports that course of action, though.

Sid Aust of Greenwood has followed the fluoridation debate for years and said, in his opinion, it’s not a good idea.

Consumers need not look any further than the back of a tube of toothpaste, Aust said. There, they will see a warning to contact a poison control center if they swallow too much.

“My main concern is that fluoride is a poison,” he said. “They can’t deny the fact that it is a poison.”

Even in small doses, it can accumulate over time, Aust said. Also, he worries what would happen if machinery used to add the fluoride malfunctions, dumping large portions into the water supply.

“We have enough stuff in the air we breathe and that they spray on cotton,” Aust said. “Why would we want to put poison in our water? That’s stupid.”

He praised the quality of Greenwood’s drinking water and said he hopes fluoride is never added.

Mosca said the fluoride opposition is misinformed. He said more than 100 credible national and international organizations support its use as a public health tool.

“There is no scientific evidence that it has any negative health effects besides that if you have too much fluoride, you can have discoloration. But that’s cosmetic,” Mosca said.

Mosca said water supplies receive a very small amount of fluoride, about 1 part per million; toothpaste has 1,500 ppm.

All water naturally has some fluoride; Greenwood’s supply has about 0.2 ppm. Bottled water generally does not contain fluoride, because natural amounts are filtered out, Mosca said.

Despite its minute amounts, fluoride still prevents tooth decay, he said.

That’s a needed step in Mississippi.

About 42 percent of the state’s residents don’t go to the dentist yearly, according to one study. Two other recent studies of Mississippi children by the health department showed the rate of tooth decay is 56 percent for Head Start children and 70 percent for third-graders, Mosca said.

The health department beefed up its program in 2002 in response. Since then, 64 water companies have added fluoride, Mosca said. About 53 percent of Mississippi’s population is on fluoridated public water systems.

That number includes Itta Bena, the only water supplier in Leflore or Carroll counties with more than 2,000 customers that fluoridates.

The other local water companies that are big enough for the new rule to apply to are East Leflore Water and Sewer, Mississippi Valley State University, Vaiden and North Carrollton.

Mosca said the health department has private and public funds available to pay for equipment, although not enough for everyone in the state.

The Bower Foundation, a non-profit that supports health projects in Mississippi, pays for equipment and a year’s worth of fluoride. The health department offsets about 40 percent of that cost with federal grants.

Assuming a 15-year lifespan, the average annual cost to fluoridate is 75 cents per person, according to an economic impact statement filed by the health department.

The purpose of the new regulation was to establish rules for monitoring — which must be done at least three times per week — and give the department access to stimulus money, according to Mosca.

Locally, Smith is looking for the ball to get rolling.

“I just hope that it gets pushed on through,” he said.